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| No. 20 | 
Oct 07, 2009, 03:24 PM
 Re: How often do EMS crews show up to your dept unannounced?
It is important to understand that an encode is a courtesy by EMS - not a requirement. That being said, by not encoding, EMS certainly isn't on the fast track to having a good working relationship with the ED. I do agree that lengthy reports over the radio are basically pointless and a waste of time. Only need to know enough over the radio to make an appropriate bed assignment. Everthing else should be done at bedside.
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Oct 07, 2009, 08:31 PM
Re: How often do EMS crews show up to your dept unannounced?
Unannounced,,,,, not too often. At the last minute,,,,,,,most of the time. To the wrong level of care,,,,, far too often. A 92yo F who fell down 13 steps should not show up anywhere other than a Level 1 Trauma, which is protocol. EMS can make up all the excuses they want, they do and will do what they want.
| | No. 22 |
Oct 07, 2009, 11:52 PM
Re: How often do EMS crews show up to your dept unannounced? Originally Posted by whatdayoftheweekisit  It is important to understand that an encode is a courtesy by EMS - not a requirement.
So is it a "courtesy" for us to call the floors with a report?
I agree that the only report I need is are they "sick" or "not sick"...but unless they want to start standing-by for a room, they need to give me a heads-up.
| | No. 24 |
Oct 09, 2009, 08:08 PM
Re: How often do EMS crews show up to your dept unannounced?
EMS report is considered a courtesy, not a requirement. That said, I've only brought one patient in without a report and that was because the ED's EMS radio was on the wrong channel. Believe me when I say that EMS crews do not enjoy bringing their patients in to the ER without calling ahead with report. It creates unnecessary hassles with getting a room together and causes a delay in patient care. If the patient is critical enough that calling ahead is impossible for the medic, he or she will ask the EMT driving to call ahead with a very brief "hey, we're enroute with a cardiac arrest, asystole on the monitor, pt is intubated, ACLS protocols in effect, see you in 5" type of report. Gives the ER time to throw a room together and allows the medic to work without worrying about giving a report.
| | No. 25 |
Oct 09, 2009, 08:12 PM
Re: How often do EMS crews show up to your dept unannounced? Originally Posted by Traumaslave Unannounced,,,,, not too often. At the last minute,,,,,,,most of the time. To the wrong level of care,,,,, far too often. A 92yo F who fell down 13 steps should not show up anywhere other than a Level 1 Trauma, which is protocol. EMS can make up all the excuses they want, they do and will do what they want.
Please remember that medics are governed by medical control. To by pass a hospital, we must ask permission from med control...even if we think that it's a given that the level I trauma center is needed. Sometimes docs say "bring them here" when they don't need to go to that facility. I do agree that sometimes the medics don't think and will just transport to the closest facility...then you must look at other factors. Is there an unstable airway? Is it an arrest situation? Is it a mortal wound that would not survive transport to the LI (such as a GSW to the head)? Medics have rules to follow just likes nurses.
| | No. 26 |
Oct 09, 2009, 08:21 PM
Re: How often do EMS crews show up to your dept unannounced? Originally Posted by SpaceCoastRN Well I have now seen this from both sides. I worked as a paramedic from 1992 to about a month ago, in that time I have given many radio reports and to be honest, most were pretty pointless. Unless I was calling in to speak to an MD for orders beyond protocol I thought reports should be done away with other than for notification on codes, or higher acuity that will require more resources. After being in the ED since June, I still feel this way, most reports are pointless. The ED I work in is almost always packed (19 beds and room for 7 hall beds). So really if EMS calls in with anything other than codes or high acuity nothing is done with it other than telling triage they can't have the bed for the random ailment they are about to use it for that should have been handled by a primary care MD. The system I am originally from I think did it best, Methodist in Indianapolis had a nurse assigned to ambulance triage. When a unit came in there was only a radio call for orders, and advanced warning of codes, cardiac alerts, and trauma alerts. It removed a lot of wasted time of going through a radio report (on both sides of the microphone).
This is the way Grady in Atlanta does it and it works really well. Every patient that isn't critical goes through triage. Some are sent to the medical side, some to the trauma side and many to the waiting room. It's simple and effective. We call for orders or to notify the ED of a CPR in progress, a very critical medical pt or a major trauma. That's it.
| | No. 27 |
Oct 10, 2009, 04:17 PM
Re: How often do EMS crews show up to your dept unannounced?
I have worked as a paramedic and i can tell you if a patient is dying in the back of my ambulance, i don't care what level your hospital is or if you want to "divert" me, i'm coming anyways. In the hospital you have many nurses, doctors and equipment i dont in the back of the rig. Stabilize the patient, then i'll transport them. Thats what i would want done to me. As far as a report is concerned, i consider them a courtesy, i, as a general rule do. That being said, i have had nurses ask stupid questions (pt. age? did you get an IV, What do you see on monitor, ect). In my opinion, radio reports are only to give the hospital a heads up, 50 year old patient, chest pain, be there in 5 minutes. I've got my hands full in the back of the rig, don't come back and ask a million questions you can figure out when i get there. I've done many clinicals in the ER and know how difficult the job can be, How much ride time have nurses done on an ambulance? I bet if they did some they would understand why sometimes we dont give a radio report. Medics are expected to do a lot in a very short time, most of the time with very little info ( pt. history, ect) and very little help if any and sometimes being very close to a hospital. I'm not going to sit on scene for 10 minutes figuring stuff out and give a radio report if i'm 5 minutes from the hospital. I load and go and do what i can for the patient in the meantime. I have no problem walking into an ER without calling if time didn't allow.
| | No. 28 |
Oct 10, 2009, 10:13 PM
Re: How often do EMS crews show up to your dept unannounced? Originally Posted by jhoefen That being said, i have had nurses ask stupid questions (pt. age? did you get an IV, What do you see on monitor, ect). In my opinion, radio reports are only to give the hospital a heads up, 50 year old patient, chest pain, be there in 5 minutes. I've got my hands full in the back of the rig, don't come back and ask a million questions you can figure out when i get there.
I agree totally...the only time I ask a question is for bed placement (ie confused goes closer to the desk).
| | No. 29 |
Oct 11, 2009, 05:58 PM
Re: How often do EMS crews show up to your dept unannounced? Originally Posted by Mike A. Fungin RN I've known critical care nurses to voice similar complaints about ED nurses who bring patients to the unit with little notice and/or incomplete reports. But y'know what, it happens man. The ED can get a little crazy and they can't always wrap my patients with a pretty bow on top. Sometimes the work environment sucks and prevents us from performing ideally. That goes for both nurses and EMTs.
Yup. Guys, the ED is the ED--things come in through the door and that is the way of life sometimes.
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