Base Hospital/MICN Question

Specialties Emergency

Published

Hey all,

I'm currently a BSN student, rotating in the ER for the next 10 weeks or so.

I am at a hospital in Southern California, apparently this facility is a base hospital for EMS. Please forgive my lack of knowledge but what is a "base" hospital and how does this differentiate from a "non-base" hospital?

I am somewhat familiar with the role of the MICN, at the facility I'm at there is a few per shift, and whoever is near the phone when it rings will answer it. Now my question for all the MICNs on the site is: what is the procedure for answering the phone/radio? I can never seem to catch someone to ask them, I hear the nurse answer with something along the lines of "XXXX Base, contact time is XXXX, and your MICN is XXXX" is there a particular format to answer/receive report from EMS?

Again, I apologize for my lack of knowledge, I aspire to land a position in this ER upon graduation and I want to be as knowledgeable as possible going into each shift.

Thanks!

Specializes in Med-Tele; ED; ICU.

A base hospital is one designated by the LEMSA whose docs and MICNs can issue orders for treatment and diverting to alternate facilities if the patient conditions warrant. Further, the base hospital will designate which patients go where in the event of an MCI.

Here's generally how the call goes:

"Base hospital, base hospital, medic 74 with ALS traffic"

"Medic 74, this is base hospital. Your call time is 1945, MICN KindaBack. Go ahead with your report."

"Base hospital, medic 74 enroute to your facility code 3. Onboard today I have a sixty-two, that's six two, year old male with a chief complaint of vomiting bright red blood for the last hour. The family denies use of blood thinners but patient is a heavy drinker; no known history of varices. Upon our arrival we found the patient seated on the toilet with a substantial amount of blood on the floor, estimated at 500mL. The patient is obtunded at this time, GCS=12. Vital signs as follows: HR=118, BP=73/45. We've been unable to establish IV access but have an IO established in the R humeral head. We've given approx 500mL NS at this time. Our ETA is.... about 5 minutes."

"Medic 74, base hospital copies. We'll see you in 5. Please update with status changes. Base hospital clear.

~~~

Sometimes the report will be scant to nearly nonexistant beyond "we're inbound code 3 with an acute GI bleed, unstable vital signs." Remember, the medic may be in the back of the rig by themselves with a crumping patient and a detailed report may be the last thing on his/her mind... just trying to avoid arriving with a corpse.

Specializes in Med-Tele; ED; ICU.

And speaking of GCS: If you really want to stand out, make sure you can do accurate GCS scoring right out of the gate. Even from experience nurses I sometimes get, "The GCS is, umm, about 11 when I find the patient E4V4M6(14) --- which is how GCS should be documented...

GCS is not an "ummm" kind of thing... it's a very specific tool that should be highly consistent between providers.

Specializes in ER, Trauma, Med-Surg/Tele, LTC.

A base hospital is, like previous poster mentioned, a hospital designated by the EMSA (or Emergency Medical Services Authority) to give EMS personnel orders for treatment of patients in the field and designate the nearest appropriate destination hospital for said patients depending on certain criteria. Contrary to previous poster, the base hospital does not only designate destination for MCIs (or mass casualty incidents), they designate destination for ALL calls. For example, if EMS calls a base station and a patient exhibits stroke-like symptoms, the MICN will direct them to the nearest primary stroke center open to receiving patients. A non-base hospital is any and every other hospital that is not designated to receive EMS calls.

The format/procedure for answering the phone is irrelevant to you right now, and will be for quite sometime actually, since in LA County you have to have at least one year of RN experience before being qualified to start MICN training. At my facility, nurses typically don't get offered to get MICN trained until they're 3 years in and have more than ample ED/trauma/triage experience. Even if your facility only requires the year as required by LA County, that's a year more ED experience and knowledge you'll have than you have now. I love your foresight and initiative, but as a nursing student, I would focus less on what the MICN does and more on what the other ED nurses do since that's what's you'll be doing right out of school if you decide to work in ED.

Thank you both for your comments/input!

For a non-base hospital, do they receive any EMS patients? Or do they only receive patients that are directed from a nearby base?

Specializes in ER, Trauma, Med-Surg/Tele, LTC.

Non-base hospitals are capable of receiving EMS patients, but they are directed there by a base. Does that make sense? Pretty much the process is that EMS will call a base station from the field and the base station will direct them to the nearest appropriate hospital, regardless if that hospital is a base or not.

EDIT: I think the confusion came from when I said non-base hospitals don't receive EMS calls. EMS will not call a non-base for orders and directions, but can take a patient to a non-base hospital after being given directions by the base hospital to do so.

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