Giving Report to Medics... What do they know?

FF-PHRN · Jul 10, 2011

Give report just like you would to a nurse. Some medics are high speed and some are not. I have been surprised at how they can be both ends of the spectrum, just like some nurses I have dealt with.

I have been on an ambulance and had a nurses talk down to me like I am some sort of EMT basic. That is a mistake. It is also unprofessional. Don't underestimate and your report will be just fine. Hopefully, if the medic doesn't understand something you give in report they will ask, but you are covered in having given a complete report.

Tait, MSN, RN · Jul 10, 2011

Generally when we transfer patients out of the hospital I will give them whatever they ask for. Mostly is is a brief description of their stay, last set of vitals, and mobility.

Those patients are all mostly stable, returning to LTC, AL, LTAC etc.

Orange Tree · Jul 10, 2011

It seems like UA results and hgb levels are overkill, to me.....not because they won't understand, they just don't necessarily need all that info to safely get the patient from point A to point B. Of course, I am usually sending them to a less acute level of care, so the patients' major issues are resolved (or at least stabilized).

Double-Helix, BSN, RN · Jul 10, 2011

Are you also giving report to the ER or is the paramedic giving the report? If you are giving report to the ED, I think the paramedics most need to know things that might affect the patient during the trip. If the patient de-sats frequently, has been vomiting, has chest pain, etc. But things like lab values and test results that don't affect the patient at that point can be left out and told to the ER staff. A paramedic probably understands everything you say on your report, it just might not be necessary. If the paramedic is giving report, they need to know everything that you want the ER to know.

I've worked with several paramedics and even done many hours of ride-along. Experienced paramedics have a huge amount of knowledge, most odd it relating to emergency medicine. They can even insert emergency trachs if needed. I'm not site how much they know/care about CBC's and UA's, but you can rarely go wrong giving too much information.

casi, ASN, RN · Jul 10, 2011

Thanks for the feedback.

I am just really not familiar with the education a paramedic receives so I am never sure if the report I am giving is adequate.

What kind of report do medics like to hear when they enter the realm of LTC and TCU?

I tend to give a brief history of while they are in TCU, any major events while they are with us, and then get more specific as to why I am calling. Any any significant recent labs and most recent set of vital signs.

Tait, MSN, RN · Jul 10, 2011

Thanks for the feedback.
I am just really not familiar with the education a paramedic receives so I am never sure if the report I am giving is adequate.
What kind of report do medics like to hear when they enter the realm of LTC and TCU?
I tend to give a brief history of while they are in TCU, any major events while they are with us, and then get more specific as to why I am calling. Any any significant recent labs and most recent set of vital signs.

Not sure if this matters but if I am calling report it is often to a nurse, when I give report to a medic I think transport (which is usually the same two guys that play Angry Birds while they wait on us) and are standing bedside.

crb613, BSN, RN · Jul 10, 2011

I agree with FF-PHRN. I respect our medics, and treat them as I would an other medical professional. They know a lot, so just give them report....They have taught me a few tricks, and I hope I have helped them with some things as well.

casi, ASN, RN · Jul 10, 2011

It seems like UA results and hgb levels are overkill, to me.....not because they won't understand, they just don't necessarily need all that info to safely get the patient from point A to point B. Of course, I am usually sending them to a less acute level of care, so the patients' major issues are resolved (or at least stabilized).

My facility sends a written report with the medics, but I know that the first thing the ER staff hear is the verbal report from the medics.

The two situations that come to mind is a patient who was having some coffee ground emesis, who had a hgb come back that day at 8.2 which was at least a point drop from her last hgb.

Another I had tonight was someone who is normally A&Ox3 who dropped down to A&Ox0... due to some confusion that wasn't nearly as bad as what I was sending her in for she had a UA/UC done earlier in the day. Which I think is essential to mention since acute confusion in the elderly is normally equated to UTI, since her UTI looked beautiful and she had a history of a subdural hematoma... I was a little concerned and thought it was important.

I just didn't want to feel like I was talking down to them by simplifying things or potentially going above their heads. I respect the medics that come out to us. They have a job I wouldn't like to do and I like to think they do a good job at it. When I am sending out a patient that is unstable and is making nervous, it lifts a ton of stress off my shoulders when they show up in the room. There is only so much I can do in a TCU setting.

ps if certain parts of this don't make sense my "I survived a bad night at work" glass of wine turned into 3... oops.

rshenry · Jul 10, 2011

Treat the Paramedics with repsect! Given them report as you would another nurse. I am a Parmedic as well as an RN. I currently work in both fields. Some nurses don't get that Paramedics aren't just "ambulance drivers". They are health care professionals with an education and professional license.

Respectfully,

Robin RN, EMT-P

danh3190 · Jul 10, 2011

When I was a paramedic we didn't learn lab values per se though we learned about the electrolytes, e.g. we knew what a low K or low hemoglobin meant, but we wouldn't have known that a K of 3.2 or and Hgb of 8.2 were low. Of course that was almost 30 years ago so they may get better training now. There are a few paramedic programs that give BS in EMS. Those are essentially like BSN programs but with EMS experience instead of bedside experience. As a medic I definitely would like to know what the patient's baseline vitals have been, what the monitor has been doing, any serious problems with labs, any serious problems with tests done.

For BLS (basic life support) transports they use EMTs not paramedics. They would definitely want to know vitals and any problems to watch out for but doubt the labs or monitor would be useful.

I find it funny that when some LTC facilities call us to take a pt to hospital on an emergency basis they give us the tranfer papers with all the patient info in a sealed envelope, feeling that we don't need to know the information. The envelope gets opened the second I get in the ambulance.

RN1980 · Jul 10, 2011

you can never be blammed for giving a to detailed report on a pt. its always best to do overkill vs not giving enough info that will come bite you in the ass later if the crap hit the fan. give report like you would want to be reported to on a pt. make it a point to ask if there is anything that they want to know particular and always ask if they have any questions afterwards.