How often do EMS crews show up to your dept unannounced?

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Had a crew show up to our dept unannounced today at peek time (19 in WR)...said "Kaiser called about this one". Yes, I got a heads-up that Kaiser clinic was sending a pt 2.5 hrs earlier. When I voiced my frustration and started to explain when we get a room ready (which I had done to this crew before and who is known to be very lazy) the EMT put his hand on my shoulder and said in a condescending tone, "Are you having a bad day Larry?"...OMG I wanted to deck him. Instead I turned on my heal and reported him to his supervisor...WOW...what a jerk.

How often do you guys have crews show up without a HEAR report and without a good reason (ie mechanical problems, working too hard on the pt etc).

Specializes in ER.

I've gotten reports as they were pulling in...I don't much care so long as we get about 30 seconds to think before they show up. I want to have a room cleared before they roll in, and if it's a sick person we'll pull equipment and people to the bedside. Report prevents a scramble, making us look and feel disorganized, and it prevents moving the patient to the right room, and doing a bed juggle 30 minutes after arrival.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
I've gotten reports as they were pulling in...

LOL! Yeah, I love it when the report ends with, "aaaaaaand ... we're at your back door." :D

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Specializes in ED, Ortho, LTC.

They show up unannounced all day long. We only get called on the box if the pt is critical or the medics are requesting the doc to order a med they can't give just based off protocol, like Cardizem.

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Very infrequently.

What gets confusing at our facility is that the city fire dept/EMS uses the fire radio, another ambulance service uses a different radio, and another two use the phone to call report. Sometimes the ones that have to call in via phone get put on hold indefinitely by someone, and they eventually just give up and hang up...But that's not their fault.

A bad part of where I work is that we have TWO nursing homes within 2 minutes of the ER, too...and lord knows we get respiratory distress calls, sat of 65%, with almost NO warning.

Every so often, we'll get an ambulance in that the crew didn't call report on, and it's almost ALWAYS one of our frequent fliers with the same bogus complaint he/she has had the last 437 times they came in by ambulance. We tend not to get too hot under the collar about it, because they usually get downloaded to triage, anyway.

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Specializes in ER.

Had one a few days ago on a record breaking day...had a full house, 4 squads out we were trying to place, and one rolls in with a respiratory distress...."oh sorry, we forgot to call". Guy....seriously? I wanted to holller "WORK WITH ME PEOPLE!"

A few weeks ago we had one bring in a homicidal mental health we had not heard about saying, "oh, the cops said they called so we didn't think we needed to"....sigh

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Specializes in ER.
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.

In the ER the problem has little to do with caring a whole lot about the report and a LOT to do with traffic flow. I don't really give a crapolla how much notice I have on pt information/condition...I care about having a couple minutes to figure out where the heck I am going to put the patient amidst the throng of other sick people.

And yes....mistakes happen. But that does not mean it isn't frustrating when they do.

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Unannounced? Really? We will get a notification if they are bringing us someone really jacked up, but other than that..we don't get any " warning" before they come rolling in with a pt...:clown:

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I work in a Level 1, 48 bed pediatric ER and I am going to say that most of them come in without warning. Usually we get warning on the Trauma's or CPR in progress, other than that, they just come in. No big deal.

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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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Specializes in ER, ICU.

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.

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Specializes in Trauma/ED.
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.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
It is important to understand that an encode is a courtesy by EMS - not a requirement.

I guess that depends on where you are. According to the EMS council protocols that govern my paramedic practice, there are many situations in which I'm required by protocol to provide notification to the receiving ED -- some of them, like pregnant patients with prolapsed presenting parts, even specify EARLY notification to the ED! :D

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