Hospital Notifications - What to say over the HEAR

[Guest]

Had a job at work today in which a patient had a syncopal episode due to a pre-existing medical condition. Patient was A&O x 3, + PERLA, - trauma, - Head, neck, back, and chest pain, - sob, L/S clear and = bi. lat, and the patient was completely ambulatory upon EMS arrival. Vitals were all within normal ranges with no abnormalities in quality. While the patient refused transport, a quick thought came up in my head while i did my personal "after call report" in my head. If i had transported this patient i would have withheld stating the patients medical condition, history, and medications over the HEAR. Rather, i would have stated "standby for land line for further information." I've done this before, with patient information that i either sense or feel is particularly personal. My biggest concern is that people are out there monitoring the ambulance to hospital communications. What does everyone have to say about this? Am i being silly or do others have the same concerns?

[firemoose827 324]

Good post. No matter what you do someone is listening, either on the air or monitoring a scanner that has cell phone channels tuned in.

The major thing is, your arent giving the PT's name or vital stats, just medical condition and Rx given to let the ER know what they have coming in. So I dont worry about that.

I just give age, sex, Chief Compaint, my brief assesment, vitals, and rx rendered. I usually dont go crazy with last meal or other info not pertinent to chief complaint. The staff at our local ER goes NUTS when someone reads a book about the pt when the chief complaint is "unable to urinate" or something silly. So we have learned to keep it simple. In fact, the staff here has even had a seminar at the hospital for EMS, and they went over what they want in an EMS to ER radio report. It was a good seminar and we learned a lot. Just something you can think about with your hospital.

Stay safe.

[Guest]

I don't think you're being silly at all. Acting in someone's better interests includes taking steps to keep private personal information private. Perhaps EMS should consider using encrypted radio equipment on the HEAR frequencies. Just my opinion.

[helicopper 1,050]

The purpose of the notification as I've always understood it is to provide a quick snapshot of what's going on so the ER staff can prepare for what's coming in vs. who they bring in from the waiting room next, etc. If you're bringing in a stable patient there is no need to give a five minute dissertation about all the pertinent negatives. Just tell them what they need to know - stable/unstable BLS/ALS vital signs/major findings and ETA. I don't think they need a radio call and a phone call for the same patient if they're stable, but that's just me.

You're not being silly at all. It is a safe assumption that our communications can/are being monitored so limiting personal information is a good idea.

[nycemt728 49]

Agreed, the less pt info over the air the better! I'm not from W'chester, so perhaps you can explain the protocols: when does one use the HEAR system? I would have to agree w/ chris192 on this from the info presented, I probably would not have considered a note in this instance. Is HEAR required on all calls? What prompted its use on this call?

Edited April 30, 2007 by nycemt728

[Guest partyrock]

In my experiance there is nothing that needs to be given over the air that you should have to worry about going over the air. To those out there reading a book to the hospital or dispatcher, KISS. Age, sex, vitals, pertinant +'s and -'s

[Remember585 815]

Unit ID (Usually I say the Agency too since most ER's have no idea who 55B1 is.)

Age

Gender

Chief Complaint

Findings pertinent to the above

Vitals

ETA

ALS/BLS

Seems to work fine.

[Guest]

I appreciate the feedback guys. Just as a side. I do find it, at times, necessary to relay some brief medical history and medications to the ER so that they can be prepared. In the instance i encountered yesterday, there would have been a need for some additional medical resources not common to an ER.

As far as the HEAR, i do 99% of all hospital communication with the radio (which is monitored by the 911 center). If, for some reason, i'm unable to reach them by radio i do land line. When i rode in Westchester, we did all of our hospital notifications via phone.

[Guest partyrock]

Just out of curiosity, what would these resources be? Was it an issue specific to that hospital or is it more ER's in general?

[irishfire2491 24]

I always give the bear min because half the time they zone you out and they are just going to ask you the same thing in about 5 mins any way. I let them know the pt age, sex, condition, and if they are back borad and collor so the can try to find the right room for the pt.

[irishfire2491 24]

I always give the bear min because half the time they zone you out and they are just going to ask you the same thing in about 5 mins any way. I let them know the pt age, sex, condition, and if they are back borad and collor so the can try to find the right room for the pt.

[Guest]

Just out of curiosity, what would these resources be?  Was it an issue specific to that hospital or is it more ER's in general?

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More ERs in general, the needs of the patient would have gone beyond the attending and into more specialized care.

Edited May 1, 2007 by 66Alpha1

[Turborich 12]

I use the "CHART" method.... it keeps it simple.

C- Chief Complaint (i.e. 25 y/o male complaining of extreme boredom)

H- History of present illness/ pertainent medical hx

A- Assessment (only pertainent findings)

R- Rx (medications) only if necessary

T- Treatment

-Always give ETA and request orders following report.

If you really are wondering what they want to hear (no pun intended) ask for or look at what they write down the report on when you call in... do they have yellow post it notes that they just throw on a whiteboard following your call in or do they actually have a certain piece of paper specifically for ambulance reports that they hand off to the attending... food for thought...

As far as the sensitive info deal the phone works just fine.

[trauma74 111]

I usually look at the gray shaded areas on the PCR and that is the info I give to ER. I always keep it short and sweet. Our local hospitals perfer us calling in on the radio. They actually record our radio transmissions to them.

In our SOPs we have a section on what info the hospital should be provided with. All my members know that a patient name must NEVER be transmitted over the HEAR radio.

[Guest]

Appreciate the responses Turbo and Trauma. Trauma, just out of curiosity, do you know how long the transmission tapes are kept at your receiving hospital(s)? Also, have you ever had to pull the tapes and are you allowed to use brief sections of tape for training purposes?

[STAT213 332]

I say as little as possible. If its BLS, it is literally agency ID then 46 female ankle injury from a fall, awake and alert, see you in 5. ALS, I might give some details if I want them to be ready for something big, but if its a routine workup, I'll just say 46 female, CP workup, had the meds, vitals are good, see you in 5.

There really is no reason to say things over the radio that you'll just have to say again to a different person. Up in the syracuse area, all but complicated cases are transmitted to the ED's via computer through the dispatch agency. It works slick, and once the EDs get used to it, they actually love it. No more answering the damn radio every few minutes.

[RWC130 594]

RAMPART this is SQUAD 51, Were sending you an EKG!

HAHA!

[trauma74 111]

66,

I am not sure how long they keep the tapes for. Also, We have never asked for a copy of the tape or to listen to the tape at the ER.

[Guest]

making a notification is a courtesy unless it is a priority job cardiac arrest,ape,code grey,an mi so they could set up tpa, I dont think we should call for every single job they say it is so they can be ready for the pt, I gotta tell ya it does NOT make a differance in the time I am standing at the desk while they all ignore us for 10 mins, as for the content of the note it should not be a book I am inbound your location with a 65 y/o female with a FX right arm v/s are stable als established eta ~5-7 mins. That is the general idea, no need to give a long drawn out speech. any physician will want it in 2 sentences no more

Edited May 7, 2007 by PEDSTRUK

[Guest]

making a notification is a courtesy unless it is a priority job cardiac arrest,ape,code grey,an mi so they could set up tpa, I dont think we should call for every single job they say it is so they can be ready for the pt, I gotta tell ya it does NOT make a differance in  the time I am standing at the desk while they all ignore us for 10 mins, as for the content of the note it should not be a book I am inbound your location with a 65 y/o female with a FX right arm  v/s are stable als established eta ~5-7 mins.  That is the general idea, no need to give a long  drawn out speech. any physician will want it in 2 sentences no more

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Don't tell that to some of the hospital staff!