Hospital Notification

[DaveTFD 0]

heres my question for you: do you really have to notify the hospital you are enroute to that you are coming? or is it just a nice thing to do. when i took my EMT cert i was taught that it was just a nice thing to do, but when you get out into the feild hospital nurses will do everything short of attack you if you dont.

so do you or dont you have to?

[unleashedff248 3]

I personally always like to call up and let the ER know what's coming, ESPECIALLY if it's something they may need special preparation to handle (ie major trauma, CVA, heart attack, etc.) or if the patient's going downhill REAL fast (if you say to yourself "oh s***, we might not make it"). In my experience ALS runs usually should get phoned in by the medic unless he/she asks you to call it in for them. As for your question, the NYS protocols do include ER notification. I've always made an honest attempt to notify for every run. Sometimes you just can't call it in, and as you say the nurses and other ER staff are usually seconds short of strangling you when you get there. If I have a 3 minute transport time or if I'm trying to deal with 2 or more patients at the same time then there's no way I'm going to give a full notification. I've transported 3 patients before from an MVA alone, and I literally called up the hospital and said "I'm inbound with 3 adult patients from a MVA all ambulatory, minor injuries, and stable vitals. We'll be there in 5 minutes." The hospital ER staff who answered the phone asked me for a full set of vitals on each, so I hung up the phone. I'm there to treat the patients, not to have a 5 minute conversation with the ER. I told them I lost cell service.

Moral: The patient comes first.

[Jybehofd 85]

I personally always like to call up and let the ER know what's coming, ESPECIALLY if it's something they may need special preparation to handle (ie major trauma, CVA, heart attack, etc.) or if the patient's going downhill REAL fast (if you say to yourself "oh s***, we might not make it"). In my experience ALS runs usually should get phoned in by the medic unless he/she asks you to call it in for them. As for your question, the NYS protocols do include ER notification. I've always made an honest attempt to notify for every run. Sometimes you just can't call it in, and as you say the nurses and other ER staff are usually seconds short of strangling you when you get there. If I have a 3 minute transport time or if I'm trying to deal with 2 or more patients at the same time then there's no way I'm going to give a full notification. I've transported 3 patients before from an MVA alone, and I literally called up the hospital and said "I'm inbound with 3 adult patients from a MVA all ambulatory, minor injuries, and stable vitals. We'll be there in 5 minutes." The hospital ER staff who answered the phone asked me for a full set of vitals on each, so I hung up the phone. I'm there to treat the patients, not to have a 5 minute conversation with the ER. I told them I lost cell service.

Moral: The patient comes first.

←

I know I couldn't have said it any better.

[IzzyEng4 427]

I used to work for a C-MED (Centalized Medical Emergency Dispatch) up here and it was set up to notify everyone over everything. Including "band-aid" and "drunk tank" runs.It was good an bad, since the hospitals we covered were all in a major population area and deversions happened all the time.

The other C-MED regions would only get patched that were not "priority" calls such as minor finger lacks, detox calls, psych calls et. al.

[ny10570 745]

ER notification works best for everyone involved. Even if you just have the driver radio the ER just to say X# of patients f*cking bad 5 minutes out. Just enough so they aren't blind sided

[calhobs 110]

I disagree, in NYC you only give notifaiction if the pt is in dire strits. If you called lets say Jacobi and tell them you are coming in with a pt that as a broken toe they will hang up on you, for the simple reason they are too busy. In this county they are not even as close to busy as the city. What special things have to be prepared for a broken toe, or a pt with a runny nose, or any other minor troubles. I can understand for major medical and trauma. But 90% of our calls really dont fit into those. I think its awaste of radio usauge or phone call that could be use for a real major incident. Its the same as excess radio usage that happens all the time or when someone is fooling around on the radio.

[roeems87 0]

Careful with the idea that Westchester hospitals aren't busy or that "real reasons for calling" don't exist up here either. The city is a new ball game, obviously. Throw 10million people on top of the population of westchester and you would have the same situation...

I can 100% guarantee you that if I ever called Lawrence and said "broken toe," either I would get a sharp attitude or get hung up on. So the principal stands no matter where you are. If you have something "triage" worthy, might as well just take it there. If you have something that needs a room immediately or will need to see a doctor, needs noification.

In Westchester, it's nice to have a rapport with the people you are calling. If you go there enough, the nurses and doctors recognize your voice on the HEAR or you call them and say exactly who it is. They are more willing to hear you out and know what you have than not. You should give a call on anything you have a chance to that is going right into the back. If you as the EMT can't give a call, have the driver. If they're not an EMT, give them a quick line to say "Xage, problem, vitals."

On a side note: if you call... 9/10 you're more likely to see a friendly nurse ready to give you a room when you get there... If you don't, they may not be so willing, because the ambulance coming in the door behind you WAS nice enough to call...

[Remember585 815]

For starters, those at the ER / ED (whatever it is called today) are humans too. They may be in a good mood one minute and hell on wheels the next. It's just the nature of people. A hospital report should be conducted just as you would any other radio transmission. Know what you will say before transmitting. Be clear, be "to the point" and most importantly - BE ON THE RIGHT FREQUENCY.

On the other hand, one hospital I deal with quite often hardly ever has a working radio. When you call on the phone, you usually get put on hold. By the time someone takes your report, you are parking the rig.

As someone else said, keep a good rapport. It helps - believe me.

[mfc2257 464]

I haven't taken an EMS response in 5 years, BUT before that I took hundreds.

Best rule of thumb is if there is something to be gained by calling the hospital then call. If the ER crew will be better prepared to treat your patient when you arrive if they've been notified, then call. If your patient has a minor injury or complaint that doesn't warrent a call to the ER, then you are only taking time away from other patients already in the ER by calling.

I've had some frequent flyers in the past that call every time they had a stomach ache just so they could get treated right away and not wait in line with everyone else that got there on their own. Our policy prohibited us from refusing to transport, but when we arrived at the hospital, we would drop them in the waiting room to sign in after notifing the charge nurse or ER doc that they were there. If the doc wanted to see them right away, then in they went, if not, they wait just like everyone else.

As far as the driver calling the ER, even if they aren't an EMT or Medic, if they are driving an ambulance and participating on EMS calls, they should at least be a first responder. They should be familiar with giving a basic report to the hospital either via cell or radio patch. They should also be familiar with how to establish both phone and radio patch to each hospital that they could potentially transport to on a regular basis. If a Medic, EMT, and Attendant are working a 12 year old that is in arrest after being hit in the chest with a baseball, the driver better be able to let the ER know what's going on...

[Guest]

I DONT THINK WE SHOULD CALL FOR EVERY JOB WE BRING IN,UNLESS IT IS IN THE PATIENTS BEST INTEREST LIKE IF THEY HAVE APE OR AN MI OR AN ARREST BUT OTHER WISE WHY BOTHER. THE HOSP THAT I GO TO PRIMARILY WILL JUST STARE AT YOU FOR TEN MINS THEN COMPLAIN. I AM ALL FOR TRYING TO PLAY NICE IN THE SANDBOX BUT SOMETIMES IT JUST DOSENT MATTER. IF WHEN I GOT TO THE ER A BED WAS READY FOR "THE PATIENT " THEN I WOULDNT MIND,AFTER ALL ARENT THEY 911 RECIEVING HOSPITALS? ..........

[roeems87 0]

They are indeed receiving hospitals, but their patients don't only come from ambulances. It's not only protocol, but it's common courtesy to let them know what you're coming in with. If you're coming in with a twisted ankle, they may advise you to go straight to triage. In that case, they won't stare at you for 20 minutes and you will be in and out. If you have something that needs a bed right away, it all depends on the nursing manager whether or not you will get it. My experience is that getting a bed immediately is a matter of who the nurse in charge is. The ER could be dead or crazy busy, and no matter what, with some nurses you will wait, with others you will get in right away. Getting to know the people you're working with (emergency medicine is both hospital and prehospital care, so you are "working with" the ED staff) and building a rapport means when you call, you will get your bed or whatever it is you need.

Here's a reason to call with a less-serious patient: You are two minutes out, they have three open minor rooms, but the hospital has three minor patients also in the waiting room. If you call, they save you a bed. if you don't, you sit in the hallway and suffer the consequences of having to wait.

In the end, everyone is more informed (BETTER COMMUNICATION) and everyone is happier. It just makes sense to call ahead if you have the chance. It doesn't require all that much effort...

[Guest paramedico987]

The BLS protocol is ambiguous... in the "Genereal Approach" section it gives a list of things that you must transmit to the ED "as per system protocol."

I know that the WREMAC ALS protocol states the the Paramedic must make contact with online medical control after completing standing orders AND must not remain on scene longer than 20 minutes without contacting medical control. [another item to review in later editions of the protocol, 20 minutes isn't all that long when you've got to wait for an elevator twice and convince someone that they are in fact ill in addition to straight-up patient care.]

CALL IT IN WHEN YOU CAN,but don't stress it if you get to the hospital before you do. Ask the nurse if she would rather you get the patient to definitive care sooner or pull over IFO the ED and wait so that you can make notification.

Whichever nurse, doc, PA etc. is whining to you about it probably has such a bad attitude that they're going to find something to complain that you did or didn't do anyway.

Edited January 2, 2006 by paramedico987

[Guest alsfirefighter]

If I have a minor patient, and there are 3 minor beds and 3 in the waiting room, then give them to those in the waiting room and my minor can go sit in there after speaking to the triage nurse. The "I'm gonna get right in if I call an ambulance" routine is why some people call in the first place. If they sit like everyone else then it will reduce some of the BS.

As far as calling in, its a courtesy and professional to do so. Whether you walk right in to a stretcher, or stand there for 10 mins. They have their job, I have mine and it makes mine easier to call in. As far as info, if they ask for vitals and I don't have time, they get either 'stable' or whatever particular vital sign isn't within normal parameters. If they don't like it, so be it, but at least I called in to let them know the chief complaint and/or mechanism. Just like they look at you like your crazy sometimes when you don't know or can't remember the patients name. To me sometimes its just "sir" or "ma'am" when they need rapid treatment.