How are you triaged? Do you update?

[vs-eh?]

Ninety percent of the calls (or more) I don't update the hospital, regardless of acuity. We generally don't update hospitals at all unless it fairly significant (ROSC cardiac arrest, severe SOB, STEMI, etc...).

For the general calls how do you get triaged? Do they just want the gist (i.e. abdo pain N/V/D x 2 days, etc...) or do they want more in depth (prior but with XYZ, meds, hx).

It's like 50/50 here. Triaging they may want all or minimum. Then when transfered to the RN for care, they want the full story.

How often do you have to "sell" your patient to the RN (with an acute [you think] patient)?

PS- Do you think I'm awesome? I asked Jesus himself on this holiest of days, he said "meh". I was like "WTF Jesus!"

[northernmedic]

Our system sounds similar to yours. We don't notify unless it is something of significance or unless there is some special requirement, i.e. sexual assault team or social work etc.

I would say the sicker the pt, the less the triage. For CTAS 1 and 2 patients I pretty much just go right to the bedside and give a report directly to the emergency physician and bedside nurse. For lower acuity pts generally the triage nurse will do a more complete triage. Sometimes it drives me insane because you end up giving a bigger report than you would at the bedside. CTAS 4 and 5 pts usually just get put in the waiting room (as long as they are ambulatory) and the transporting crew can clear. The 2 major hospitals that I normally transport to are excellent and both are large teaching hospitals, trauma centers and cardiac centers so they have great staff and we have a very good working relationship. You get the normal occasional attitude on both sides but normally it's very good and we do go out and party together as well.

[Chief1C]

Do you think I'm awesome? I asked Jesus himself on this holiest of days, he said "meh". I was like "WTF Jesus!

I think... It doesn't matter what I think. However, if I may make a suggestion? Step away from the crack pipe.

[AZCEP]

I will only go into great detail if the patient is presenting in such a way that the standard treatment will make things worse. Mostly due to my dread of repeating the same story so many times.

[AnthonyM83]

We hardly ever update after initial contact unless something major happens that they need to specifically prepare and get more resources/personnel for (like a full arrest).

As for the triage report for non-emergent patients, it seems to depend on the hospital. The overworked really freaking busy ones want just the basics and have a few questions to make sure it doesn't qualify as critical....then half the time they send them back out to the waiting room.

Sometimes I have to sell the patient (we're that patient's advocate, right?) so they get seen right away...but most don't do that because if they're 'too serious' then we have to wait with them in the ER hallways until a room becomes available (can take HOURS).

Half the time you end up trying to sell it that they're not critical, so you don't have to wait...some people are known to lie (I've been tempted, it sucks waiting 6 hours when you know patient will be fine, but they meet some criteria...that would be stepping into the dark side).

[mobey]

If the pt. is stable I give a very brief patch:

Coming in with 87 y/o female complaining of mild SOB. SPO2 96 RA, Skin pink warm dry, we have her on 3lt nasal cannula, she is normotensive we will be there in ***minutes.

If they are unstable by my standards I will phone in and be a little more detailed with a little history and whatnot.

I can also request this pt. go direct to the trauma room and they will have the Dr meet us in there.

[JPINFV]

BLS, ALS "No base hospital contact": Age, gender, CC, anything major (normally not needed)

ALS "Base hospital contact": Essentially say the entire run sheet over the radio (demographics, v/s, treatments including IVs).

Contact vs no contact determined by protocol. Ain't EMS based fire suppression is fun?

[AnthonyM83]

LA is exactly how JP described.

BLS you usually don't make contact, though some hospitals like you to call in (half the time it's a receptionist) just so they can get a bed ready. But with busier hospitals, it doesn't quite matter.

ALS, they read the entire runsheet off to base station nurse, just so they can tell you "O2 and IV".

[northernmedic]

Anthony,

I'm a little confused on your ALS patching. Are you saying you get orders from a nurse for an IV en route?

[kitkat]

I would say at 2 of our major hospitals, if you don't have a "red" they wouldn't even hear the "patch" just a big sigh and a 10-4, then you can expect to wait, ... to be triaged, after the other 4, or so, ambulances, then wait for a bed, oh did I say wait, for a bed?? yeah, bring a book, your ipod, or whatever. They may only start showing intrest if a supervisor shows up.

So, how do we patch? -Red, Amber, Green-C/U/R-and (# code) for medical/trauma/pregnancy/burns/cardio/resp