6. First Response to Ambulance
Ambulance to Paramedic
Paramedic to ED
ED to Interventional Staff
Interventional Staff to Critical Care Staff
And so on… This information has been brought to you by
15. Delay in treatment
Inappropriate treatment
Adverse events
Omission of care
Increased hospital length of stay
Avoidable readmissions
Increased costs
Inefficiency from rework
Other minor or major patient harm.
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18. Culture: Lack of teamwork and respect
Expectations between sender and receiver differ
Ineffective communication method, e.g. verbal, recorded, bedside, written
Timing of physical transfer of the patient and the hand-off are not in sync
Inadequate amount of time provided for successful hand-off
Interruptions occur during hand-off
Lack of standardized procedures in conducting successful hand-off
Inadequate staffing to accommodate successful hand-off
Patient not included during hand-off
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19. Sender provides inaccurate or incomplete information, e.g.
medication list, DNR, concerns/ issues, contact information
Sender, who has little knowledge of patient, is handing off patient
to receiver
Sender unable to provide up-to-date information, e.g. lab tests,
radiology reports, because not available at the time of hand-off
Inability of sender to follow up with receiver if additional
information needs to be shared
Sender asked to repeat information that has already been sharedThis information has been brought to you by
20. Receiver has competing priorities and is unable to focus on
transferred patient
Receiver unaware of patient transfer
Inability for receiver to follow up with sender if additional
information is needed
Lack of responsiveness by receiver
Receiver has little knowledge of patient being transferredThis information has been brought to you by
24. Glasgow Coma Scale GCS
Face Arm Speech Time ER FASTER
Boston Operation Stroke Scale BOSS
Cincinnati Prehospital Stroke Scale CPSS
Melbourne Ambulance Stroke Screen MASS
Age, Blood Pressure, Clinical Features, Duration Score ABCD
Brooklyn Stroke Scale BSS
Los Angeles Prehospital Stroke Screen LAPSS
Miami Emergency Neurological Deficit Checklist MEND
National Institute of Health Stroke Scale NIHSS
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Begin every class no mater where thinking…For years at the beginning of every course that I taught I explained to my students that no matter where they were Practicing EMS I was teaching them like any one of them could be responding to care for the people that I cared about.
2006 WSJ health columnist Laura Landro referred to patient handoffs as “The Bermuda Triangle of health care.”
Please indicate the correct response in this section – if there is a correct response.
This will help address specific issues that you identify.
Vertical up to intervention, critical care, etc.Horizontal across trauma, cardiac, medical, etc.
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