Pediatric emergency medicine trisk 4611 4611
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ambulance crew’s handover. Any information that was not handed over verbally, not recorded on the patient
report form, or not retained by ED staff may be irretrievable after the ambulance crew leave. There is significant
variation in sign out practice, and current processes have been criticized as being highly variable, unstructured,
and potentially unreliable. Several standardized approaches to sign outs have been defined, including IMISTAMBO:
Identification of the patient
Mechanism of trauma or Medical complaint
Injuries or Information relative to the complaint
Signs (vital signs and GCS)
Treatment and trends/response to treatment
Allergies
Medications
Background history
Other
To aid in family reunification, it is important for the transition of care from EMS providers to include
information about the condition and destination of family members. It is also important for providers to report
pieces of information or visual clues to potential nonaccidental trauma or neglect that may be noted at the scene.
Each encounter between EMS and the hospital should be considered as a potential learning and teaching
experience, and deficits noted as a stepping stone for future improvement. Providing patient follow-up, where
allowable, is another way of including the EMTs in the care continuum.
