Paramedic to trauma team verbal handover optimization - a complex interaction.

Autor:	Cowan S; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North) cowan@ualberta.ca., Murphy P; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North)., Kim M; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North)., Mador B; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North)., Chang E; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North)., Kabaroff A; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North)., North E; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North)., Cameron C; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North)., Verhoeff K; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North)., Widder S; From the Department of Surgery, University of Alberta, Edmonton, Alb. (Cowan, Kim, Mador, Verhoeff, Widder); the Department of Surgery, Indiana University, Indianapolis, Indianna (Murphy); the Department of Critical Care, University of Alberta, Edmonton, Alb. (Cowan, Kim, Widder); the Department of Emergency Medicine, University of Alberta, Edmonton, Alb. (Chang, Kabaroff); the Alberta Emergency Medical Services, Alberta Health Services, Edmonton, Alb. (Cameron); and the Shock Trauma Air Rescue Society, Alberta, Edmonton, Alb. (Cowan, North).
Jazyk:	angličtina
Zdroj:	Canadian journal of surgery. Journal canadien de chirurgie [Can J Surg] 2023 May 24; Vol. 66 (3), pp. E290-E297. Date of Electronic Publication: 2023 May 24 (Print Publication: 2023).
DOI:	10.1503/cjs.013622
Abstrakt:	Background: Handover to the trauma team is crucial to trauma care. The emergency medical services (EMS) report must be concise, contain key details, and be time-limited. Effective handover is difficult, often occurring between unfamiliar teams, in chaotic environments, and without standardization. We aimed to evaluate handover formats in comparison to ad-lib communication during trauma handover. Methods: We conducted a single-blind randomized simulation trial evaluating 2 structured handover formats. Paramedics randomly assigned to ad-lib, ISOBAR (identify, situation, observations, background, agreed plan, and readback) or IMIST (identification, mechanism/medical complaint, injuries/ information about complaint, signs, treatments) handover formats underwent scenarios in an ambulance, then transfer to the trauma team. Assessment of handovers was completed by the trauma team and by experts using audiovisual recordings. Results: Twenty-seven simulations were conducted, 9 for each handover format. Participant ratings of the usefulness of the IMIST and ISOBAR formats were 9/10 and 7.5/10, respectively ( p = 0.097). Quality of the handover was deemed higher by team members when a statement of objective vital signs and a logical format was used. Handovers delivered with confidence, directed and summarized by a trauma team leader, before physical patient transfer, and without interruption were identified as having the highest quality. The type of format was not a significant contributor to handover; however, we identified a matrix of factors affecting the quality of trauma handover. Conclusion: Our study shows agreement by prehospital and hospital personnel that a standardized handover tool is preferred. A brief confirmation of physiologic stability, including vital signs, limiting distractions, and team summarization improves handover effectiveness. Competing Interests: Competing interests: S. Cowan declares receiving in kind simulation support from Alberta Health Services. K. Verhoef declares consulting fees from AMJS, ViaCyte Inc., Diagon Inc., Protokinetix Inc., and Pelican Therapeutics Inc. No other competing interests were declared. (© 2023 CMA Impact Inc. or its licensors.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu