AMBO in ATLS Trauma Assessment
In the ATLS trauma assessment using the IMIST-AMBO handover tool, "BO" stands for "Burns and Other injuries."
Understanding the IMIST-AMBO Handover Tool
The IMIST-AMBO acronym is a structured communication framework used during paramedic-to-trauma team handovers 1. This tool was specifically designed to improve the quality and efficiency of patient information transfer in trauma settings.
The Complete IMIST-AMBO Structure
The acronym breaks down into two main sections:
IMIST section:
- I - Identification
- M - Mechanism of injury
- I - Injuries found/suspected
- S - Signs (vital signs)
- T - Treatment given
AMBO section:
- A - Allergies
- M - Medications
- B - Background/past medical history
- O - Other injuries (including burns)
Clinical Implementation and Evidence
The IMIST-AMBO tool has demonstrated measurable improvements in trauma handover quality 1:
- Reduced handover duration from 2 minutes 47 seconds to 1 minute 58 seconds
- Decreased interruptions from 3.05 to 1.5 per handover
- Improved communication quality with fewer parallel conversations (61% to 30%) and informal handovers (65% to 13%)
Adherence Patterns
When implemented, paramedics showed 82.2% adherence to the IMIST section but only 47.1% adherence to the AMBO section 1. This suggests that the "BO" (Burns and Other injuries) component is frequently underreported during handovers, representing a potential gap in communication that trauma teams should actively address by specifically prompting for this information.
Practical Application
During trauma bay handovers, ensure the "BO" component captures:
- Presence and extent of any burns
- Additional injuries not covered in the initial "Injuries" section
- Secondary findings discovered during transport
- Any complications that developed en route