What is the proper procedure for handing over a deteriorating patient to a paramedical (paramedic) team?

From the Guidelines

The proper procedure for handing over a deteriorating patient to a paramedic team involves using a structured communication approach such as SBAR (Situation, Background, Assessment, Recommendation) to ensure continuity of care and patient safety. When handing over a patient, it is crucial to introduce yourself and identify the patient, clearly describing the current situation including vital signs, level of consciousness, and immediate concerns 1. Provide relevant background information including the patient's diagnosis, medical history, allergies, and recent interventions. Share your assessment of the patient's condition, highlighting abnormal findings and deterioration patterns, as recommended by the Society of Critical Care Medicine guidelines on recognizing and responding to clinical deterioration outside the ICU 1.

Some key points to consider when handing over a deteriorating patient include:

• Ensuring bedside staff promptly and accurately acquire and document all vital signs, with significant abnormalities urgently acted upon 1
• Empowering patients, families, and care partners to alert staff or response teams about signs of deterioration 1
• Incorporating patient and family concerns into early warning systems 1
• Deploying a designated response team with well-defined activation criteria 1
• Focused education of non-ICU staff in recognizing clinical deterioration 1

Using a structured handover approach like SBAR is essential for reducing the risk of information loss and ensuring paramedics can quickly understand the patient's needs and begin appropriate interventions without delay. Ensure all relevant documentation and test results are transferred with the patient, and clearly state what you believe the patient needs and any time-critical interventions 1. By following these guidelines and using a structured communication approach, healthcare teams can ensure the best possible outcomes for deteriorating patients being handed over to paramedic teams.

From the Research

Handing Over a Deteriorating Patient to a Paramedical Team

• The proper procedure for handing over a deteriorating patient to a paramedical team involves a detailed and systematic approach, including the use of structured communication tools such as SBAR (situation, background, assessment, recommendation) or ISBAR (introduction, situation, background, assessment, recommendations) 2, 3.
• Effective handovers are crucial in ensuring that deteriorating patients receive timely and appropriate interventions to reverse or optimize their condition 2.
• The handover process should include the transfer of relevant information, such as vital signs, medical history, and current treatment, as well as an assessment of the patient's condition and recommendations for further care 3.
• Professional relationships, respect, and effective communication are essential in facilitating a smooth handover process, and barriers to communication should be identified and addressed 3.
• The use of a structured handover tool can help to ensure that all relevant information is communicated clearly and concisely, and that the paramedical team is aware of the patient's condition and needs 3.

Key Components of an Effective Handover

• Identification of the patient and their condition 3
• Assessment of the patient's vital signs, including oxygen saturation, pulse rate, respiratory rate, blood pressure, and temperature 4
• Communication of relevant medical history and current treatment 3
• Recommendation for further care and interventions 2
• Use of a structured handover tool, such as SBAR or ISBAR, to facilitate clear and concise communication 2, 3

Importance of Vital Signs in Handover

• Vital signs, including oxygen saturation, are crucial in assessing the patient's condition and identifying potential deterioration 4
• The measurement of oxygen saturation, in particular, can provide valuable information about the patient's respiratory function and potential hypoxemia 4
• The use of pulse oximetry to measure oxygen saturation can be an effective tool in monitoring patients and identifying potential deterioration 4