When EMS arrives at the hospital and care of the patient is transferred from paramedics to the nursing staff or trauma team, the staff can always tell the seasoned paramedic crews from those still learning the ropes. One crew arrives with patient treatment underway, a report prepared and anticipating what the nurses are going to ask, and can follow the routine without instruction. Another crew arrives with the patient unprepared, gives a disjointed report and has to be asked by the nurses to assist in boosting the patient to the trauma stretcher. Can you tell which crew is which? The hospital staff, especially front-line nursing staff, are always appreciative when the EMS crew patches a call in correctly, arrives prepared and assists with the little details with the noncritical patients. The patient is at a critical junction in time from their initial injury to their path to recovery, and the time where EMS hands the patient over to hospital staff can be filled with pitfalls that can adversely affect the patient's care. If paramedics take an organized approach when transferring the patient to nursing staff, they can ensure the quality and continuity of care and improve the chances of a favorable outcome for the patient.

   The initial patch call should be short, giving only the most pertinent information. Rather than holding the nurse on the patch phone to give an overly detailed report, patch in early to allow the hospital staff to arrange a bed, call the respiratory therapist, page x-ray, set up the rapid infuser, get the warming blanket out of the storeroom and do all those other tasks to prepare for your arrival. The patch should be problem- focused, with the most life-threatening injury topping the list. If the patient has sustained an arterial bleed, be sure to mention it, since that means the hospital may have to find the vascular surgeon who is on call. Attempting to list the patient's medications only takes time away from the nurse's other duties. Although a brief biography can be helpful, don't get bogged down in irrelevant details. Telling the nurse the 12-year-old with a leg fracture from skiing had his tonsils out five years ago is too detailed for the patch call. A full, detailed report can be given upon arrival. The following case scenarios illustrate these points.

Case #1