RT Journal Article
SR Electronic
T1 Paramedic to trauma team verbal handover optimization — a complex interaction
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP E290
OP E297
DO 10.1503/cjs.013622
VO 66
IS 3
A1 Shaun Cowan
A1 Patrick Murphy
A1 Michael Kim
A1 Brett Mador
A1 Eddie Chang
A1 Alison Kabaroff
A1 Emerson North
A1 Cheryl Cameron
A1 Kevin Verhoeff
A1 Sandy Widder
YR 2023
UL http://canjsurg.ca/content/66/3/E290.abstract
AB 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.