The emergency room (ER) is one active and complicated part of an active and complicated emergency response system. As an emergency response worker, you are crucial to this system! You may be the single most important point of communication for the ER. By better understanding how things work at the ER, you can ensure the smoothest transition and best possible outcomes for patients who depend on you. You can also help your friends and family understand the process. Remember, much of what they think they know may come from television.

First on the Scene

Unexpected things happen all the time. Health also varies a great deal from person to person. Typically if EMS is called, the situation is serious. The people involved feel that someone needs your professional, life-saving help. Your expertise improves the patient’s chances of survival on the way to the hospital.
When you, the EMS responders, receive a 911 call, the dispatch gives you the description of the situation. Use every piece of information, no matter how seemingly insignificant. In a moment, you will leap into action.You are likely the first medically trained professional on the scene.

As you transport a patient to the ER, the hospital is already preparing their next steps based on information you provide.

Life in the Emergency Room

Life doesn’t occur at a steady pace. As with your job, activity at the ER often comes in waves. It can be quiet then suddenly get very busy. The sick and injured may arrive faster than the staff can handle. Also like you, ER staff has to be ready for a tremendous range of different conditions they might encounter.
Generally a nurse conducts triage. Remember, he or she must assess not only the needs of the patient you’re bringing in but how that patient fits into everything already happening in the ER. The triage nurse may repeat steps you’ve already completed, like taking vital signs and history of the situation.
The moment you transfer a patient to the care of the hospital is critical. The Southwest Texas Regional Advisory Council has implemented a time-out procedure to ensure they get all the correct information for each patient. They use the acronym”MIST.” M describes the Medical problem; I is a complete description of the Injury from head to toe; S stands for Vital Signs including the first taken and any changes since; T tells the ER nurse the Treatment you’ve been giving during the time the patient has been in your care.
Before the transfer is complete, the first responders must give the patient care transfer report to the hospital in written or electronic form. This report documents the treatment the patient received from the time EMS arrived at the scene, to the time they delivered the patient to the hospital.
Also remember, an ER stands ready to handle many different kinds of needs. This careful identification and describing of where this patient is in the whole process eliminates mistakes like misdiagnosis and overdoses of medication.

Working Together

The whole emergency response system must continuously consider the way the parts work together. 
Some hospitals in Australia designate a special position, a Hospital Ambulance Liaison Officer (HALO) to help bridge this gap. These officers work at the hospital but coordinate with the EMS system. Frankston Hospital reports a 90% increase in speed of patient transfers.
With strong communication, treatment can move more swiftly for this patient and for all the others that follow. Medical professionals who encounter a patient with missing information may have to pause their flow in the system to make sure they understand what is going on. Valuable moments could be saved when the information has the added assurance of being complete and correct.

Everyone in the emergency response system, from the 911 operator, the EMS responders and the hospital staff must always treat one another with respect. In a heated moment, it is difficult to see how filing a routine report is so important to a patient’s safety. These procedures ensure correct information arrives with the patient. The smooth operation within this complex system, depends on this flow of information. It may not be this patient whose life is affected. A slow moment now, might reduce the chances of the next patient to arrive.

PHOTO: Paul Brennan / CC0 Public Domain