Communication with CVMC changes
To EMS District Six Responders,
CVMC is working on to improve our interactions with EMS. We are looking to change the method EMS calls in reports and calls in to the hospital. We are also changing the method that EMS gives their verbal report upon arrival.
Finally, we are strengthening the staff that should be immediately available in the room when certain critical patients arrives and empowering EMS to categorize these severe patients. This includes calling in alerts as guided by our EMS protocols.
Please take a moment to review this e-mail in its entirety. All five points are important. It includes various changes that go in effect in two days.
MARCH 1st:
1) EMS will no longer notify the hospital when they are responding to an incident, unless there is a suspected critical patient (trauma, stroke, cardiac/respiratory arrest) or a multi-patient incident.
- a. CVMC is working to get the charge nurse notification via Active911 when EMS is dispatched. This will be by SMS text only and hospital personnel will not have access to the Active911 application. CVMC leadership is still working through there Information Services (IS) department to get this activated.
2) EMS will use the EMS phone line (371-4999) to call in their pre-arrival reports. This phone is at the charge desk and has a distinctive ring. If a second call comes in simultaneously, it rolls over to the ED main line.
- a. If cell phone communication is not practical or operational, or if cell signal cannot be reached, EMS can use the radio to give their prior-arrival report. This is still being monitored.
- b. All pre-arrival reports should not give patient’s initials or DOB, to include both phone and radio. Age and gender will suffice.
- c. Pre-arrival reports should be given as close to ten minutes before arrival as possible. We recognize that this is sometimes not practically possible, but the goal should be ten minutes notification.
- d. Also, ambulances should not call on the radio when they arrive at the hospital.
3) EMS reports need to be shortened! They should be no more than 30-60 seconds in length. Remember, the purpose of the report is to prepare a room/stretcher for the EMS crew’s arrival and ensure staff are prepared at bedside, if needed. Most patient reports do not require more than minimal information to achieve these goals.
4) EMS will call ALERTS for critical patients, that are always priority one. These alerts include the following (along with their association protocol)
- a. CODE BLUE {cardiac/respiratory arrest} Protocols 3.2A/P
- b. SEPSIS ALERT {SIRS Criteria w/ ? infection} Protocols 2.23A/P
- c. STEMI ALERT {STEMI on 12-lead} Protocol 3.0
- d. STROKE ALERT {Evidence of CVA/LVO} Protocol 2.26
- e. TRAUMA ALERT {Critical Injury or VS} Protocol 4.9
5) Vital Signs are only given on the pre-arrival report if abnormal. This is guided by the vital sign parameters in EMS Protocol 8.15, as outlined below.
If EMS reports “stable vital signs”, all vitals fall within these parameters.
- a. Pulse Rate between 50 and 105
- b. Respiratory Rate between 10 and 24
- c. Systolic Blood Pressure 90 and 190
- d. Diastolic Blood Pressure 50 and 105
- e. Oxygen Saturation between 92 and 100
- f. Blood Glucose between 60 and 300
APRIL 1st:
There is a part two of our changes that CVMC is deploying. Part two includes a “Time Out for EMS” for verbal patient transfer of care at the ED. This will use a “D-M-I-S-T“ format. All receiving personnel in the room will become silent and still while paying attention to the verbal report. The crew chief will give a verbal report to the receiving staff. The patient will remain on the stretcher until report is complete and accepted (unless patient is critically unstable).
Scott Bagg is going to assign a Vector Training to all EMS personnel and Cornerstone training to all ED personnel. We will all be on the same page on how this process will be completed. Videos demonstrating the process will be included. CVMC personnel is also hoping that the same “EMS Time Out” will happen in reverse when patients are being transferred from our ED by EMS.
We recognize that this is a work in progress. Some of this is being “trialed” and will be nuanced if its impact is poor on our system. Please reach out to Scott Bagg or Kristen Schieman if you have any questions.
Scott Bagg, MSN, RN, NR-P, CCRN, CEN, CPEN, CTRN
Training Coordinator
Vermont EMS District Six
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MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10
MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10
MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10
Link to VT EMS 2023 Protocols
MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10
MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10
Vector log in
MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10
Vector log in
Link to Vector below.
For protocol update Sign in and follow links to videos corresponding to your license level. Don't forget to finish and click done at the end of each video for credit.
If not finding updates, go to the RESOURCE KIT and complete 2023 updates for your licensing level.
Questions: Contact your service training officer.