An analysis of paramedic verbal reports to physicians in the emergency department trauma room.
OBJECTIVE
To measure the verbal communication between emergency medical technician-paramedics (EMT-Ps) and physicians in an emergency department trauma room (EDTR) before and after an educational intervention.


METHODS
Using a before-after design, we audio-recorded paramedic verbal trauma reports in a large EDTR over a 12-week period. Trained research assistants subsequently queried physicians about information from the paramedic report in a separate interview. Physician recall was quantified. Midway through the study, a web-based, educational intervention designed to enhance paramedic communication skills was administered to the three participating emergency medical services (EMS) systems. Physician recall of more severely injured trauma cases (red triage) was compared with their recall of less severely injured cases (yellow triage). Further comparisons were made between pre- and post-intervention physician recalls, and the extent to which physicians recalled three distinct categories of paramedic verbal information was measured.


RESULTS
Overall, physicians accurately recalled 36% of the paramedic verbal report. Information from less severe "yellow" trauma reports was recalled more accurately than that from more severe "red" traumas (40% vs. 34% p = 0.02). Pre- and post-intervention recalls were not significantly different (33% vs. 38% p = 0.16). Physicians' recall of information about the crash scene (46%) was significantly greater than their recall of information about the patient's health status (34%) or information about prehospital patient care (30%) (p = 0.0012).


CONCLUSIONS
Physicians appear to recall paramedic verbal reports about trauma patients poorly. Recall is probably multifactorial and will require further work to design appropriate interventions.
Scott
Lancer A
LA
University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. lancer_scott@med.unc.edu
Brice
Jane H
JH
Baker
Christopher C
CC
Shen
Ping
P
D004634:Emergency Medical Technicians / Q000193:education* / Q000523:psychology*; D004636:Emergency Service, Hospital; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D011939:Mental Recall; D009657:North Carolina; D017063:Outcome Assessment, Health Care; D010820:Physicians / Q000523:psychology*; D013060:Speech; D013637:Tape Recording; D014218:Triage; D014947:Wounds and Injuries / Q000145:classification*