Fostering a partnership between home care and emergency medical services
A few months ago, we wrote about how PHS and emergency medical services (EMS) started working together to build a more collaborative relationship – one that results in improved care as EMS personnel in the Hennepin County area were trained on infusion basics and trach tube essentials.
With this new approach to community partnership, paramedics have a better understanding of the setup and needs in a medically complex patient’s home, leading to the patient receiving the most immediate and comprehensive care.
After recognizing that it is equally important for nurses to be educated on EMS practices, PHS recently held a training on what to expect when they need to call paramedics to a patient’s home. We were honored to host Erin Glover from Hennepin County EMS and Amber Lage from Minneapolis Fire for this training – two educators who know firsthand how these calls play out from an EMS perspective.
The other end of the line
No home care nurse hopes to meet the moment where they need to call 9-1-1 while caring for a patient. However, it is crucial for our nurses to be prepared for every situation – and that means being properly trained should they ever need emergency services.
One of the first steps to ensuring a seamless response process may seem like an obvious one, but can make a big difference – relaying the complete, accurate home address to the dispatcher to avoid EMS being lead to the wrong location – a big stressor when every minute matters. If there are any particular indicators it would be helpful for them to know, include those as well.
Our Nurse Training Supervisor, Becca Pasch, shared some additional expectations callers (home care nurses or otherwise) should have for a 9-1-1 call:
- The purpose for your call – is there an obstructed airway? Seizure? Are they conscious? Breathing?
- Dispatchers will ask you questions multiple times – they’re making sure they have complete information so they’re sending who you need and where you need them
- Place your phone on speaker so you still have both hands to help the patient – be sure to speak loudly and clearly so they can hear you
- Make sure EMS has access to your location – unlock doors, prop them open etc.
- If you don’t know where you are, look for a piece of mail with the address
- If you’re on the road, look for mile markers, buildings, exit signs, or anything that could indicate where you are. If you are driving, you need to pull over to have EMS dispatched to you.
Providing information for improved care
Amber Lage gave a breakdown of what family and nurses can expect from her team once they arrive at the home – including supplies and equipment, questions they’ll ask (have the patient’s medication list, symptoms, allergies, and any pertinent medical history available), or who will tend to what role in the home.
Once the scene and patient have been assessed, paramedics might “stay and play” (provide care on the scene) or “load and go” (get the patient in the ambulance for transport) depending on the severity of the situation and where they can best provide cares for the patient.
PHS has created an EMS Basic Information Form for our families to print and keep in the home for situations involving EMS. This will answer a lot of their crucial questions in a brief, succinct way, and it is a beneficial to already have answers compiled during a stressful situation.
“The concept of this form came from the previous training done between PHS and Hennepin County EMS personnel,” said Becca Pasch. “Providing paramedics what they need – not what nurses or family think they need, but what they actually need – is crucial so they can review it and get to providing patient care as quickly as possible.”
Real life scenarios for relevant learning
Before getting into the scenario portion of the training, nurses had the opportunity to tour an ambulance. You can watch the tour for yourself here to get an idea of what equipment and supplies are on hand, how they load and unload patients in the ambulance, and more.
By observing scenarios from the moment a patient shows signs of distress to their transfer into the ambulance, nurses were given the chance to identify solutions and feel prepared for a situation that could occur while in a medically complex patient’s home. Some of the scenarios played out between a home care nurse and paramedics included:
- Infant patient having a seizure
- Trached infant patient with an obstructed airway
- Full code, vented patient, at home
- Full code, trached patient, in transit
- Autonomic event
Partnerships benefit everyone
By educating both EMS personnel on children with medical complexities and home care nurses on the needs of EMS, community providers become more knowledgeable and new levels of comprehensive care for our patient population are reached. In a growing population where more kiddos are living in their homes, proactively providing this training for all professionals involved means.
Originally published: June 10, 2016