Paramedic-to-Hospital Handoff Documentation
The short answer
A paramedic handoff has two parts: a short, structured verbal report to the receiving team, and a record of what was said, when care was transferred and who accepted it. Both should match the patient care record you complete. Your service and receiving hospital may have required formats, so follow your service's protocols.
Choose a structure and use it every time
Many services use a trauma-style acronym such as ATMIST, or SBAR. ATMIST stands for Age and sex, Time of incident, Mechanism, Injuries suspected, Signs (vital signs and level of consciousness), and Treatment given; a longer version adds estimated time of arrival and requirements on arrival. For medical (non-trauma) patients, the mechanism and injuries are replaced with the medical problem. SBAR works equally well. Which format you use matters less than using the same one each time.
A fictional example
"This is a 74-year-old woman, history of heart failure, with 2 hours of worsening shortness of breath. On arrival her breathing was laboured with crackles on both sides. Oxygen saturation 86% on room air, 94% on supplemental oxygen. Heart rate 108, blood pressure 148/86. We gave oxygen and positioned her upright; an IV was started. Allergies: none known. She is alert. I need a bed and a physician now."
The report starts with the current problem, shows the trend and the treatment, and ends with what the paramedic needs from the team.
What to document about the transfer
- Time of arrival at the hospital and time of transfer of care.
- Name and role of the person who accepted the patient.
- The patient's condition at transfer: level of consciousness, vital signs and any ongoing treatment (for example oxygen or an infusion).
- What you told the receiving team, including anything you were unsure about.
- Belongings, valuables, consent or refusal discussions, and equipment left with the patient, per your service's policy.
- Anything the receiving team asked you to do, or any disagreement you raised.
Common mistakes
- Giving the history in a long narrative before the current problem.
- Leaving out the time of the last vital signs or treatment.
- Documenting before the handoff what you assume will happen, instead of what did.
- Forgetting to record who accepted care.
- Writing a report that contradicts what you said verbally. If you remembered a correction, add a clearly marked late entry per your service's policy.
A fill-in handoff template
A: age and sex ___ T: time of onset or incident ___
M: mechanism or medical problem ___ I: injuries or key findings ___
S: signs, with the most recent set and the trend ___
T: treatment given and response ___
Needs: what you need on arrival ___ Accepted by: ___ at ___
Where Fiabita fits
Fiabita's rewrite and SBAR tools can turn rough notes into clearer wording, and you review every line before it goes anywhere. Fiabita does not know your employer's policy, cannot certify that a note is compliant and does not replace your judgment, your instructor or your supervisor.
FAQ
Q: Is ATMIST required in Canada?
No single format applies across Canadian services. Many structures exist, and your service and receiving hospital set the expectation.
Q: Should the verbal report and the written record match?
Yes. If a difference appears, correct it according to your service's late entry or amendment policy rather than leaving a contradiction.
Q: Does Fiabita replace my service's patient care record?
No. Fiabita can help you practise a structured report; your official record is completed in your service's system.
Sources and further reading
- RCEMLearning: ATMIST(ER) in pre-hospital communication — a UK-origin handover format
- AHRQ TeamSTEPPS: SBAR — definition and purpose of SBAR