Awareness and First Aid

When done well, a patient handover ensures smooth, safe care. 

Without a clear process, important details can be missed, putting the patient at risk. That’s why having a structured handover system is essential.

How ER24 ensures a structured patient handover

The receiving practitioner must understand the patient’s current condition and every intervention ER24 paramedics have performed, says Linoi Moravin, an Emergency Care Practitioner at ER24 North Metro. “This isn’t just professional courtesy, it’s a patient safety imperative,” she explains.

“At ER24, we follow the ‘DEMIST’ and ‘SAMPLE’ programmes,” – as explained below. “We deliver this information verbally to both the receiving doctor and nurse at the Emergency Centre.”

The DEMIST approach

DE = Demographics

We start with the basics – name, age, and gender. Simple, but essential for accurate patient identification.

M = Mechanism

We clearly identify whether this is a medical or trauma case.

Medical conditions might include: 

  • Abdominal complaints
  • Respiratory issues
  • Cardiovascular problems
  • Neurological conditions
  • Oncology-related emergencies
  • Infections

Trauma cases could involve:

  • Motor vehicle accidents
  • Falls
  • Stabbings or assaults
  • Gunshot wounds
  • Pedestrian vehicle accidents.

I = Injury, observations, or problems

  • For trauma patients, we specify the location of wounds, which limb is fractured, or note complications like medication overdoses, restlessness, agitation, or confusion.
  • For medical patients, we focus on symptoms like wheezing, chest pain, shortness of breath, abdominal cramps, rashes, headaches, or facial drooping.

S = Signs and symptoms

This is where we share the patient’s vital statistics, including:

  • Oxygen saturation levels
  • Heart rate and blood pressure
  • Blood glucose levels (HGT)
  • Level of consciousness (increased or decreased)
  • Electrocardiogram (ECG) findings.

We watch closely for ECG abnormalities such as bradycardia (slow heart rate), tachycardia (rapid heart rate), and ST elevation – a key sign of acute myocardial ischaemia, which can indicate a heart attack.

T = Treatment

Here’s where we detail every intervention:

  • Pain medication administered
  • Nebuliser treatments for respiratory distress
  • Splinting for fractures
  • Reassurance for anxious patients
  • Aspirin for suspected heart attacks
  • Oxygen therapy
  • IV fluid administration
  • Wound dressings, burn shields, tourniquet
  • Spinal immobilisation on a spine board or vacuum mattress.

We explain what interventions we’ve provided and their effectiveness. For example, “I administered fluid for low blood pressure, and the patient’s condition improved,” or “Pain medication changed the patient’s pain scale from 8/10 to 4/10.”

The SAMPLE method

Alongside DEMIST, we use the SAMPLE method to ensure a complete transfer of the patient’s medical history.

S = Signs and symptoms: The issues the patient is currently experiencing.

A = Allergies: Record any known allergies to foods, medications, or other substances. Allergies to morphine, penicillin, or nuts can be life-threatening, though anaphylaxis can be treated if it occurs. Clearly state if the patient is unconscious, confused, or otherwise unable to provide this vital information.

M = Medications: The patient’s chronic medications, like hypertension drugs, antidepressants, or insulin.

P = Past medical/surgical history: We must note conditions like hypertension, asthma, diabetes, dementia, cardiac issues, osteoporosis, mental health conditions, or surgical history such as emergency procedures, appendectomies, C-sections, or orthopaedic hardware.

L = Last meal: This is critical for emergency operations where airway management is a concern, or when assessing for hypoglycaemia.

E = Event: Why they called ER24 for an ambulance in the first place.

Practical handover tips

These tools help ER24 medics share all the important information in a clear, organised way.

The handover usually takes 5-10 minutes. The receiving nurse documents everything, creating a conversation that becomes part of the official handover record. Once the nurse or doctor signs the document, we’ve officially transferred patient care.

Where applicable, we also ensure patients bring their chronic medications, ID, medical aid cards, next-of-kin details, overnight bags, and personal belongings. If we suspect neglect or abuse – particularly with children or elderly patients – we also report this.

Why clear communication matters

A structured handover isn’t just about following policy; it’s a vital part of ensuring continuity of care and patient safety. Every detail matters. The doctors will conduct their own history and observations, but a structured handover gives them the foundation they need to provide the best possible care. In emergency medical services, clear communication can save lives.