Handover tools
There are many handover tools that are used throughout a patient journey to good effect, but only a few that have been validated. NICE in 2017 wrote about structured patient handover but did not go as far as recommending a structure for the pre-hospital to hospital handover. Common to all of the tools is a structure that provides the whole team with a common language and predictable sections.
ATMIST and IMSIT-AMBO are the most frequent tools used for handover in the pre-hospital setting. Both aim to tell the receiving team who the patient is, what happened, what injuries have been found, the physiological changes and treatments delivers so far. ATMIST is the Joint Royal College Ambulance Liaison Committee (UK National Ambulance Guidelines) preferred mnemonic, particularly for trauma. IMIST-AMBO is an alternative used in Australia but not by the NHS.
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ATMIST AMPLE |
IMIST-AMBO |
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Age Time Mechanism of injury Injuries sustained Symptoms and signs Treatments given
Allergy Medications Past Medical History Last ate (time) Events |
Identification Mechanism (medical complaint) Injuries (information regarding medical complaint) Signs Treatments/trends
Allergies Medications Background Other |
(Images courtesy of Dr D Maxwell)
SBAR is well known, used in the inpatient setting and advocated by the WHO. In the pre-hospital setting it may be useful for a pre-alert but studies have shown it is least favoured by pre-hospital clinicians.
SBAR; Situation, Background, Assessment, Recommendation.
Learning bite
- ATMIST and AMPLE are the common handover tools used in the UK.
- ATMIST is the JRCALC preferred mnemonic of choice particularly for trauma.
- Being familiar with your local handover tool is vital.