IMST -

AMBO
Clinical handover is an integral part of the daily clinical
work that takes place between paramedics and Emergency
Department (ED) staff for every patient arriving at the hospital
by ambulance or helicopter.
An ineffective handover represents a breakdown in
communication of health information which in turn may
have deleterious effects on patient care and safety, including;
misdiagnosis or unnecessary delays in diagnosis; delays in
administration of treatment; administration of incorrect
treatment or medication errors; and omission of care.

The IMIST-AMBO tool guides the paramedic not only to

structure the communication but also to remember the
necessary data set that need to be conveyed during an urgent or
emergent clinical handover. When IMIST-AMBO is used, there
is a consistent ordering of the information, greater frequency
of the necessary data set being conveyed and a reduction in
information repetition.

I dentification:
Identify Age, Gender and
Time of Injury or Illness
onset
M
echanism/ medical
complaint:
Describe the Mechanism
of Injury or the Medical
Complaint
I
njuries/ information
relative to the complaint:
Patient assessment and
history relevant to
complaint
S
igns:
Vital signs and Glasgow
Coma Scale (GCS)
T
reatments:
Interventions and response
to treatment
llergies:
No specific AMBO details.
IMIST-AMBO
Clinical Handover Protocol
Approx Age: 23 years ☐ Adult ☐ Pediatic
Nationality
Caucasian
Gender:
☐ Male
☐ Female
Time of injury/ illness onset: h or minutes ago
Mechanism of injury/ Medical Complaint:
Car accident, caused by phone distraction driving at a speed of approximately 60km/h.
Lost control over the vehicle and crashed into a light pole.
Trauma to the head, patient recalls hitting the windshield and shattering the glass.
Does not recall a loss of consciousness.
The patient complains of light-headedness, weakness and leg pain.
Injuries or Illnesses
Possible head trauma – concussion/hematoma.
Possible leg fracture or trauma – was trapped under the steering wheel
Complaints of light-headedness and weakness.
First set of Vital Signs:
BP= 130/80 mm Hg HR = 120bpm GCS: E=4 V=5 M=6 (15/15)
SpO2=- RR=29 EtCO2=- ECG=-
Symptoms: light-headedness, weakness & leg pain
Signs: Elevated heart rate – tachycardic: 120bpm
Slightly elevated blood pressure – hypertension: 130/80 mm Hg
High respiratory rate: 29s
Treatment and responses
Leg splint to stabilise limb and admission of pain killers
Medication and doses
Pain killers
A
 edications: M
ackground: B
ther: O
Definitions
BP Blood pressure (BP)
is the pressure of circulating blood against the walls of blood vessels.
HR Heart rate: The number of heartbeats per unit of time, (per minute).
Glasgow The Glasgow Coma Scale (GCS) is used to objectively describe the extent of impaired
Coma Scale consciousness in all types of acute medical and trauma patients. The scale assesses
(GCS) patients according to three aspects of responsiveness: eye-opening (E), motor (M),
and verbal responses (V). Based on the responses a total is taken of each response
out of 15 for the GCS.
E Eye-opening (E), best score is 4:
1. No eye opening
2. Eye opening to pain
3. Eye opening to sound
4. Eyes open spontaneously

V Verbal responses (V), best score is 5:

1. No verbal response
2. Incomprehensible sounds
3. Inappropriate words
4. Confused
5. Orientated

M Motor (M) best score is 6:

1. No motor response.
2. Abnormal extension to pain
3. Abnormal flexion to pain
4. Withdrawal from pain
5. Localizing pain
6. Obeys commands

Sp02 SpO2, also known as oxygen saturation, is a measure of the amount of oxygen-
carrying hemoglobin in the blood relative to the amount of hemoglobin not carrying
oxygen.
RR Respiratory rate (RR), or the number of breaths per minute, is a clinical sign
that represents ventilation (the movement of air in and out of the lungs).
EtC02 End-tidal CO2 (EtCO2) monitoring is a noninvasive technique which measures the
partial pressure or maximal concentration of carbon dioxide (CO2) at the end of an
exhaled breath, which is expressed as a percentage of CO2 or mmHg. The normal
values are 5% to 6% CO2, which is equivalent to 35-45 mmHg.

ECG An electrocardiogram (ECG) is a medical test that detects cardiac (heart)

abnormalities by measuring the electrical activity generated by the heart as it
contracts.