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.
 IMIST-AMBO
Clinical Handover Protocol

Approx Age: 80 years ☐ Adult ☐ Pediatic

I dentification:
Nationality
Greek
Gender:
☐ Male
☐ Female
Identify Age, Gender and
Time of Injury or Illness Time of injury/ illness onset: h or minutes ago
onset

M
Mechanism of injury/ Medical Complaint:
echanism/ medical The patient complains of severe chest pain, weakness and light-headedness.

complaint:
Describe the Mechanism
of Injury or the Medical
Complaint

I
Injuries or Illnesses
njuries/ information Had been heavily drinking the night prior.
relative to the complaint:
Patient assessment and
history relevant to
complaint

S
First set of Vital Signs:
igns: BP= 158/81 mm Hg HR = 83 bpm GCS: E=4 V=5 M=6 (15/15)
Vital signs and Glasgow SpO2= 100% RR=28 EtCO2=- ECG=-
Coma Scale (GCS) Symptoms: Severe chest pain, light-headedness and weakness.

Signs: Temperature 36.3 °C (Normal), elevated blood pressure 158/81 mm Hg,

sinus heart rate – 83 bpm.

T
Treatment and responses
reatments: -
Interventions and response
to treatment Medication and doses

The patient took Aspirin approximately 30 minutes ago.

 llergies:
A
edications: M
B ackground:

ther:
O The patient’s dad had died of a heart attack – family history of
heart conditions.

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.