Trauma Bay Handoff
Objective: Give one short trauma handoff, with one speaker. Use MIST or IMIST-AMBO, and include the times. Lead with the problem that can still kill the patient, then stop talking.
Why this matters
A long story, told while the patient is still bleeding, does not help the trauma team. MIST and IMIST-AMBO exist so a tired team hears the time, the bleeding, and the airway in one pass.
First, decide who will speak. Lead with the problem that can still kill the patient, and include the times. Then stop. MIST is mechanism, injuries, signs, and treatment. IMIST-AMBO adds identification, then allergies, medications, background, and other information. Practice the 30-second version on the way in. Do not invent it at the foot of the bed.
- One person talks. That is the clinician who managed the patient. Everyone else stays quiet unless asked.
- Lead with the problem that can still kill the patient. For example, the tourniquet went on the left leg at 18:42, the blood pressure is 88, and the airway is a supraglottic airway.
- Give vital signs as a trend if you have two sets. One number is only a snapshot.
- Write the times for the tourniquet, the needle, the last blood pressure, and the last end-tidal carbon dioxide. Do not trust memory at the bedside.
- I have a 20-second report.
- The mechanism is ___.
- The tourniquet went on at ___.
- The most concerning vital sign is ___.
Clinical sequence
- Before you enter, decide who talks. Name the one problem that can still kill the patient. Say what the team needs to do in the first 30 seconds.
- Give age, sex, and name if you have them. Give the mechanism in one sentence.
- Name the injuries you found. Give the signs: heart rate, blood pressure, oxygen saturation, Glasgow Coma Scale or AVPU, and end-tidal carbon dioxide. AVPU means alert, voice, pain, or unresponsive. Give the treatment: airway, procedures, blood products, and tranexamic acid if you gave it, with the times.
- Stop talking. Answer questions. Do not retell the whole call unless they ask. Then write the chart.
Teaching points
- MIST is mechanism, injuries, signs, and treatment. That is enough for a trauma team to start.
- IMIST-AMBO adds identification, then allergies, medications, background, and other information if there is time. Lead with MIST. The second half is extra. It is not a reason to stall the team.
- Times are part of the treatment. Say when the tourniquet went on, when the needle went in, and when blood started.
- If you only get 10 seconds, say the problem that is still unsolved.
Common errors
- Giving a five-minute story before the first set of vital signs.
- Letting two clinicians talk at the same time.
- Forgetting the tourniquet time.
- Saving the low blood pressure for the end of the story.
Practice
One-minute check
A 40-year-old from a crash has a pelvic binder, a left-leg tourniquet from 10 minutes ago, a last blood pressure of 92/60, a supraglottic airway, and an end-tidal carbon dioxide of 32. Give the 20-second MIST report. Then the team asks when the tourniquet went on.
Related: Trauma Triage & Destination, Massive Hemorrhage Comes First.
Sources & Further Study
Named guidelines for further study. They are not clinical orders and do not replace your protocol or medical direction.
- NASEMSO National Model EMS Clinical Guidelines (2022) — U.S. EMS model language; your protocol decides
- ACS Committee on Trauma / field triage communication — the receiving team needs mechanism, physiology, and times, not a long story
Education only. Apply learning within your protocols and medical direction. This is not clinical care guidance.
Check Your Understanding
Questions drawn only from this lesson. After you check, the key is highlighted. Education practice — not a certification exam.