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pre-hospital

Military and civilian handover communication in emergency care: how does it differ?

02 February 2019
Features
02 February 2019
Volume 11 · Issue 2

Abstract

There is a growing body of literature on handover communication between prehospital and hospital receiving teams in civilian emergency care settings but little is known about how this differs from handover in the UK military medical services. This literature review shows that civilian handover is a complex process conducted in less-than-ideal circumstances, and it is affected by human behaviour and patient factors. There is a debate around standardisation including the use of the Mechanism, Injury or Illness, Signs, Treatment (MIST) mnemonic. There is limited understanding of how this mnemonic was used by the UK military, how it was developed to deal with specific patient characteristics or in the context of military operations in Afghanistan within which it evolved. Advancements in clinical practice made during conflict are ancillary to military objectives and should be supported by an evidence base before being transferred to civilian health care.

Handover communication between paramedics and hospital receiving staff in the emergency department (ED) involves a transfer of responsibility, continuation of patient care and a formal hospital admission. This communication includes a verbal handover as well as documentation, which may be paper-based or electronic. However, little is known about handover communication in the UK military and how this might differ from civilian practices. According to Hodgetts and Mahoney (2009), there are potential benefits from studying civilian and military health care while acknowledging their differences.

Handover communication protocols between medical emergency response teams (MERTs) and hospital receiving staff are governed by the Ministry of Defence's (MoD) (2013) joint service publication Clinical guidelines for operations (2013) (now under review). The objectives of the current literature review were to understand more about handover communication in civilian and military emergency care settings and how they might differ from one another.

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Handover communication
Prehospital
ATMIST
MIST
Military emergency care