ATMIST Handover

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As a Responder, if a life threatening injury or condition was identified during the Primary Survey, it is very likely that a handover to paramedics or other medical staff will be required. Ensuring that the handover is both efficient and complete is critical to a good handover. If unsure, you could simply follow through the ABCDE of the Primary Survey and state what was found and what was done at each stage, however an “ATMIST” report is a very common method of handover. The ATMIST acronym runs through the key details and ensures nothing is missed.

Additionally, by standardising the handover, the aim is to ensure that it can be completed quickly, so that the casualty can get on their way to further support.

A — Age of Casualty

Key details of the identity of the casualty, including Age, Name, Gender, and Date of Birth.

T — Timings of Incident

The time of the incident, or the onset of symptoms. Additionally, the time of arrival for response personnel.

M — Age of Casualty

The major mechanism of injury including any known factors associated. Such as a crash, stabbing, or a fall. Include details such as entrapment, rollover, or if they were ejected.

I — Age of Casualty

Any injuries discovered or suspected.

S — Age of Casualty

Vital signs including heart rate, respiratory rate, SpO2 and AVPU. Include whether the patient has improve or deteriorated since response arrival.

T — Age of Casualty

Any treatment given including the timing, and dose or rate.

Some people may refer to the ATMIST report as a “pre-alert“, as it is used by a number of ambulance services to notify the receiving hospital of details about the casualty whilst on route.