1724: Assessing Ems-to-Ed Handoff Quality in Out-of-Hospital Cardiac Arrest via Video Review

Introduction: The transfer of care for critically ill patients from emergency medical services (EMS) to the emergency department (ED) is an important phase in prehospital management. Effective communication during this handoff ensures continuity of care and optimizes patient outcomes. However, prior research indicates these handoffs are often incomplete and frequently interrupted. This study uses video review to analyze the impact of interruptions on EMS-to-ED handoff quality. Methods: This retrospective study was performed at a single urban academic ED equipped with continuous audiovisual recording in resuscitation bays. Cases involving cardiopulmonary resuscitation (CPR) undergo routine review for education, research, and quality improvement. We analyzed videos from 83 out-of-hospital cardiac arrest (OHCA) cases to evaluate EMS handoff quality during patient transfer, assessed by presence of a quiet environment before handoff, interruptions during reports, and how this affected the communication of relevant patient history and prehospital interventions Results: Among 83 OHCA cases, arrests were witnessed in 57.8% of cases; 43.3% received bystander or immediate CPR. Mean prehospital resuscitation time lasted 30.1 minutes (SD 16.8). Prehospital interventions included epinephrine administration (49.4%), defibrillation (22.9%), and end-tidal CO2 monitoring (36.1%). Incomplete communication of key prehospital interventions was rare (3.6%). EMS handoffs occurred in a quiet environment initially in 81.9% of cases, though 28.9% experienced interruptions. Only 3/83 reports (3.6%) omitted key prehospital interventions. Conclusions: Effective transfer of care is vital in managing critically ill patients. Although most EMS handoffs started quietly, interruptions affected nearly one-third of reports. Despite this, handoffs commonly included key prehospital interventions. This study highlights how video review proves valuable for objectively assessing handoff quality and can be used to identify opportunities for quality improvement to enhance EMS-to-ED communication and patient care