Re-published 29 July, 2024.
If you work in emergency health, the term IMIST AMBO will be familiar. The acronym outlines the step-by-step process of communicating patient information during the handover from pre/out-of-hospital staff to the treating staff in-hospital.
In this blog, you will understand who created this acronym, how to use it, and examples for each letter too.
Who created IMIST-AMBO?
IMIST AMBO was coined by Intensive Care Paramedic Jacinta Young*.
*(International Journal of Paramedic Practice, July 2024)
Understanding that the key points of a patient history are usually delivered verbally, a systematic approach was needed to ensure information was delivered correctly, assertively and clearly. Using the mnemonic IMIST AMBO eradicated common difficulties of clinical handovers between emergency services teams due to the now consistent structure of shared information.
What is the difference between IMIST-AMBO and IMIST AMBO?
Both achieve the same results; it is just a matter of the term being spelled slightly differently. Generally, the ‘-‘ or space is to pause for questions. When doing a patient handover, interruptions should be avoided. As such, two question points are provided during an IMIST AMBO handover, each being:
I → M → I → S → T → PAUSE → A → M → B → O → PAUSE
Each pause will be for approximately 2-3 seconds.
How to Perform Patient Handover with IMIST-AMBO
Whilst there are some slight variances, most paramedics use the IMIST AMBO acronym as follows:
I is for identification.
The patient’s name, gender, and age.
For example, ‘This is John, a 65 year old male.’
M is for mechanism.
The injury or medical complaint. This means that it’s the presenting problem.
For example, ‘John fell down two flights of stairs at his home.’
I is for injuries or information.
Sharing additional information about the patient and their injury
For example, ‘John is suffering left-sided chest pain today following his fall. John has a past medical history of a previous myocardial infarction in 2018, in which he received a stent.’
S is for signs.
State any abnormal vital signs, including the patient’s GCs score if it is under 50.
For example, ‘John is tachycardic with a pain score of nine out of 10 and on-scene, his saturations were only at 88%. St. Elevation was noted on his ECG, and John’s GC is currently 13. He is confused, and his eyes are opening to speech. Other ob’s were non-remarkable.’
T stands for treatment and trends.
What have we given the patient? How have we intervened? How has the patient responded?
For example, ‘John received 300 milligrams of oral aspirin, 400 miles of sublingual, GTN, 25 mikes of I M fentanyl and 15 litres of oxygen via a non-rebreather mask to good effect.’
A is for allergies.
For example, ‘John is allergic to paracetamol and latex.’
M is for medications.
The medication your patient regularly takes, including prescription and over-the-counter drugs.
For example, ‘John takes daily aspirin and warfarin, and any medication packets belonging to the patient can also be handed over to the treating physician.’
B stands for background.
This includes other history that’s relevant to the particular case.
For example, ‘John attended this hospital last year for a stent surgery.’
O is for other information.
Scene characteristics, how we found the patient, cultural and religious considerations, and belongings valuable to the patient.
For example, ‘John lives alone, and he follows the Buddhist faith.’
Further resources
For further assistance, check out the video below for a demonstation of a patient handover:
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