Structured triage handover builder · College of Paramedics / AACE handover standard
I·M·I·S·TA·MB·O
Page 1 of 5 — Before you start
Why handovers get lost
A triage nurse's attention is highest in the first 15–20 seconds. Chronological storytelling ("so we arrived and then...") front-loads the least useful information. IMIST-AMBO reorders the same facts so the dangerous stuff lands first, then attention can drop off without losing anything critical.
Golden rules
1
Headline first. One sentence — what does she most need to know before you say anything else?
2
Findings, not data dumps. "GCS 13, confused since the fall" beats reciting a GCS breakdown with no framing.
3
Fixed order, every time. Even when the story in your head runs differently — I·M·I·S·T·A·M·B·O, always.
4
If she disengages, cut B and O first. Background and Other are context — trim them before you'd ever trim signs or treatment.
5
Pause after Treatment. Let her ask questions before you plough into Allergies/Meds/Background — most of her decision is made by then.
Pre-alert given for this patient?
Yes — already pre-alerted
If pre-alerted, don't repeat the full call — lead with what's changed since the pre-alert (obs trend, response to treatment, new findings), then fill gaps only if asked.
Page 2 of 5 — The Story (Identification · Mechanism · Injuries/Info · Signs)
Identification & headline
Age, sex, then one sentence — the thing that should make her look up.
Male
Female
Not stated
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Mechanism / complaint
How this started or happened — brief, not a full history.
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Injuries / information
Pertinent positives and pertinent negatives from your exam.
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Signs
Vitals as findings, not just numbers — trend matters more than a single reading.
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Page 3 of 5 — Treatment (T)
Treatment given
What you did, and when — this is where you naturally pause for questions.
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This is a natural pause point. Most triage decisions are made by here — let her ask before you continue.