In pre-hospital care, effective communication can be just as critical as clinical skill. When every second counts, a clear, structured handover ensures nothing vital is missed — and that the receiving team can act immediately. One of the most recognised and reliable handover tools in UK ambulance practice is the ATMIST format.
What is ATMIST?
ATMIST provides a consistent framework for clinicians to communicate essential patient information — whether at the roadside, in resus, or during an inter-facility transfer.
It breaks information down into six key elements:
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A – Age
What is the age and sex of the patient?
This sets the clinical scene and helps guide initial expectations for likely conditions. -
T – Time of Incident / Onset
When did the injury or illness occur?
Understanding timing can influence decisions on urgency and interventions — for example, in trauma (the ‘golden hour’) or stroke (‘time is brain’). -
M – Mechanism of Injury / Medical Complaint
In trauma, this includes details like entrapment, vehicle speed, or height fallen.
In medical cases, it covers the presenting complaint — location of pain, duration, and associated symptoms.
This context helps the receiving clinician anticipate unseen injuries or complications. -
I – Injuries or Illness Assessment
Outline what you’ve found — from visible wounds to suspected internal injuries, or your working diagnosis in medical presentations.
Think of this as your clinical impression. -
S – Signs and Symptoms
Provide key observations: HR, RR, BP, SpO₂, temperature, GCS, blood glucose.
Note trends — are they improving or deteriorating? These patterns can be vital for ongoing management. -
T – Treatment
Detail what you’ve done: medications (dose, route, time), splinting, fluids, oxygen, or other interventions.
Include the response to treatment — did the patient improve, deteriorate, or remain unchanged? -
E – Extras
Include additional but important background details such as allergies, past medical history, or last meal.
These might seem minor, but they can completely alter a treatment plan.
Trauma vs Medical ATMIST
While the core structure remains the same, the focus shifts slightly between trauma and medical cases.
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Trauma ATMIST looks at mechanism of injury and physical trauma patterns. For instance, “40-year-old male, rollover RTC, entrapped 20 minutes, open fracture right femur, BP 90/60, HR 120, morphine 5 mg IV given, nil known allergies.”
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Medical ATMIST emphasises the presenting complaint and assessment findings. For example, “65-year-old female, onset of chest pain 45 minutes ago, central crushing pain radiating to left arm, ECG shows ST elevation, GTN and aspirin administered, BP 110/70, PMH hypertension.”
Both versions share the same logic — concise, structured, and clinically relevant.
Why Structure Matters
A chaotic or incomplete handover risks delays in care, duplication of effort, or missed critical information.
Using ATMIST ensures:
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Continuity of care: The receiving team can instantly understand what’s been done and what still needs doing.
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Confidence under pressure: A structured format reduces cognitive load in high-stress situations.
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Professionalism: Clear, concise handovers improve teamwork and trust between services.
Your ATMIST Reference Card
Our ATMIST Handover Card has been designed specifically for paramedics, student clinicians, and emergency teams to keep this vital framework at your fingertips.
It features Trauma ATMIST on one side and Medical ATMIST on the other — a quick, wipe-clean guide that fits neatly in your ID holder. Perfect for practice placements, handovers on shift, or training scenarios.
Shop the ATMIST Reference Card
Final Thoughts
When it comes to patient care, clarity saves time — and time saves lives.
Whether you’re handing over a trauma or medical case, using ATMIST keeps communication focused, efficient, and effective.
Learn. Adapt. Respond.