Zero Point Survey

The pre-alert allows time to prepare the department for the next patient. Zero-point survey has been advocated as a tool to allow the Emergency Department resus lead to pre-plan to best meet the needs of the expected patient. It is described as the stepping stone to the primary survey. A zero-point survey uses a STE-PUP assessment with the STE being relevant after the pre-alert;

1. Self – Perform self-assessments of personal, physical and cognitive readiness.
2. Team – leader identified, team roles allocated and briefing.
3. Environment – danger, space, light, noise, crowd-control.
4. Patient
5. Update
6. Priorities

With critical care patients a pre-alert may allow additional considerations around team and equipment. This is especially relevant to ensure the appropriate PPE state is achieved prior to the patients arrival due to the Covid-19 pandemic. Additional tasks such as pre-alerting relevant members of the hospital team or instigating a major haemorrhage call and preparing the blood warmer rely on an accurate pre-alert to prevent waste of valuable resources.

The handover should be like a relay race where the patient is handed to a team who are already up and running to take over the care rather than at a standing cold start. Having a good working relationship between local pre-hospital providers and emergency departments aids best practice. The use of trauma networks and clinical governance days to share best practice and develop areas for change should be standard.

Learning bite

• A zero-point survey uses the STE-PUP assessment to prepare a department.