For EMT / Paramedics ·
What you'll accomplish
By the end of this guide, you'll have Twofold Health set up on your phone or tablet to dictate patient care notes using your voice while en route or at scene — generating a complete, formatted chart entry in real time. This frees you from typing in the back of a moving ambulance.
What you'll need
Go to trytwofold.com on your device and download the app, or find it in the iOS App Store / Google Play Store. Create a free account and select your certification level (EMT or Paramedic) during setup.
What you should see: An account creation screen followed by a dashboard with a "New Encounter" or "Start Recording" option.
Twofold Health is built specifically for EMS — it recognizes clinical abbreviations like SpO2, GCS, IV, ALS, BLS, and medication names without needing to spell them out. Browse the settings or "Help" section to see what voice commands and terminology it supports.
What you should see: A settings screen or terminology guide showing recognized EMS terms.
Tap "New Encounter" or "Start" when you're on a call or just finished patient contact. You can dictate at scene, en route, or immediately post-call. The app records audio and transcribes in real time.
What you should see: A recording interface with a waveform indicator showing your voice is being captured.
Dictate your patient care narrative in clinical language. You don't need to follow a rigid script — speak naturally. Include: dispatch info, scene size-up, patient presentation, SAMPLE history, vitals, assessment findings, interventions, and disposition. Twofold will organize it.
What to say: "We were dispatched to a 55-year-old male for chest pain. On scene: patient found alert, sitting in recliner, diaphoretic, pale. Chief complaint: substernal chest pain, onset 30 minutes, 9 out of 10, radiation to left jaw. History: hypertension, hyperlipidemia, on aspirin and lisinopril. NKDA. Vitals: BP 190 slash 102, heart rate 106, respirations 20, SpO2 94% on room air, GCS 15. 12-lead: ST elevation leads I, aVL, V1 through V4 — anterior STEMI pattern. Treatment: oxygen 4 liters, aspirin 324 milligrams PO, nitroglycerin 0.4 milligrams SL, IV 18 gauge right AC, transported priority to cath lab, hospital notified with ETA."
What you should see: Real-time transcription appearing on screen as you speak. Troubleshooting: If transcription misses terms, slow down slightly for drug names and numbers. Medical abbreviations sometimes need to be spoken fully on first reference.
When you stop recording, Twofold processes the dictation and generates a formatted chart entry. Review it for completeness and clinical accuracy — the app knows EMS terminology but you know the call.
Copy the generated narrative and paste it into your agency's ePCR (ESO, ImageTrend, ZOLL emsCharts). Some ePCR platforms may have direct integration with Twofold — check the app's settings or your agency's IT for integration options.
Speak these frameworks for consistent documentation:
Medical call: "[Age/sex], [chief complaint]. Found [scene/patient description]. History: [relevant history, medications, allergies]. Vitals: [BP/HR/RR/SpO2/GCS]. Assessment: [findings]. Treatment: [interventions, response]. Transported [priority] to [destination]."
Trauma: "[Mechanism of injury], [age/sex]. Scene: [safety, MOI details]. Patient found [position, GCS]. Complaints: [injuries/pain]. C-spine [applied/not applied, rationale]. Vitals: [vitals]. Treatment: [interventions]. Transported [priority] to [trauma center/ED]."
Cardiac arrest: "Witnessed/unwitnessed cardiac arrest. Patient found [position, bystander CPR yes/no]. Initial rhythm: [rhythm]. CPR initiated [time]. Shocks delivered: [number, energy, times]. Medications: [drugs, times, doses]. ROSC achieved at [time]. Post-ROSC vitals: [vitals]. Transported [priority]."