EMS Communications Power point presented by Dr. Samah Mohammed Power point presented by Dr. Samah Mohammed

Chapter 5Chapter 5

EMS Communications

Power point presented by

Dr. Samah Mohammed

Power point presented by

Dr. Samah Mohammed

Learning Outcomes Learning Outcomes

• By the end of the session the student will be able to :

Define the communication .

Explain types of communication.

List phases of communication.

Discus element of communication.

Explain component of communication.

Identify Communication With hostile

INTRODUCTIONINTRODUCTION

• In EMS communication, information must

move rapidly, efficiently, and effectively.

Know how to make communication as

efficient as possible.

The EMD facilitates communication.

Therapeutic communication requires skill.

EMS Communication EMS Communication

• Definition of communication: The process of

exchanging information between individuals.

EMS System Communication needed to:

1. Call for resources.

2. Transfer care of the patient.

3. Interact within the team structure.

4. Communication with other health care professionals

5. Team communication and dynamics

ROLE OF COMMUNICATION IN Ems

ROLE OF COMMUNICATION IN Ems

ELEMENTS OFCOMMUNICATIONELEMENTS OFCOMMUNICATION

1. Sender: The person Who Putting message in an

understandable format.

2. Message: Information sent or expressed by sender

3. Channel: The medium through which a channel is

transmitted.

4. Receiver: Is the person who receives and interprets

the sender’s message.

5. Feedback: the receiver’s reaction to the message.

Five Phases of EMS Communication

• Event occurs.

• Need for emergency services detected.

• Notification /emergency response.

• EMS arrival, treatment, transport preparation.

• Preparation for next emergency response.

• .

CodesCodes• Some EMS services use radio codes to:

1. Maintain security.

2. Keep airtime brief.

3. Prevent patient from understanding what is being said.

• To be effective:

• Everyone must learn them.

• Codes should be:

• Simple and standardized Posted

•

Clarity of TransmissionClarity of Transmission

• Basic model of communication

1. Sender 2. Clear message

2. Channel 3. Receiver

5. Feedback

Communications equipment is designed to permit communication.

• Many guidelines can improve clarity, such as:1) Make sure the channel is clear.

2) Speak clearly and distinctly.

3) Keep calm and free of emotion.

4) Keep transmissions brief.

Content of TransmissionsContent of Transmissions

• Guidelines include:

1. Protect the patient’s privacy

at all times.

2. Be impersonal.

3. Use clear text.

4. Question orders you did not

hear/ but understand.

TYPES OF COMMUNICATION TYPES OF COMMUNICATION

TYPES OF COMMUNICATION TYPES OF COMMUNICATION

Factors to Improve CommunicationFactors to Improve Communication

1. Use simple language.

2. Show/ draw pictures.

3. Limit the amount of information provided & repeat it.

4. Produce/ use easy-to-read written material.

5. Confirm the patient’s understanding.

6. Create good environment.

7. Address the needs of patients with disabilities.

Therapeutic CommunicationTherapeutic Communication

Your job will involve daily

interactions with people.

At least half of calls

involve going in someone’s

home.

See every invitation into a

home as a personal honor.

Therapeutic Communication Therapeutic Communication

• Therapeutic communication uses various communication techniques and strategies

• – Both verbal and nonverbal

• – Encourages patients to express how they feel and achieves a positive relationship with patient

• 1. Asking questions: is a fundamental aspect of pre-hospital care.

• •Open-ended questions require some level of detail. Use whenever possible.

• Example: “What seems to be bothering you?”

Therapeutic Communication Therapeutic Communication • Closed-ended questions:- require some level of detail

in the response.

– Response is sometimes a single word like yes or no.

– Use if patients cannot provide long answers.

– Example: “Are you having trouble breathing?”

• 2. Touch is a powerful tool.

• – Use it consciously and sparingly.

• – Avoid touching the patient’s torso, chest, or face simply as a means of communication.


3. Active listening:-

- Repeat key parts of a patient’s response.

- Especially when taking notes.

- Helps confirm the information patients are providing

4. Use interviewing techniques e.g.

1. Make and keep eye contact at all times.

2. Provide your name and use patient’s proper name.

3. Tell patient the truth.


4. Use language the patient can understand.

5. Be careful what you say about patient to others.

6. Be aware of your body language.

7. Speak slowly, clearly especially patient as the hearing-impaired patient.

8. Allow the patient time to answer.

9. Act and speak in a calm, confident manner.


Try hard not to shout:

1. Reduce noise when possible.

2. Move the patient to a quiet area.

3. Speak close to the patient’s ear in a calm voice.

4. Complete all your history taking at once.

5. Ask personal questions quietly and in private.

6. Communication is critical in challenging environments.

Communication Tools Communication Tools • Use the following tools:

1. Reflection

Repeat a word or phrase a patient used to encourage more detail.

2. Interpretation

Vocalize what you think the patient said, and have him or her correct you.

3. Facilitation

Encourage hesitant ( uncertain) patients to provide more detail.

Communication Tools Communication Tools • There are many powerful communication tools that EMTs:-

1. Silence

2. Empathy

3. Simplification

4. summarization

5. Clarification

6. Redirection

7. Explanation

Communication With other Health Care ProfessionalsCommunication With other Health Care Professionals

1. Effective communication between EMT and health care professional must be effective, efficient, and appropriate.

2. Your reporting responsibilities do not end when you arrive at the hospital.

3. Give oral report to hospital staff member who has at least your level of training.

4. Oral report components:


• The following six component must be included in the oral report.

1. Opening information

Include patient name, age, gender, chief complaint, nature of the illness

2. Detailed information

Not provided during radio report.

3. Any important history


• The patient response to treatment

Initial treatment that provided

• Vital signs

Assess during transport.

• Other information

• Information gathered during transport

• ( medication )

Communicating with older patientsCommunicating with older patients

Old patients:-

• older patients are harder to communicate with than anyone else.

– Illnesses may be more complex.

– May be differences in hearing, mobility, etc.

– Older patients who express that are not well.

Communicating with older patientsCommunicating with older patients

• Old patients:

1. Identify yourself.

2. Look directly at patient.

3. Speak slowly and clear

4. Explain what you are going to do before you do it.

5. Listen to the answer the patient gives you.

6. Show the patient respect.

7. Do not talk about the patient in front of him or her.

8. Be patient!

Communicating with childrenCommunicating with children

• Children can be difficult patients.

A. Practice skills to help improve these interactions.

B. Fear is cause severe anxiety in children.

• Children may be fearful by:

A. Your uniform.

B. The ambulance.

C. A crowd of people gathered around them.

• Let a child keep a favorite toy, doll, security blanket.

• If possible, have a family member or friend nearby.

– If practical, let parent hold child during evaluation and treatment.

Communicating with childrenCommunicating with children

• 1. Children:

1. Maintain friendly eye contact.

2. Smile.

3. Give calm, and reassurance.

4. Minimize movements.

5. Lower your voice.

6. Keep eye level at or below child’s.

7. Be honest.

• If possible, involve a parent with the care of a small child.

Special Considerations of AgeSpecial Considerations of Age

• 2. For young children:

Toys may be useful.

Create a toy to connect

with the child

• 3. Adolescents:1. May not want their

parents present.

• An adult who assists on monitoring.

• Do not refuse, but

inform ED physician.

2. Offer options; honor their choices.

3. Modesty is especially important.

Communicating with hearing impaired


• Patient who are hearing impaired are usually have disability.

• It is the people around a hearing impaired person who have problems coping.



• Remember the following five steps to efficiently communicate with patients who are hearing impaired

• 1. Have paper and a pen available.

• 2. If patient can read lips, you should face the patient and speak slowly.

• 3. Never shout.

• 4. Be sure to listen carefully, ask short question, and give short answer.

Communicating with visually impaired

Communicating with visually impaired

• Like hearing impaired patients.

• Remember the following steps to efficiently communicate with patients who are visually impaired.

1. Explain every thing you are doing in detail.

2. Be sure to stay in physical contact with the patient.

3. Transport any mobility aids as stick.

Communicating with non English speaking

Communicating with non English speaking

1. First step is to find out how much English the patient can peak.

2. Use short , simple question and simple words.

3. If the patient doesn’t speak any English , find a family member to act interpreter.

4. Avoid use medical terms.

Medical terms are mainly derived from Latin.

Integrates comprehensive anatomic and

medical terminology and abbreviations into

written and oral communication with colleagues

and other health care professionals.

MEDICAL TERMINOLOGY IN EMS MEDICAL TERMINOLOGY IN EMS

Common Medical Terminology in EMS

Common Medical Terminology in EMS

Term meaning

An Without

Algia Pain

Brady Slow

Tachy Fast

Neuro Nerve

hyper Above

hypo under

NEW TECHENOLOGY IN EMS NEW TECHENOLOGY IN EMS

1. Used to collect and exchange patient information electronically.

2. Reduces dependence on traditional means of verbal and written documentation.

3. May allow "real-time catch" of events and information.

4. Integrated with diagnostic technology.

5. May influence role of medical direction. Advanced notification. Save time in-hospital for diagnosis and therapy.

NEW TECHENOLOGYNEW TECHENOLOGY

• Legal-status electronic medical report

A. Same status as written documentation.

B. May not have a "paper record" of incident.

C. Security safeguards must be in place.

EMS Communications Systemand Equipment

EMS Communications Systemand Equipment

• Radio and telephone communication link you and your team with other members of the EMS.

• This link helps the team to work together more effectively, provides safety and protection for each member of the team.

• You must be able to use your system efficiently and effectively.

• You must be able to send, accurate reports about scene, the patients condition and treatment provide

Communications Systems and Equipment

Communications Systems and Equipment

1. Base station radios.

2. Mobile and portable radios.

3. Repeater-based systems.

4. Digital equipment.

5. Cellular/satellite telephones.

6. Other equipment.

Communication System Equipment

1. Base station:

a) the dispatcher usually communicates with field units by transmitting through a fixed radio base station that is controlled from the dispatch center.

b) Base station: defined is any radio hardware containing transmitter and receiver that is located in a fixed place.

c) base station may inculde dispatch centers , fire stations, ambulance bases, or hospitals.

d) A two- way radio consists of two units: transmitter and receiver.



2. Mobile and potable radio: is built up in ambulance

• Used to communicate with:

Dispatcher Medical controlAn ambulance will often have more than mobile

radio, each on a different frequency.

• One radio may be used to communicate with the dispatcher or other public safety agencies

• A second radio is often used for communicating patient information to medical control.

Communication System Equipment Communication System Equipment

3. Repeater based systems

• is a special base station radio receives massage and signals on one frequency and then automatically retransmits them on a second frequency.

Advantages of repeaters

1) Permits communication over a large area.

2) Allows flexibility in areas with abnormal land.

3) Assures better communication.

4) Weak transmissions will be heard.

5) A repeater is able to receive low-power signals.


4. Digital Equipment:

a) Digital signals are also apart of EMS communication

b) Voice is not the only EMS communication.

c) Some EMS systems use telemetry to send an

electrocardiogram from the unit to the hospital.

d) Electronic signals are converted into coded.

e) Example: of telemetry is a fax message.

f) Digital signals are faster than spoken words and allow more

choices and flexibility.

Communication System EquipmentCommunication System Equipment

5. Cellular/Satellite Telephones:

A. Cellular phone: (Be familiar), Simply low-power portable radios.

B. Satellite phones (sat phones) are another option, this phone use Satellite

Advantage of cellular/satellite telephones:

i. Know the location of dead spots.

ii. Used for large areas.

iii. Receives weak transmissions and relays to base station

6. Other communication equipment.

Communication System EquipmentCommunication System Equipment

Portable Base station

Repeater

Digital

Modes of Radio OperationModes of Radio Operation

1. Simplex: Uses one frequency to either transmit or receive. ( push to talk , release to listen) mode

2. Duplex: Uses two frequencies to transmit and receive together. ( talk and listen) mode

3. Multiplex: Combines signals to transmit together

on one frequency.

4. Digital radio: helps clear up lost transmissions.

5. Digital trunked radios: have channels related by

groups.

Radio CommunicationsRadio Communications

• The Federal Communications Commission (FCC)

regulates all radio operations in the United States.

• The FCC has five principal EMS include:-

1. Allocates specific radio frequencies for use by

EMS provider.

2. Licenses base station and assigning appropriate

radio call signs for those station.

An FCC license is usually issued for 5 years.

Radio CommunicationsRadio Communications

3. Establishes licensing standards and operating

specifications for radio equipment.

4. Establishes limitations for transmitter power

output.

FCC regulates power to reduce radio interference

between communication system.

5. Monitors radio operations

DispatchDispatch

Definition of dispatch: The process of

sending prehospital care (Emergency Medical

Services or EMS) vehicles and personnel to

respond to requests for medical aid.

Involves personnel, facilities, vehicles, and communications.

DispatchDispatch

• Is a vital part of the paramedic team:

1. Obtains as much information as possible.

2. Directs appropriate vehicle(s) to the scene.

3. Provides caller with information.

4. Monitors and coordinates communication.

5. Maintains written records.

Dispatcher ResponsibilitiesDispatcher Responsibilities

The dispatcher has several important responsibilities:-

1. Answer the telephone immediately.

2. Identify himself or herself and the agency.

3. Speak directly into the mouthpiece. (speaker)

4. Observe telephone instructions.

5. Take charge of the conversation.

Information Received from DispatchInformation Received from Dispatch

• Information which crew/vehicle to dispatch.– Depends on:

1. Nature and severity of injury, illness, or incident.

2. Location of incident.

3. Number of patients.

4. Responses by other agencies.

5. Special information.

6. Time dispatched.

Communicating With DispatchCommunicating With Dispatch

1. Report any problems during run.

2. Advise of arrival.

3. Communicate scene size-up.

4. Keep communications brief.

Giving the patient reportGiving the patient report

• The report commonly includes seven elements:

1- Your unit identification and level of services e.g. BLS.

2. The receiving hospital and your estimated time of arrival.

3. Patient Age and gender.

4. Patient’s chief complaint

5.A brief history of present problem.

6. A brief report of physical findings.

7.A brief summary of the care given and any patient response.

Relaying Information to Medical Control

Relaying Information to Medical Control

• Communications with

medical control should be

concise and accurate.

Use a standard format.

• Different methods as

Know protocol.

Special Interview SituationsSpecial Interview Situations

Some situations require special techniques.

Difficult patients are especial.

General tips for caring for difficult patients:-1. Be carful , maintain eye contact.

2. Introduce yourself; ask for the patient’s name.

3. Use open-ended questions.

4. Provide positive feedback.

5. Make sure patient understands you.

6. Continue to ask questions; rephrase if necessary.

7. Use patience, persistence.

People Who Are Hostile (inimical)People Who Are Hostile (inimical)

• Additional tips include:

1. Identify escape routes.

2. Be carful.

3. Ask permission to interact with the patient.

4. Be wary for signs of impending attack.

5. Be prepared to escape if necessary.

Assessing Mental StatusAssessing Mental Status

• Mental status is often indicator of the illness or injury.

• AVPU is one of the rapid ways to asses:-

1. A: Alert to person, place, and day.

2. V: Verbal response.

3. P: Pain response.

4. U: Unresponsive.

Sexually Aggressive PatientsSexually Aggressive Patients

1. Follow your agency’s policies.

2. Make sure someone is always present.

3. Communicate professionally and politely.

Avoid sexually unclear words.

4. Document your interview.

Get witness names and signatures on notes.

Documents

EMS Communications Power point presented by Dr. Samah Mohammed Power point presented by Dr. Samah Mohammed