Communication, Documentation and Scene Safety S-SV EMS MICN Course Module 3 Communication, Documentation and Scene Safety S-SV EMS Agency MICN Training (Updated 12-2018)

Communication and Documentation Procedures S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications EMS Communications Are Utilized To: Dispatch EMS resources Provide online medical control Medical consultation Pt. destination consultation Pt. refusal of EMS treatment/transport consultation Receiving hospital notification and pt. reporting Control Facility (CF) patient distribution during an MCI S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications EMS Communication Methods UHF radio (Mednet) VHF radio 800 MHz radio Amateur radio (ham radio) Blast phone/landline Cellular telephone EMResource *Not all EMS communication methods are utilized by all hospitals S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications EMS Dispatch Receives/processes information Emergency Medical Dispatch (EMD) used by some agencies Determines/assigns resources Medical Priority Dispatch System (MPDS) used by some agencies Relays information to appropriate entities (EMS resources, hospitals, other dispatch centers, etc.) S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Communication Rules FCC rules/radio etiquette apply to hospitals and EMS providers Utilize clear text No profanity Maintain professionalism S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Radio Communication Etiquette When utilizing any radio system, you must identify yourself Goal is to convey information in a clear, concise and accurate manner Avoid turning the receiver volume too low (incoming calls may be missed) Think ahead, keep transmissions short and to the point to minimize airtime S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Radio Communication Etiquette (cont.) Listen to the radio channel and ensure it is clear before beginning transmission Press Push To Talk (PTT) button on the radio and wait one second before speaking Speak with your mouth about 2 – 3 inches away from the microphone S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Radio Communication Etiquette (cont.) Speak distinctly, at a moderate rate Use plain language to describe a particular condition/event Avoid words that are difficult to hear like “yes” and “no”, instead use “affirmative” and “negative” Close the conversation appropriately so both parties are clear that the communication has ended S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Radio Communication Etiquette (cont.) When answering the radio, state: Unit number of who is calling Base hospital name Current time (military time) Your name (last name) “go ahead” Example – “Medic 2 this is Mercy Redding, your time is 1530. This is MICN Smith, go ahead” S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Cellular Telephone Communication Preferred method by many prehospital personnel Readily available Easy to converse More secure form of communication vs radio Follow the same communication rules/etiquette as with the radio S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Prehospital Pt. Report Be ready to answer the call and listen carefully Review the information provided Did you receive enough information to prepare for the pts. arrival? If more information is needed, ask pointed/clarifying questions Keep conversation concise S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Medical Consultation – Refusal of EMS Care The following pts. refusing EMS care require base hospital consultation by prehospital personnel: New altered LOC Potentially life threatening condition, including but not limited to, pts meeting STEMI, stroke, or trauma triage criteria Unstable vital signs Disagreement between law enforcement and EMS personnel about whether or not the pt. requires EMS care S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Medical Consultation – Refusal of EMS Care (cont.) A pt. not legally responsible for their own healthcare being released to self or another individual on scene who is not their legally designated healthcare decision maker Any other circumstance where EMS personnel believe that the involvement of the base hospital would be helpful Pt. refusal consultation can normally be completed by an MICN, but may require physician consultation if there are concerns for the pts safety S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Medical Consultation – Pt. Destination EMS personnel are required to consult with the base hospital for destination of the following pts: Trauma pts: Mechanism of injury trauma criteria Special considerations trauma criteria if they believe that a trauma center is the most appropriate destination Adults meeting Anatomic &/or Physiologic Trauma Triage Criteria if a level III trauma center is closest Pediatrics meeting Anatomic &/or Physiologic Trauma Triage Criteria if > 45 minutes to UCDMC or patient is too critical S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Medical Consultation – Pt. Destination (cont.) Other: Burn pts meeting destination consultation criteria VAD pts Pts requesting transport to a further facility when ALS care has been established and they do not meet criteria for transport directly to a specialty care center Suspected STEMI pts > 45 minutes from a STEMI receiving center or not confirmed by 12-lead ECG computer readout Suspected stroke pts > 45 minutes from a stroke receiving center S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Medical Consultation – General If prehospital personnel believe they need to do something that is not in their protocol, or are not sure what to do, they can ask for a medical consultation If prehospital personnel ask for a medical consultation, provide them a physician as quickly as possible If you believe that prehospital personnel should be doing something different than what the protocol outlines, quickly obtain a physician consult S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Additional Communication Notes The airways are public and radio scanners are popular – EMS communications may be overheard by more than just the EMS community All radio and cellular telephone communications are recorded for QI and liability purposes S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) EMS Communications Radio Communication Examples (Insert base hospital specific audio recording examples here) S-SV EMS Agency MICN Training (Updated 12-2018)

S-SV EMS Agency MICN Training (Updated 12-2018) Documentation Documentation Requirements Base hospital specific documentation/logs are required to be completed by the MICN for all prehospital pt. reports and medical consultations Follow hospital procedures for submitting/ maintaining completed MICN documentation Prehospital documentation requirements: Interim patient care report – left at receiving hospital Electronic PCR – completed within 24 hours S-SV EMS Agency MICN Training (Updated 12-2018)

Prehospital EMS Scene Safety S-SV EMS Agency MICN Training (Updated 12-2018)

Prehospital EMS Scene Safety Primary concern of EMS responders Determination of safety is based on information provided by dispatch as well as scene observations GSW/stabbing/unsecure scene/hazardous materials incident ‘Staging’ off scene may be necessary until cleared by law enforcement or other appropriate first responders (fire department, Haz Mat team, etc.) S-SV EMS Agency MICN Training (Updated 12-2018)

Prehospital EMS Scene Safety Goal is to ensure safety of responders, patients and bystanders Scene safety issues may delay patient contact, treatment, transport, and/or base hospital notification S-SV EMS Agency MICN Training (Updated 12-2018)

Prehospital EMS Scene Safety S-SV Active Shooter/Mass Violence Policy (834) Establishes guidelines for EMS response to an active shooter/mass violence events Concept of properly trained and equipped medical personnel escorted by law enforcement into areas of mitigated risk (cleared but not secured), to execute triage, medical stabilization at the point-of-wounding, and provide for evacuation or sheltering in place S-SV EMS Agency MICN Training (Updated 12-2018)