© 2011 National Safety Council 4-1 COMMUNICATION LESSON 4

© 2011 National Safety Council 4-2 Introduction Effective communication ensures critical resources reach the scene as quickly as possible Clear communication with patients necessary to make correct assessments and provide treatment

© 2011 National Safety Council 4-3 Communication Within the EMS System Calls to and from dispatch or medical direction Verbal communication with other EMS personnel Verbal communication at the scene with law enforcement and other responders Written communication (documentation)

© 2011 National Safety Council 4-4 Factors That Make Communication Difficult Noise and other distractions at the scene Multiple people talking at once Stress Emotional patients, family members and bystanders

© 2011 National Safety Council 4-5 Principles of Communication Maintain professionalism to build trust Maintain confidentiality Speak in plain English and avoid slang Use medical language only when it is correct Use exact, specific words Make eye contact Speak calmly Control your body language Be a good listener

© 2011 National Safety Council 4-6 Communication from the Dispatcher Nature of the call and severity of problem Name, location and callback number of the caller requesting assistance Number and location of patient(s) Other pertinent information

© 2011 National Safety Council 4-7 Radio and Telephone Communication Speak slowly and clearly on the radio Be concise and use the radio only as needed Remember that others may be listening and maintain confidentiality Ask dispatcher to repeat information if you are unsure Stay in communication with dispatch Report any delay in reaching the scene Alert dispatch when you arrive Report any observed hazards or needs for additional resources Follow your local protocol for reporting in

© 2011 National Safety Council 4-8 Transferring Care of Patient Give patient information that other responders do not know Continuing patient care depends on your clear, detailed communication

© 2011 National Safety Council 4-9 Verbal Report to Responders The patient’s current condition The patient’s age and sex if not apparent The chief complaint A brief history of what happened The patient’s condition as found

© 2011 National Safety Council 4-10 Verbal Report to Responders (continued) Relevant information from the history The patient’s vital signs Relevant information from your physical examination The treatment you have provided and the patient’s response

© 2011 National Safety Council 4-11 Importance of Documentation Prehospital patient care report used by those continuing care The report provides a permanent record Documentation is a legal record: “If it’s not documented, it wasn’t done” Documentation provides legal evidence of standards of care Documentation often used in research to improve patient care

© 2011 National Safety Council 4-12 Principles of Documentation Complete all documentation as soon as possible Focus on factual, objective information Identify sources of subjective information Be as specific and detailed as possible with clinical data With handwritten documentation, write clearly If you make an error, correct it properly With computerized documentation, maintain passwords and protect confidential patient information Follow all local procedures

© 2011 National Safety Council 4-13 Information in the Call Report Time of events Assessment findings Emergency medical care provided Patient changes after treatment Other observations at the scene Patient disposition

© 2011 National Safety Council 4-14 Medical Terminology Understand basic medical and anatomical terms Medical terms are more precise Use medical terms only when you are certain of their precise meaning

© 2011 National Safety Council 4-15 Principles of Medical Terminology Most medical terms are based on Greek or Latin words Many terms are composed of 2 or more parts Prefix + Root + Suffix -Hypothermia (below normal body temperature) hypo – prefix (being below or low) therm/o – root (referring to temperature) -ia – suffix (referring to a condition)

© 2011 National Safety Council 4-16 Patient Communication Much needed information comes from responsive patients Clear, effective communication is needed With unresponsive patients, information from others is critical Pain, discomfort and emotions make communication difficult Therapeutic communication includes a caring attitude and reassurance

© 2011 National Safety Council 4-17 Effective Communication with Patients Maintain professionalism Speak in plain English Use exact, specific words Make eye contact Speak calmly Control your body language Be a good listener

© 2011 National Safety Council 4-18 Guidelines for Patient Communication Introduce yourself and other EMS personnel Politely ask the patient’s name and use it respectfully Ask for permission to provide care Be reassuring and calming For patients in a behavioral crisis use calming methods Be honest with the patient Maintain patient privacy Respect cultural differences Try not to invade the patient’s personal space Position your face at the same level as the patient’s

© 2011 National Safety Council 4-19 Guidelines for Patient Communication (continued) Control communication barriers Use active listening skills Paraphrase what the patient tells you Give the patient time to speak Tell the patient before touching his or her body Explain what you are about to do Pay attention to patient’s body language Write notes about significant information Use the same principles of effective communication to speak with family members

© 2011 National Safety Council 4-20 Barriers to Communication Environmental distractions: -Noise -Bright lights or poor lighting -Medical equipment Interference by others Discomfort, pain Lack or privacy or personal space

© 2011 National Safety Council 4-21 Barriers to Communication (continued) Inattention to body language Cultural differences Language differences Visual or hearing impairments Judgmental attitude

© 2011 National Safety Council 4-22 Interviewing Techniques Ask open-ended questions to gain information Use closed-ended or direct questions for specific additional information Ask only one question at a time Give the patient time to answer Use language the patient will understand Observe closely that patient understands what you are asking

© 2011 National Safety Council 4-23 Avoid During the Patient Interview Don’t offer false assurance that everything will be OK Don’t give advice Don’t ask leading or biased questions Don’t talk too much yourself Don’t interrupt the patient Don’t ask why the patient did what he or she did Don’t be judgmental

© 2011 National Safety Council 4-24 Patients with Hearing Impairments If in doubt, first ask if the person can hear you If the patient uses a hearing aid, assist in locating or using it Speak slowly and carefully, facing the patient who may read lips Communicate with gestures and touch Point to body areas and at equipment, pantomiming what will be done

© 2011 National Safety Council 4-25 Patients with Hearing Impairments (continued) Involve family members Eye contact is especially important Do not shout or treat the patient like a child For essential communication, write down simple phrases on a pad of paper

© 2011 National Safety Council 4-26 Patients with Visual Impairments If in doubt, first ask if the person can see you well If the patient uses eyeglasses or other aids, assist in locating them Allow the patient’s guide dog to stay Involve family members Always tell the patient before you will touch him or her

© 2011 National Safety Council 4-27 Patients with Visual Impairments (continued) Describe what is happening around the patient Identify unusual sounds or other stimuli Avoid long periods of silence when the patient may fear being left alone

© 2011 National Safety Council 4-28 Patients for Whom English Is a Second Language First ask if patient speaks English (or a language you know) Involve family members or an interpreter Speak slowly and in simple words and phrases Communicate with gestures and touch Point to body areas and at equipment, pantomiming what will be done Some people may not admit not understanding If people in your area speak another language, take a conversational language course