Power point presented by Chapter 5 EMS Communications Power point presented by Dr. Samah Mohammed

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

INTRODUCTION 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 System Communication needed to: Definition of communication: The process of exchanging information between individuals. EMS System Communication needed to: Call for resources. Transfer care of the patient. Interact within the team structure. Communication with other health care professionals Team communication and dynamics

ROLE OF COMMUNICATION IN Ems

ELEMENTS OFCOMMUNICATION Sender: The person Who Putting message in an understandable format. Message: Information sent or expressed by sender Channel: The medium through which a channel is transmitted. Receiver: Is the person who receives and interprets the sender’s message. 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. .

Codes Everyone must learn them. Some EMS services use radio codes to: Maintain security. Keep airtime brief. Prevent patient from understanding what is being said. To be effective: Everyone must learn them. Codes should be: Simple and standardized Posted

Clarity of Transmission Basic model of communication Sender 2. Clear message Channel 3. Receiver 5. Feedback Communications equipment is designed to permit communication. Many guidelines can improve clarity, such as: Make sure the channel is clear. Speak clearly and distinctly. Keep calm and free of emotion. Keep transmissions brief.

Content of Transmissions Guidelines include: Protect the patient’s privacy at all times. Be impersonal. Use clear text. Question orders you did not hear/ but understand.

TYPES OF COMMUNICATION

TYPES OF COMMUNICATION

Factors to Improve Communication Use simple language. Show/ draw pictures. Limit the amount of information provided & repeat it. Produce/ use easy-to-read written material. Confirm the patient’s understanding. Create good environment. Address the needs of patients with disabilities.

Importance of communication in EMS 1 Achieve a positive relationship with patients and emergency team. 2 Transfer the patient’s care to physicians at hospital. 3 Collaborate effectively with the emergency team. 4 Get and give information. 5 Communicate problems and solutions 6 Improve patient safety and quality of healthcare.

Therapeutic 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 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 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.

Therapeutic 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. Make and keep eye contact at all times. Provide your name and use patient’s proper name. Tell patient the truth.

Therapeutic Communication Use language the patient can understand. Be careful what you say about patient to others. Be aware of your body language. Speak slowly, clearly especially patient as the hearing-impaired patient. Allow the patient time to answer. Act and speak in a calm, confident manner.

Therapeutic Communication Try hard not to shout: Reduce noise when possible. Move the patient to a quiet area. 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 Use the following tools: Reflection Repeat a word or phrase a patient used to encourage more detail. Interpretation Vocalize what you think the patient said, and have him or her correct you. Facilitation Encourage hesitant ( uncertain) patients to provide more detail.

Communication Tools There are many powerful communication tools that EMTs:- Silence Empathy Simplification summarization Clarification Redirection Explanation

Communication With other Health Care Professionals Effective communication between EMT and health care professional must be effective, efficient, and appropriate. Your reporting responsibilities do not end when you arrive at the hospital. Give oral report to hospital staff member who has at least your level of training. Oral report components:

Communication With other Health Care Professionals The following six component must be included in the oral report. 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

Communication With other Health Care Professionals The patient response to treatment Initial treatment that provided Vital signs Assess during transport. Other information Information gathered during transport ( medication )

Communicating 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 patients Old patients: Identify yourself. Look directly at patient. Speak slowly and clear Explain what you are going to do before you do it. Listen to the answer the patient gives you. Show the patient respect. Do not talk about the patient in front of him or her. Be patient!

Communicating with children Children can be difficult patients. Practice skills to help improve these interactions. Fear is cause severe anxiety in children. Children may be fearful by: Your uniform. The ambulance. 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 children Maintain friendly eye contact. Smile. Give calm, and reassurance. Minimize movements. Lower your voice. Keep eye level at or below child’s. Be honest. If possible, involve a parent with the care of a small child.

Special Considerations of Age 3. Adolescents: May not want their parents present. An adult who assists on monitoring. Do not refuse, but inform ED physician. Offer options; honor their choices. Modesty is especially important. 2. For young children: Toys may be useful. Create a toy to connect with the child

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.

Communicating with hearing impaired 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 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 First step is to find out how much English the patient can peak. Use short , simple question and simple words. If the patient doesn’t speak any English , find a family member to act interpreter. Avoid use medical terms.

MEDICAL TERMINOLOGY IN EMS 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.

Common Medical Terminology in EMS meaning An Without Algia Pain Brady Slow Tachy Fast Neuro Nerve hyper Above hypo under

NEW TECHENOLOGY IN EMS Used to collect and exchange patient information electronically. Reduces dependence on traditional means of verbal and written documentation. May allow "real-time catch" of events and information. Integrated with diagnostic technology. May influence role of medical direction. Advanced notification. Save time in-hospital for diagnosis and therapy.

NEW TECHENOLOGY Legal-status electronic medical report Same status as written documentation. May not have a "paper record" of incident. Security safeguards must be in place.

EMS Communications System and 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 Base station radios. Mobile and portable radios. Repeater-based systems. Digital equipment. Cellular/satellite telephones. Other equipment.

Communication System Equipment Base station: the dispatcher usually communicates with field units by transmitting through a fixed radio base station that is controlled from the dispatch center. Base station: defined is any radio hardware containing transmitter and receiver that is located in a fixed place. base station may inculde dispatch centers , fire stations, ambulance bases, or hospitals. A two- way radio consists of two units: transmitter and receiver.

Communication System Equipment 2. Mobile and potable radio: is built up in ambulance Used to communicate with: Dispatcher Medical control An 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 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 Permits communication over a large area. Allows flexibility in areas with abnormal land. Assures better communication. Weak transmissions will be heard. A repeater is able to receive low-power signals.

Communication System Equipment 4. Digital Equipment: Digital signals are also apart of EMS communication Voice is not the only EMS communication. Some EMS systems use telemetry to send an electrocardiogram from the unit to the hospital. Electronic signals are converted into coded. Example: of telemetry is a fax message. Digital signals are faster than spoken words and allow more choices and flexibility.

Communication System Equipment 5. Cellular/Satellite Telephones: Cellular phone: (Be familiar), Simply low-power portable radios. Satellite phones (sat phones) are another option, this phone use Satellite Advantage of cellular/satellite telephones: Know the location of dead spots. Used for large areas. Receives weak transmissions and relays to base station 6. Other communication equipment.

Communication System Equipment Base station Portable Repeater Digital

Modes of Radio Operation Simplex: Uses one frequency to either transmit or receive. ( push to talk , release to listen) mode Duplex: Uses two frequencies to transmit and receive together. ( talk and listen) mode Multiplex: Combines signals to transmit together on one frequency. Digital radio: helps clear up lost transmissions. Digital trunked radios: have channels related by groups.

Radio Communications The Federal Communications Commission (FCC) regulates all radio operations in the United States. The FCC has five principal EMS include:- Allocates specific radio frequencies for use by EMS provider. Licenses base station and assigning appropriate radio call signs for those station. An FCC license is usually issued for 5 years.

Radio Communications Establishes licensing standards and operating specifications for radio equipment. Establishes limitations for transmitter power output. FCC regulates power to reduce radio interference between communication system. Monitors radio operations

Dispatch 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.

Dispatch Is a vital part of the paramedic team: Obtains as much information as possible. Directs appropriate vehicle(s) to the scene. Provides caller with information. Monitors and coordinates communication. Maintains written records.

Dispatcher Responsibilities The dispatcher has several important responsibilities:- Answer the telephone immediately. Identify himself or herself and the agency. Speak directly into the mouthpiece. (speaker) Observe telephone instructions. Take charge of the conversation.

Information Received from Dispatch Information which crew/vehicle to dispatch. Depends on: Nature and severity of injury, illness, or incident. Location of incident. Number of patients. Responses by other agencies. Special information. Time dispatched.

Communicating With Dispatch Report any problems during run. Advise of arrival. Communicate scene size-up. Keep communications brief.

Giving 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 Communications with medical control should be concise and accurate. Use a standard format. Different methods as Know protocol.

Special Interview Situations Some situations require special techniques. Difficult patients are especial. General tips for caring for difficult patients:- Be carful , maintain eye contact. Introduce yourself; ask for the patient’s name. Use open-ended questions. Provide positive feedback. Make sure patient understands you. Continue to ask questions; rephrase if necessary. Use patience, persistence.

People Who Are Hostile (inimical) Additional tips include: Identify escape routes. Be carful. Ask permission to interact with the patient. Be wary for signs of impending attack. Be prepared to escape if necessary.

Assessing Mental Status Mental status is often indicator of the illness or injury. AVPU is one of the rapid ways to asses:- A: Alert to person, place, and day. V: Verbal response. P: Pain response. U: Unresponsive.

Sexually Aggressive Patients Follow your agency’s policies. Make sure someone is always present. Communicate professionally and politely. Avoid sexually unclear words. Document your interview. Get witness names and signatures on notes.

Thank you