1 EMS COMMUNICATIONS

2 Objectives Phases of Communication Role of Communications in EMS Basic Model of Communication Communication Systems Role of Dispatch Radio Communication

3 EMS COMMUNICATION LINKS Sequence of EMS event Occurrence of event Occurrence of event Detection of event Detection of event Notification and response of emergency personnel Notification and response of emergency personnel Treatment and preparation of patient for transport Treatment and preparation of patient for transport Transport and delivery of patient to receiving facility Transport and delivery of patient to receiving facility Preparation for next event Preparation for next event

4 COMMUNICATION LINKS Notification of EMS systems 9-1-1, E , E Radio report from another agency Radio report from another agency

5 COMMUNICATION LINKS Notification of response personnel Direct telephone link to crews Direct telephone link to crews Radio dispatch of crews Radio dispatch of crews Pagers Pagers Computer aided dispatch Computer aided dispatch

6 COMMUNICATION LINKS Intermediate to medical control Patient report from field to hospital Patient report from field to hospital Direct communication at hospital Direct communication at hospital Detailed verbal report Detailed written report

7 COMMUNICATION LINKS Notification of return to service Ambulance restocked, cleaned, refueled Ambulance restocked, cleaned, refueled Infection control procedures Infection control procedures

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10 What effects communication? Attributes of the receiver Cultural differences Cultural differences Language Barriers Language Barriers Age Age Attitude AttitudeResponderDispatcher

11 Selective Perception Block out other information Block out other information Selective hearing Selective hearing Semantic Problems Words may have different meaning Words may have different meaningComatose Time pressure Message gets distorted Message gets distorted Bypass normal communication channels Bypass normal communication channels

12 COMMUNICATION SYSTEMS: Simple Desk top radio Desk top radio Portable Portable Microphone and antenna Microphone and antennaComplex High-power transmitters High-power transmitters Repeaters Repeaters Satellite Receivers Satellite Receivers

13 TECHNICAL ASPECTS Base station Located in High spots Located in High spots Principal transmitter and receiver for system Principal transmitter and receiver for system 45 to 275 watts set by FCC 45 to 275 watts set by FCC Multiple-channel capabilities Multiple-channel capabilities

14 TECHNICAL ASPECTS Mobile two-way radios Vehicular mounted, 20 to 50 watts Vehicular mounted, 20 to 50 watts Range can depend on terrain Range can depend on terrain Multiple channel capabilities Multiple channel capabilities Biotelemetry capabilities Biotelemetry capabilities

15 TECHNICAL ASPECTS Portable radios Hand-held, 1 to 5 watts, often used with repeaters Hand-held, 1 to 5 watts, often used with repeaters Multiple channel capabilities Multiple channel capabilities

16 TECHNICAL ASPECTS Repeater systems Receives weak signal and rebroadcasts at higher power Receives weak signal and rebroadcasts at higher power Important for large geographical areas Important for large geographical areas Can be vehicular mounted Can be vehicular mounted

17 TECHNICAL ASPECTS Advantages of repeaters Permits communication over a large area Permits communication over a large area Allows flexibility in areas with abnormal terrain Allows flexibility in areas with abnormal terrain Assures better communication Assures better communication Weak transmissions will be heard Weak transmissions will be heard

18 TECHNICAL ASPECTS Remote consoles Operation of base station from another location Operation of base station from another location Use telephone lines or microwave links Use telephone lines or microwave links

19 TECHNICAL ASPECTS Satellite receivers Used for large areas Used for large areas Receives weak transmissions and relays to base station Receives weak transmissions and relays to base station

20 TECHNICAL ASPECTS Encoders and decoders Encoders activate decoders by sending out specific tones over the air Encoders activate decoders by sending out specific tones over the air Decoders activated by the signal Decoders activated by the signal

21 TECHNICAL ASPECTS Mobile telephones Cellular technology is now cost-effective Cellular technology is now cost-effective Capability to send biotelemetry Capability to send biotelemetry Dedicated lines for the EMT-I Dedicated lines for the EMT-I Digital Modes Computers Data Access Data Access Send out information Send out information

22 RADIO COMMUNICATIONS

23 RADIO WAVE TRANSMISSION Amplitude modulation - AM Modifies radio transmission by varying the amplitude of the signal Modifies radio transmission by varying the amplitude of the signal Poor quality, good range Poor quality, good range

24 RADIO WAVE TRANSMISSION Frequency modulation - FM Modifies radio transmission by varying the frequency of the signal Modifies radio transmission by varying the frequency of the signal Good quality, poor range Good quality, poor range

25 FREQUENCIES Hertz (Hz) The number of cycles per second in a radio signal The number of cycles per second in a radio signal 1 Hz = 1 cycle per second; 1 Kilohertz (KHz) = 1,000 cycles per second 1 Hz = 1 cycle per second; 1 Kilohertz (KHz) = 1,000 cycles per second 1 Megahertz (MHz) = 1,000,000 cycles per second 1 Megahertz (MHz) = 1,000,000 cycles per second 1 Gigahertz (GHz) = 1,000,000,000 cycles per second 1 Gigahertz (GHz) = 1,000,000,000 cycles per second Most radio communications are 100 KHz to 3,000 GHz Most radio communications are 100 KHz to 3,000 GHz

26 FREQUENCIES Band A small segment of the total frequency spectrum A small segment of the total frequency spectrum Public safety bands Public safety bands VHF low band - 30 MHz to 50 MHz VHF high band MHZ to 170 MHz UHF MHz to 470 MHz New MHz

27 FREQUENCIES Trunking Computerized allocation of frequencies Computerized allocation of frequencies Eliminates need to find open frequency Eliminates need to find open frequency

28 FREQUENCIES Med channels Duplex pairs designed for ALS Duplex pairs designed for ALS Channels 1-8 for Intermediate to physician Channels 1-8 for Intermediate to physician Channels 9-10 for EMS dispatching purposes Channels 9-10 for EMS dispatching purposes

29 BIOTELEMETRY The process of transmitting physiological data, such as ECG, over the radio A modulator electrically translates voltage changes (ECG) into sound waves The telemetry radio has a modulator The telemetry radio has a modulator A demodulator translates sound waves back into voltage changes The hospital base station has a demodulator The hospital base station has a demodulator

30 BIOTELEMETRY Common causes of interference in biotelemetry communications Loose electrodes Loose electrodes Muscle tremors Muscle tremors 60 Hz interference and power fluctuations 60 Hz interference and power fluctuations Voice over EKG Voice over EKG

31 TRANSMISSION TYPES Simplex The ability to transmit or receive only at one time The ability to transmit or receive only at one time One frequency used One frequency used Most organizational communications are simplex Most organizational communications are simplex

32 TRANSMISSION TYPES Duplex Transmit and receive simultaneously using two separate frequencies Transmit and receive simultaneously using two separate frequencies Either party can interrupt the other during transmission Either party can interrupt the other during transmission

33 TRANSMISSION TYPES Multiplex Transmit voice and EKG simultaneously over the same frequency Transmit voice and EKG simultaneously over the same frequency Allows the Paramedic to talk while sending an EKG strip Allows the Paramedic to talk while sending an EKG strip

34 EQUIPMENT MAINTENANCE EMS communications equipment is fragile and expensive Proper care and maintenance are important for long life Avoid mishandling Schedule regular cleaning Have equipment repaired by a qualified technician Keep batteries charged and spares ready

35 RULES AND OPERATING PROCEDURES

36 THE FEDERAL COMMUNICATIONS COMMISSION Licenses agencies and transmitters Allocates frequencies for use Establishes technical standards for hardware Licenses personnel Monitors frequencies for proper use Conducts site checks

37 DISPATCH PROCEDURES The EMS dispatcher Obtains information Obtains information Directs appropriate agency Directs appropriate agency Monitors and coordinates communications Monitors and coordinates communications Gives pre-arrival instructions Gives pre-arrival instructions Maintains written records Maintains written records Manages systems resources Manages systems resources

38 RADIO CODES Communicate a large amount of information quickly Allows for confidentiality Ten-code system ( Not so much anymore) Using standard Plain English

39 RADIO COMMUNICATION TECHNIQUES Listen before talking, press and wait Speak at close range, slowly and clearly Avoid emotion Be brief and do not waste air time Protect patient privacy Avoid slang, profanity, use standard formats Repeat all orders, confirm message received Write down specific information

40 COMMUNICATION OF MEDICAL INFORMATION

41 VERBAL COMMUNICATION OF PATIENT INFORMATION Agency, unit designation, Intermediate name, and level of certification Scene description/mechanism of injury Patient’s age, sex, and weight Chief complaint Primary problem Associated symptoms Brief history of present illness

42 VERBAL COMMUNICATION OF PATIENT INFORMATION Past medical history Vital signs; level of consciousness; general appearance; glucose testing; any pertinent physical exam findings Treatment rendered and request for further treatment ETA Private physician’s name

43 GUIDELINES/COMMUNICATING WITH MED CONTROL PHYSICIAN Give an accurate and complete report Provide whatever information requested by physician Repeat orders and question unclear orders Report back and keep physician informed Protect patient privacy Consult and seek advice in unusual situations

44 WRITTEN COMMUNICATIONS Record patient’s initial condition and care Becomes legal record of pre-hospital care Information for billing, chart audits Document patient’s refusal of care Defense against malpractice

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