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

2. Communication and Documentation Procedures
S-SV EMS Agency MICN Training (Updated )

3. S-SV EMS Agency MICN Training (Updated 07-2017)
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 )

4. S-SV EMS Agency MICN Training (Updated 07-2017)
EMS Communications
EMS Communication Methods
UHF radio (Mednet)
VHF radio (Blue Net, HEAR)
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 )

5. S-SV EMS Agency MICN Training (Updated 07-2017)
EMS Communications
EMS Dispatch
Receives and processes information
Emergency Medical Dispatch (EMD) used by some dispatch agencies
Determines and assigns necessary resources
Medical Priority Dispatch System (MPDS) used by some dispatch agencies
Relays information to appropriate entities (EMS resources, hospitals, other dispatch centers, etc.)
S-SV EMS Agency MICN Training (Updated )

6. S-SV EMS Agency MICN Training (Updated 07-2017)
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 )

7. S-SV EMS Agency MICN Training (Updated 07-2017)
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 )

8. S-SV EMS Agency MICN Training (Updated 07-2017)
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 )

9. S-SV EMS Agency MICN Training (Updated 07-2017)
EMS Communications
Radio Communication Etiquette (cont.)
Speak distinctly, at a moderate rate
Use plain language to describe a particular condition or 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 )

10. S-SV EMS Agency MICN Training (Updated 07-2017)
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 This is MICN Johnson, go ahead”
S-SV EMS Agency MICN Training (Updated )

11. S-SV EMS Agency MICN Training (Updated 07-2017)
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. S-SV EMS Agency MICN Training (Updated 07-2017)
EMS Communications
Prehospital Pt Report
Be ready to answer the call and listen carefully
Review the information provided
Did you receive enough information to appropriately prepare for the pts arrival?
If more information is needed, ask pointed/clarifying questions
Keep conversation concise
S-SV EMS Agency MICN Training (Updated )

13. S-SV EMS Agency MICN Training (Updated 07-2017)
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 )

14. S-SV EMS Agency MICN Training (Updated 07-2017)
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 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 )

15. S-SV EMS Agency MICN Training (Updated 07-2017)
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 too critical
S-SV EMS Agency MICN Training (Updated )

16. S-SV EMS Agency MICN Training (Updated 07-2017)
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 > 30 minutes from a stroke receiving center
S-SV EMS Agency MICN Training (Updated )

17. S-SV EMS Agency MICN Training (Updated 07-2017)
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 )

18. S-SV EMS Agency MICN Training (Updated 07-2017)
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 )

19. S-SV EMS Agency MICN Training (Updated 07-2017)
EMS Communications
Radio Communication Examples
(Insert base hospital specific audio recording examples here)
S-SV EMS Agency MICN Training (Updated )

20. S-SV EMS Agency MICN Training (Updated 07-2017)
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 )

21. Prehospital EMS Scene Safety
S-SV EMS Agency MICN Training (Updated )

22. 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 )

23. 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 )

24. Prehospital EMS Scene Safety
S-SV Active Shooter/Mass Violence Policy (834)
Establishes guidelines for EMS response to an active shooter/mass violence event
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 )