1. Principles of Patient Assessment in EMS

2. Listening to Patients

3. Introduction
Establishing a rapport with patient and family is important
Effective communication between EMS provider and patient takes practice
Obtaining a good history is often difficult, yet necessary
This chapter focuses on interpersonal dynamics and communications strategies

4. Communication is a 2-way process

5. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.
The Feedback Loop
Sender
Receiver
Message
Encoding
Decoding
Feedback
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6. Message is Communicated
Verbal – speaking and observing feedback
Non-verbal – use of body language
Non-verbal – understanding of one’s personal space
Listening – adjust the environment so it is possible to listen
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

7. Factors that Facilitate Effective Communication
Is the patient comfortable?
Consider your method of approach
Professional, respectful introductions
Addressing the patient: name and formality
Establishing trust
Consider the environment, modesty, emotional, and biological needs
Confidentiality
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

8. Communication Techniques
Facilitation – positive or negative
Open-ended questions
Closed questions
Reflection – echoing the patient’s words to encourage the flow of conversation
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

9. Communication Techniques (continued)
Clarification of confusing or ambiguous responses
Silence is sometimes helpful
Explanation to help put the patient more at ease
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

10. Barriers to Communication
Words and phrases the patient does not understand
Technical terms should be kept to a minimum (unless dealing with a health care worker)
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

11. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.
Special Challenges
Hearing impairment
Visual impairment
Speech impairment
Non-English speaking
Developmental disability
Terminally ill
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12. Special Challenges (continued)
Hostile patients
Anxious patients
Abused patients
Patients with multiple symptoms
Asymptomatic patients
Overly talkative patients
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

13. Communicating with Children
Your interview must be age appropriate
Kneel down to get to the child’s level
Involve the parent or caregiver in the interview
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

14. Communicating with the Elderly
Aging rate differs with the person so do not assume all elderly are visually or hearing impaired
Give the patient time to discuss the chief complaint
Verify information with a family member or caregiver as necessary
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

15. Cultural Considerations
Recognize cultural differences in your patients
Culture based preferences may conflict with usual medical practices
Don’t assume patients with a particular cultural background are different…take the time to learn about the culture
Consider verbal and non-verbal messages
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

16. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.
Conclusion
Practice your listening skills
Do not judge
Demonstrate kindness, compassion, and empathy
Understanding basic communications skills is essential to EMS providers
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.