1. CHAPTER 13
Communications

2. Three Types of EMS Communication Radio communication Verbal reports
Interpersonal

3. Components of a Radio Communication System
Base station
Two-way mobile radio
Portable radio

4. Base Station
A two-way radio which is located at a stationary/fixed site such as a hospital, mountain top, or public safety agency

5. Mobile Two-Way Radios (transmitters/receivers)
Implies a vehicular mounted device; Mobile transmitters usually transmit at lower power than base stations (typically 20 – 50 watts); Typical transmission range is 10 – 15 miles over average terrain

6. Portable Radios (transmitters/receivers)
Implies a hand held device; Typically have power
output of 1 – 5 watts, limiting their range

7. Radio System Components
Repeaters/Base Station – receives a transmission from a low-power portable or mobile radio on one frequency and retransmits at a higher power on another frequency; used when radio transmissions must be carried over great distances
Digital radio equipment – key punching; transmission of some standard messages by punching a key
Cellular telephones – transmit through the air instead of over wires so that the phones can be transported and used over a wide area

8. Radio Communications
Radio frequencies are assigned and licensed by the FCC (Federal Communications Commission); you must follow established codes
Response to scene
The dispatcher needs to be notified that the call was received
Dispatch needs to know that the unit is en route
Other agencies should be notified as appropriate (i.e. local hospital)
Arrival at scene – the dispatcher should be notified prior to patient contact

9. Communication with Medical Direction and Dispatch
(Interpersonal Communication)

10. Reasons to Communicate with Medical Direction
In some systems, medical direction is at the receiving facility. In others, medical direction is at a separate site.
In either case, EMT-Basics may need to contact medical direction for consultation and to get orders for administration of medications. Radio transmissions need to organized, concise and pertinent.
Since the physician will determine whether to order medications and procedures based on the information given by the EMT-Basic, this information must be accurate.
After receiving an order for a medication or procedure (or denial of such a request), repeat the order back word for word (you do this so that the physician knows how you understand the orders given).
Orders that are unclear or appear to be inappropriate should be questioned.
Communication with receiving facilities
EMT-Basics provide information that allows hospitals to prepare for a patient’s arrival by having the right room, equipment and personnel prepared (paint a picture).

11. Communication
Principles

12. Communication Principles
When speaking on the radio, keep these principles in mind:
Radio is on and volume is properly adjusted
Listen to the frequency and ensure it is clear before beginning a transmission.
Press “Push To Talk (PTT) button on the radio and wait one second before speaking.
Speak with lips about 2 to 3 inches away from microphone.

13. Communication Principles
When speaking on the radio, keep these principles in mind cont’d…:
Address the unit being called, then give the name of the unit (and number if appropriate) where the transmission is originating from.
The unit being called will signal that the transmission should start by saying “go ahead” or some other term standard for that area. A response of “stand by” means wait until further notice.
Speak clearly and slowly, in a monotone voice.

14. Communication Principles
When speaking on the radio, keep these principles in mind cont’d…:
Keep transmissions brief. If, on occasion, a transmission takes longer than 30 seconds, stop at that point and pause for a few seconds so that emergency traffic can use the frequency if necessary.
Use clear text/plain English
Avoid codes
Avoid meaningless phrases like “Be advised”

15. Communication Principles
When speaking on the radio, keep these principles in mind cont’d…:
Courtesy is assumed, so there is no need to say “please,” “thank you” and “you’re welcome.”
When transmitting a number that might be confused (e.g., a number in the teens), give the number, then give the individual digits.
The airwaves are public and scanners are popular. EMS transmissions may be overheard by more than just the EMS community. DO NOT GIVE THE PATIENT”S NAME OVER THE AIR.

16. Communication Principles
When speaking on the radio, keep these principles in mind cont’d…:
For the same reason, be careful to remain objective and impartial in describing patients. An EMT-Basic may be sued for slander if he injures someone’s reputation in this way.
An EMT-Basic rarely acts alone: Use “we” instead of “I.”
Do not use profanity on the air. The FCC takes a dim view of such language and may impose substantial fines.

17. Communication Principles
When speaking on the radio, keep these principles in mind cont’d…:
Avoid words that are difficult to hear like “yes” and “no.” Use “affirmative: and “negative.”
Use the standard format for transmission of information.
When the transmission is finished, indicate this by saying “over.” Get confirmation that the message was received.
Avoid codes, especially those that are not standardized.

18. Communication Principles
When speaking on the radio, keep these principles in mind cont’d…:
Avoid offering a diagnosis of the patient’s problem.
Use EMS frequencies only for EMS communication.
Reduce background noise as much as possible by closing the window.
Notify the dispatcher when the unit leaves the scene.
When communicating with medical direction or the receiving facility, a verbal report should be given. There are essential elements and a specific order to keep in mind when giving this report.

19. Medical Radio Report
Identify unit and level of provider (who and what)
Estimated time of arrival
Patient’s age and sex
Chief Complaint
Brief, pertinent history of the present illness
Major past illnesses
Mental Status
Baseline vital signs
Pertinent findings of the physical exam
Emergency medical care given
Response to emergency medical care
If your system has requirements for contacting medical direction, or if you have any questions.

20. Communication Principles
After giving this information (verbal medical report), the EMT-Basic will continue to assess the patient. Additional vital signs may be taken and new information may become available, particularly on long transports. In some systems, this information should be relayed to the hospital. Information that must be transmitted includes deterioration in the patient’s condition, but always care for the patient prior to relaying this new

21. Communication Principles
Arrival at the hospital
The dispatcher must be notified
In some systems, the hospital should also be notified
Leaving the hospital for the station – the dispatcher should be notified.
Arrival at the station – the dispatcher should be notified
The dispatcher does not need to be notified when you are stopping for lunch/coffee, but you must have a radio with you.

22. Radio System Maintenance
Communication equipment needs to be checked periodically by a qualified technician, (e.g. to ensure that a radio is not drifting from its frequency).
As technology changes, new equipment becomes available that may have a role in EMS systems, (e.g. cellular phones).
Since EMT-Basics may need to be able to consult on-line medical direction, an EMS system must provide a backup radio system in case of equipment failure

23. Verbal Communication:
At the Hospital

24. Verbal Communication: At the Hospital
After arrival at the hospital, give a verbal report to the staff (make sure it’s a nurse or doctor)
Introduce the patient by name (if known).
Summarize information from the radio report.
Chief complaint
History that was not given previously
Additional treatment given while en route
Additional vital signs taken while en route
Give additional information that was collected but not transmitted and anything that has changed
Continued…

25. Interpersonal
Communication

26. Make and keep eye contact. Be sure to introduce yourself and explain
why you are here.

27. When practical, position yourself at a level lower than the patient
When practical, position yourself at a level lower than the patient. Be aware of your own body language.

28. Communication Principles
Interpersonal
Communication Principles
Be honest with the patient, family and any bystanders.
Use language the patient can understand.

29. Communication Principles
Interpersonal
Communication Principles
Speak clearly, slowly and distinctly.
Use the patient's proper name, either first or last. Ask the patient what he/she wants to be called.
If a patient has difficulty hearing, speak clearly with lips visible.

30. Communication Principles
Interpersonal
Communication Principles
Allow the patient enough time to answer a question before asking the next one.
LISTEN!
Act and speak in a calm, confident manner.
Show that you are confident, attentive and always be appropriate.

31. Communication Principles
Interpersonal
Communication Principles
Be aware of disabilities that impair communication and interpreters may be needed with non-English-speaking persons.
Make sure your lips can be seen
Use hand gestures
Find an interpreter/translator
Use a manual, but do not delay care
DO NOT AVOID COMMUNICATION

32. Communication Principles
Interpersonal
Communication Principles
Elderly patients (growing segment of our population) may have visual or auditory deficits.
Elderly patients may see confused or have difficulty communicating.

33. Pediatric Note
It is often best to involve parents when communicating with a child.
Always come down to the child’s level – never stand above a child. Crouching down reduces the size difference and greatly improves communication.
Children often sense lies even faster than adults. It is important to tell the truth to children. Remember you may be the first contact from the EMS system that the child has ever had. Work to make it positive.