Prehospital Emergency Care, Ninth EditionJoseph J. Mistovich • Keith J. Karren
Objectives
1. Define key terms introduced in this chapter.2. Discuss the purposes and characteristics of each of the
following EMS system communication components(slides 15-27):a. Base stationb. Mobile radiosc. Portable radiosd. Digitalized radio equipmente. Mobile data terminalsf. Cell phones
3. Describe the responsibilities of the FederalCommunications Commission (slides 28-29).
Objectives
4. Explain the importance of EMS system communicationequipment maintenance (slides 28-29).
5. Given a radio transmitter/receiver, demonstrate thestandard ground rules for radio communications(slides 30-35).
6. List key points in an EMS call at which you shouldcommunicate with dispatch (slides 36-37).
7. Deliver a concise, organized radio report that clearlyconveys essential information to medical direction orthe receiving facility (slides 38-43).
8. Describe the process of receiving and confirming anorder from medical direction over the radio (slide 40).
Objectives
9. Identify situations in which you should make additionalcontact with medical direction or the receiving facilityafter providing an initial radio report.
10. Given a scenario, deliver an oral report to transfer careof the patient to a receiving facility or another EMSprovider (slides 44-47).
11. Given a scenario, demonstrate effectivecommunication that enhances team dynamics(slides 48-50).
12. Discuss the advantages and disadvantages of usingradio codes (slides 51-52).
13. Convert back and forth between military time andstandard clock times (slides 53-54).
Objectives
14. Communicate using commonly used radio terms(slides 55-56).
15. Describe the components of the communicationprocess (slides 57-61).
16. Discuss factors that can enhance or interfere witheffective communication (slides 57-61).
Objectives
17. Give examples of each of the following techniques oftherapeutic communication (slides 62-63):a. Clarificationb. Summaryc. Explanationd. Silencee. Reflectionf. Empathyg. Confrontation
18. Given a scenario, engage in an effectivecommunication process with a patient (slides 64-69).
Objectives
19. Recognize the potential messages that may becommunicated via nonverbal behaviors (slides 70-72).
20. Describe the uses, advantages, and disadvantages ofopen-ended and closed questions (slides 73-74).
21. Analyze your communications with a patient in ascenario to recognize the following pitfalls incommunication (slides 75-76):a. Leading or biased questionsb. Interrupting the patientc. Talking too muchd. Providing false assurancee. Giving inappropriate advicef. Implying blame
Objectives
22. Discuss considerations for each of the followingsituations (slides 75-83):a. Communicating with a patient’s familyb. Getting a noncommunicative patient to talkc. Interviewing a hostile patientd. Cross-cultural communicationse. Language barriersf. Communicating with children and elderly patients
Multimedia Directory
Slide 72 Nonverbal Communication VideoSlide 83 Alternate Methods of Communication Video
Topics
EMS Communication SystemCommunicating within the SystemTeam Communication and DynamicsTherapeutic Communication
CASE STUDYCASE STUDY
Dispatch
EMS Unit 2
Respond to 101 Bate Road for man bleeding in adriveway.
Time out 1128
Upon Arrival
• Semi-rural area• Find a 40s male sitting on a bench next to the
garage, clutching hand• See a workbench in the back of the garage• Right hand wrapped in blood-soaked rag; shirt
and pants blood-stained
How would you proceed?
Back to Topics
EMS CommunicationsSystem
Components of an EmergencyCommunications System
Base Station
Back to Objectives
• High power• Power levels limited by FCC• Transmits to repeaters
Components of an EmergencyCommunications System
Mobile Radios
• Vehicle-mounted• Lower powered than
base station• 10- to 15-mile range• Transmission affected
by terrain
Components of an EmergencyCommunications System
Portable Radios
• Out of vehicle use• Very limited range• May be used by
hospital as well
Components of an EmergencyCommunications System
Repeaters
• Rebroadcast low power signals• Can be fixed or mobile
Repeaters
Components of an EmergencyCommunications System
Digital Equipment
• Encoder• Decoder• Mobile data terminal
Components of an EmergencyCommunications System
Cell Phones
• Operation• Benefits• Disadvantages
Components of an EmergencyCommunications System
Broadcast Regulationsand SystemMaintenance
Back to Objectives
• FCC regulates functions• Appropriate system maintenance
Back to Objectives
Back to Topics
Communicating withinthe System
Ground Rules for RadioCommunication
Back to Objectives
• Radio on, correct frequency• Listen before transmitting• Push the “press to talk” button; wait one
second before speaking• Speak with your lips two to three inches
from microphone• Address the unit being called by its name
and number, then identify your unit by name• “Go ahead” or “stand by”• Keep transmissions brief
• Keep your transmission organized and tothe point
• Say the numerical digits if it would beconfusing
• Avoid diagnosing the patient’s problem• Use the “echo” method• Always write down important information• No personal information; no profanity• Use “we” not “I”• Use “affirmative” and “negative”• Say “over” when finished
Phone/Cell PhoneCommunication
• Be familiar with technology• Be aware of dead spots
Communicating withDispatch
Back to Objectives
• Acknowledge the call• En route• On Scene• Leave Scene• Arrival at hospital• Clear of hospital• Back at station
Communicating with Health CareProfessionals
Communicating withMedical Direction
Back to Objectives
• Unit ID and level• Patient age and sex• Chief complaint• History of present
illness• Past medical history• Mental status• Vital signs• Physical exam• Care already
rendered• Current condition• Request for further
actions
• Repeat orderword for word
• Ask for repetitionif confused
• Don’t be afraidto question order
Back to Objectives
SBAR
• S – Situation• B – Background• A – Assessment• R – Recommendation
Communicating with Health CareProfessionals
Communicating withthe Receiving Facility
• Same as report todoctor
• Update hospitalwith any changes
Communicating with Health CareProfessionals
The Oral Report
Back to Objectives
• Patient’s chief complaint• Vital signs en route• Treatment and response• Pertinent history
Communicating with Health CareProfessionals
Transferring Care toAnother EMS Provider
• Follow agency policy and protocols• Give a verbal report• Obtain information for your report prior to
• A: PCN• M: Denies• P: Denies• L: Coffee 15 minutes before incident• E: Denies anything unusual prior to
incident
CASE STUDYCASE STUDY
• Patient remains alert and oriented• Report to hospital
– “Columbia Memorial, this is Craryville BLSUnit 2 en route to you with an ETA of tenminutes. We have a 46-year-old male with athree-inch laceration of the right hand causedby a sabre saw. The patient is alert andoriented. The patient says he is allergic topenicillin…
Reassessment and Transport
CASE STUDYCASE STUDY
• Report to hospital, continued“…vital signs are blood pressure 146/84, radialpulse 80, respirations 14 and of good quality, skinnormal, warm, and moist. We have dressed andbandaged the wound. Bleeding appears to havestopped, and patient acknowledges only slight painfrom the wound.”
• Advise dispatch of arrival at hospital
Reassessment and Transport
CASE STUDYCASE STUDY
• Assist patient into the hospital• Partner gives report to ER nurse• Nurse takes charge of the patient• You clean your unit and go back in
service
Arrival at Hospital
• 36-year-old female complaining of severeabdominal pain
• The patient is alert and orientedVital signs:• BP: 88/64 mmHg• HR: 128 bpm with weak radial pulses• RR: 24 with adequate chest rise• Skin is pale, cool, and clammy• SpO2 is 96 percent on room air
Critical Thinking Scenario
SAMPLE history:• S – Feels light-headed and dizzy every
time she stands up; she’s also nauseated• A – No known allergies• M – Over-the-counter Claritin for allergies• P – No pertinent medical history; tonsils
removed when she was 10 years old• L – nothing to eat or drink for 7 hours• E – has “not felt real good” for a few days
Critical Thinking Scenario
Pain assessment:• O – pain began suddenly and has
progressively worsened; was sitting on thecouch watching television when it began
• P – nothing makes it better or worse• Q – dull, aching, and intermittent• R – non-radiating• S – 8 out of 10• T – four hours
Critical Thinking Scenario
Physical exam:• Pupils are equal and sluggish to respond• Breath sounds are equal and clear
bilaterally, no JVD• Abdomen is rigid and tender, no evidence
of trauma to the abdomen• Good motor and sensory function in all
four extremities, peripheral pulses are veryweak
Critical Thinking Scenario
Repeat vital signs:• BP 82/62 mmHg• HR 134 bpm, radial pulses barely palpable• RR 26 with adequate chest rise• Skin is more pale, cool, and clammy• Pulse oximeter reading “error”
Critical Thinking Scenario
• En route to the hospital, the patient beginsto close her eyes and you must verballyinstruct her to open her eyes
• Your ETA to the hospital is 7 minutes
Critical Thinking Scenario
1. What techniques would you use tocommunicate with this patient?
2. Are there any special circumstances thatyou would consider when communicatingwith this patient?
3. Would you contact medical directionduring your management of this patient?
Critical Thinking Questions
4. What information is important to relay inthe radio report to the receiving facility?
5. What information would you provide inyour oral report to the medical personnelat the receiving medical facility during thetransfer of care?
6. What information would you reportregarding the change in the patient’scondition?
Critical Thinking Questions
Reinforce and Review
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