4)Communications

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4)Communications

  1. 1. Communications
  2. 2. Communications <ul><li>Communication System </li></ul><ul><ul><li>CNS of EMS </li></ul></ul><ul><ul><li>Coordinates ALL essential activities between: </li></ul></ul><ul><ul><ul><li>Scene </li></ul></ul></ul><ul><ul><ul><li>Ambulance </li></ul></ul></ul><ul><ul><ul><li>Hospital </li></ul></ul></ul><ul><ul><li>Connection to medical direction </li></ul></ul><ul><ul><li>Notifies receiving hospital of impending arrival </li></ul></ul>
  3. 3. System Components <ul><li>Base Station </li></ul><ul><ul><li>Radio located at a stationary spot </li></ul></ul><ul><ul><ul><li>Public Safety Center, Hospital, Hilltop </li></ul></ul></ul><ul><ul><li>Provides hub for communication through EMS </li></ul></ul>
  4. 4. System Components <ul><li>Mobile Two-Way Radio (transmitter/receivers) </li></ul><ul><ul><li>Radios contained within vehicles </li></ul></ul><ul><ul><li>Mobile transmitter </li></ul></ul><ul><ul><li>Broadcast at lower power than base stations (typically 20-50 watts) </li></ul></ul>
  5. 5. System Components <ul><li>Portable Radios (transmitter/receiver) </li></ul><ul><ul><li>Handheld device </li></ul></ul><ul><ul><li>Typical power output of 1-5 Watts </li></ul></ul><ul><ul><li>Limited range </li></ul></ul>
  6. 6. Repeater Systems <ul><li>Repeater Systems </li></ul><ul><ul><li>Receive radio signal from a low power radio on a certain frequency </li></ul></ul><ul><ul><li>Rebroadcasts same signal at a higher power on another frequency </li></ul></ul><ul><ul><li>Relay signals to dispatch center, base, hospital </li></ul></ul><ul><ul><li>Place on high ground/buildings </li></ul></ul>
  7. 7. Other Components <ul><li>Digital Radio Equipment </li></ul><ul><li>Cell Phones </li></ul>
  8. 8. System Maintenance <ul><li>Checked periodically by a technician </li></ul><ul><li>As technology changes more tools become available </li></ul><ul><ul><li>i.e. Cell phones </li></ul></ul><ul><li>EMS system must provide a back up for contact of on-line medical control in case the main fails </li></ul>
  9. 9. FCC <ul><li>Federal Communications Commission (FCC) </li></ul><ul><ul><li>Government agency </li></ul></ul><ul><ul><li>Regulates all aspects of radio communications in US </li></ul></ul><ul><ul><ul><li>Est. technical standards for radio equip </li></ul></ul></ul><ul><ul><ul><li>Allocates frequencies </li></ul></ul></ul><ul><ul><ul><li>Licenses and regulates use/repair </li></ul></ul></ul>
  10. 10. Communication Center <ul><li>Duties </li></ul><ul><ul><li>Receives request for emergency assistance </li></ul></ul><ul><ul><li>Performs triage (determines priority of call) </li></ul></ul><ul><ul><li>Dispatches appropriate responders </li></ul></ul><ul><ul><li>Provides pre-arrival instructions to the caller </li></ul></ul><ul><ul><li>Notifies the hospital of the impending arrival of pt </li></ul></ul><ul><li>Receiving operator </li></ul><ul><ul><li>Individual who receives call for assistance </li></ul></ul><ul><li>Dispatcher </li></ul><ul><ul><li>Individual who communicates with field personnel </li></ul></ul>
  11. 12. Emergency Medical Dispatch <ul><li>Gives basic 1 st Aid instruction over the phone to the caller </li></ul><ul><li>Based on US DOT EMS Dispatcher National Standard Curriculum </li></ul>
  12. 13. Communications When? <ul><li>When to communicate with dispatch: </li></ul><ul><ul><li>Call is received </li></ul></ul><ul><ul><li>Unit responds/ en route </li></ul></ul><ul><ul><li>Arrival on scene </li></ul></ul><ul><ul><li>Leaving the scene/ en route hospital </li></ul></ul><ul><ul><li>Arrival at hospital </li></ul></ul><ul><ul><li>Clear from hospital </li></ul></ul>
  13. 14. Medical Direction <ul><li>EMT’s may need to call for orders/consultation </li></ul><ul><ul><li>Must be organized, persistent, concise </li></ul></ul><ul><ul><li>Physician will decide treatment upon your report </li></ul></ul><ul><ul><ul><li>Be ACCURATE </li></ul></ul></ul><ul><li>Upon approval/denial of order repeat it back WORD FOR WORD </li></ul><ul><li>Unclear/inappropriate orders should be questioned </li></ul>
  14. 15. Pt Reporting Concepts <ul><li>Radio is on </li></ul><ul><li>Volume is appropriate </li></ul><ul><li>Limit background noise </li></ul><ul><li>Frequency is clear before starting </li></ul><ul><li>Use and EMS frequency for EMS information </li></ul><ul><li>Press “press to talk” button and wait 1-2 sec </li></ul><ul><li>Speak with lips 2-3” away from mike </li></ul><ul><li>Address the unit being called and follow up with the name/number of unit calling </li></ul><ul><ul><li>i.e “Unit 310… this is Unit 311….” </li></ul></ul><ul><li>That unit will signal “go ahead” or “stand by” </li></ul><ul><li>Speak clearly and slowly </li></ul><ul><li>Keep communications brief </li></ul><ul><ul><li>If longer than 30 sec, pause and allow emergency traffic </li></ul></ul>
  15. 16. Pt Reporting Concepts Continued <ul><li>Use clear text </li></ul><ul><li>Avoid codes and meaningless phrases </li></ul><ul><li>Courtesy is assumed </li></ul><ul><ul><li>no please/thank you/etc </li></ul></ul><ul><li>Give the number and then individual digits if number can be confused </li></ul><ul><li>Airways are public. Scanners are popular. NEVER use a pt name </li></ul><ul><li>Remain impartial </li></ul><ul><li>Use “we” instead of “I” </li></ul><ul><li>Don’t use profanity. FCC is not a fan… </li></ul><ul><li>Avoid “Yes/No” – Use “affirmative/negative” </li></ul><ul><li>Indicate a transmission has ended “Over” </li></ul><ul><li>Avoid offering a diagnosis of pt </li></ul>
  16. 17. Radio Pt Reports (en route) <ul><li>Unit # </li></ul><ul><li>Level of provider reporting </li></ul><ul><li>ETA </li></ul><ul><li>Pt age & sex </li></ul><ul><li>C/C </li></ul><ul><li>Brief, pertinent Hx of present illness </li></ul><ul><li>Mental Status </li></ul><ul><li>Baseline Vital Signs </li></ul><ul><li>Pertinent findings of physical exam </li></ul><ul><li>Emergency care given </li></ul><ul><li>Responses to care </li></ul>
  17. 18. Verbal Patient Report (arrival) <ul><li>Summarize info given over radio </li></ul><ul><ul><li>C/C </li></ul></ul><ul><ul><li>Hx not given previously </li></ul></ul><ul><li>Additional treatment given en route </li></ul><ul><ul><li>Additional vital sign taken en route </li></ul></ul><ul><li>Prehospital Care Report (PPCR) </li></ul>
  18. 19. Interpersonal Communication <ul><li>Make/keep eye contact with pt </li></ul><ul><li>When practical position yourself at a level lower than the pt </li></ul><ul><li>Be honest </li></ul><ul><li>Use language the pt can understand </li></ul><ul><li>Speak clearly, slowly, distinctly </li></ul><ul><li>Speak in calm, confident manner </li></ul><ul><li>Use the pt proper name and ask what they prefer to be called </li></ul><ul><li>If pt has hearing problems speak clearly with visible lips </li></ul><ul><li>Allow pt enough time to answer before asking the next question </li></ul>
  19. 20. Special Populations <ul><li>Elderly </li></ul><ul><ul><li>RESPECT </li></ul></ul><ul><ul><li>Gentle touch </li></ul></ul><ul><ul><li>Be sensitive to spouse </li></ul></ul><ul><ul><ul><li>let them ride </li></ul></ul></ul><ul><ul><li>Do not address pt with just 1 st name unless you have permission </li></ul></ul><ul><ul><li>Allow adequate time to respond </li></ul></ul><ul><ul><li>Do not assume they are all hearing impaired </li></ul></ul>
  20. 21. Special Populations <ul><li>Children/Peds </li></ul><ul><ul><li>Doll/security blanket </li></ul></ul><ul><ul><li>Interact with parent & child </li></ul></ul><ul><ul><li>Allow parent to accompany child </li></ul></ul><ul><ul><li>Be honest </li></ul></ul><ul><ul><li>Approach child on level equal to theirs </li></ul></ul>
  21. 22. Special Populations <ul><li>Hearing Impaired </li></ul><ul><ul><li>React with normal intelligence </li></ul></ul><ul><ul><li>Look DIRECTLY at pt when talking </li></ul></ul><ul><ul><li>Write questions </li></ul></ul><ul><ul><li>Call attention/write explanations to procedures </li></ul></ul><ul><ul><li>Interpreter </li></ul></ul>
  22. 24. Special Populations <ul><li>Visually Impaired </li></ul><ul><ul><li>Maintain physical contact </li></ul></ul><ul><ul><li>Explain in detail what is being done </li></ul></ul><ul><ul><li>Explain where the pt is being moved </li></ul></ul><ul><ul><li>Make arrangements for tx of service animal </li></ul></ul><ul><ul><li>Periodically inform pt of status/activities </li></ul></ul>
  23. 25. Special Populations <ul><li>Foreign Language </li></ul><ul><ul><li>Translator </li></ul></ul><ul><ul><li>Manuals </li></ul></ul><ul><ul><li>Visual cues </li></ul></ul><ul><li>Altered Mental Status </li></ul><ul><ul><li>Communicate in simple terms </li></ul></ul><ul><ul><li>Try to confirm what is causing the problem </li></ul></ul><ul><ul><li>Do not rush pt to respond </li></ul></ul><ul><ul><li>Reinforce pt </li></ul></ul><ul><ul><li>Assure pt can understand and try not to insult them </li></ul></ul>
  24. 26. Go forth and communicate!

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