1. Slide 1 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Communications Chapter 14

2. Slide 2 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Case History You respond to a call and find a 32-year-old woman who was struck by a car. She is alert and complaining of pain in her chest and abdomen. Your assessment reveals that she has rapid and shallow breathing at a rate of 32, a weak pulse of 100 and regular, and a blood pressure of 110/70. She has absent breath sounds on the left side and tracheal shift to the right. You noted subcutaneous emphysema in the neck and upper chest. Her abdomen is tender in the left upper quadrant. You respond to a call and find a 32-year-old woman who was struck by a car. She is alert and complaining of pain in her chest and abdomen. Your assessment reveals that she has rapid and shallow breathing at a rate of 32, a weak pulse of 100 and regular, and a blood pressure of 110/70. She has absent breath sounds on the left side and tracheal shift to the right. You noted subcutaneous emphysema in the neck and upper chest. Her abdomen is tender in the left upper quadrant.

3. Slide 3 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Communications Center  Receives requests for emergency assistance  Performs dispatch triage  Dispatches EMS providers  Provides prearrival instructions  Coordinates EMS with other agencies  Notifies hospital

4. Slide 4 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Emergency Medical Dispatchers (EMD)  Serves as the coordinator of EMS system response  Receives the call for help  Dispatches the appropriate units  Provides updates throughout the call  Dispatches additional resources

5. Slide 5 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. First Aid Directions  Dispatchers may provide first aid instructions over the telephone to bystanders providing treatment on scene.  Maximizes chances for survival

6. Slide 6 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. System Components  Radio frequencies  Assigned and licensed by FCC  Portable radios  Mobile radios  Repeaters  Base stations  Cell phones

7. Slide 7 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Repeater  Receives a transmission from a low-power portable or mobile radio  Retransmits at a higher power  Strategically located to boost signals  Critical in large response areas

8. Slide 8 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Radio Communications  Response to the scene  Dispatcher notified  Other agencies notified as needed  Local hospital  Police  Arrival at the scene  Dispatcher must be notified.

9. Slide 9 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Radio Communication Technique  Turn radio on and adjust volume.  Listen to the frequency to ensure that it is clear.  Press the press to talk (PTT) button.  Wait for 1 second before speaking.  Speak with lips about 2 to 3 inches from the microphone.

10. Slide 10 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Radio Communication Technique  Address unit being called.  Give unit name and number.  Determine origination of transmission.  Unit will signal “go ahead,” “proceed,” etc.  “Stand by” means wait until further notice.

11. Slide 11 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Radio Communication Technique  Speak clearly and slowly in a monotone voice.  Keep transmissions brief.  If transmission takes longer than 30 seconds, stop and pause for a few seconds, so emergency traffic can use the frequency, if necessary.

12. Slide 12 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Radio Communication Technique  Use clear text.  Avoid codes, when possible.  Avoid meaningless phrases like, “Be advised."  Courtesy is assumed  No need to say, “Please,” “Thank you,” or “You're welcome.”

13. Slide 13 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Radio Communication Technique  When transmitting a number  Give the number  Then give the individual digits  Airwaves are public and scanners are popular.  EMS transmissions may be overheard.  Do not give a patient's name over the air.

14. Slide 14 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Radio Communication Technique  Use “We” instead of “I.”  Do not use profanity on the air.  Avoid words that are difficult to hear like, “Yes” and “No.”  Instead, use “Affirmative” and “Negative.”  Use the standard format for transmission of history.

15. Slide 15 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Radio Communication Technique  When the transmission is finished, say, “Over.”  Get confirmation  Avoid codes that are not standardized.  Avoid offering a diagnosis of the patient’s problem.  Use EMS frequencies only.  Reduce background noise.

16. Slide 16 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Report to Medical Direction/Receiving Facility  Identify unit and level of provider.  Indicate patient's age and sex.  Relate chief complaint.  Provide estimated time of arrival.

17. Slide 17 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Report to Medical Direction/Receiving Facility  Brief, pertinent history of the present illness  Major past illnesses  Mental status  Baseline vital signs

18. Slide 18 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Report to Medical Direction/Receiving Facility  Pertinent findings of the physical exam  Emergency medical care given  Response to emergency medical care

19. Slide 19 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Report to Medical Direction/Receiving Facility  Provide updates  Vital signs and changes in patient status  Notify dispatcher  Arrival at the hospital Notify hospital Notify hospital  Leaving hospital  Arrival at the station

20. Slide 20 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. System Maintenance  Communications equipment needs to be checked periodically.  New technology (e.g., cellular phones)  EMS system must provide a backup communications system.

21. Slide 21 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Interpersonal Communications  Make and keep eye contact.  Position yourself at a level lower than the patient.  Be honest.  Use language the patient can understand.  Be aware of your body language.

22. Slide 22 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Interpersonal Communications  Speak clearly, slowly, and distinctly.  Use the patient's proper name.  If a patient has difficulty hearing, speak clearly with lips visible.  Allow the patient enough time to answer.  Act and speak in a calm, confident manner.

23. Slide 23 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Special Considerations  Hearing impaired and nonEnglish-speaking patients  Use interpreters, when possible.  Communicating with elderly  Potential for visual deficit  Potential for auditory deficit