1. Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 4-1 Chapter 4 EMS System Communications

2. 4-2 Objectives

3. 4-3 Communications Systems

4. 4-4 Communication –The exchange of thoughts and messages that occurs by sending and receiving information –Use clear text or speech to relay data

5. 4-5 Regulation Federal Communications Commission (FCC) –Responsible for regulation of interstate and international communications –Develops and enforces rules and regulations pertaining to radio transmissions –Controls licenses and allocates frequencies –Establishes technical standards for radio equipment –Monitors frequencies for appropriate usage –Spot-checks for licenses and records

6. 4-6 Radio Frequencies and Ranges

7. 4-7 Very High Frequency (VHF) Band VHF low band frequencies –Bend and follow the curvature of the earth VHF high band frequencies –Travel in a straight line

8. 4-8 Ultra-High Frequency (UHF) Radio waves travel in a straight line –Can reflect off or bounce around buildings –Shorter range than VHF high or low bands Often requires the use of repeaters

9. 4-9 800-Megahertz Frequencies UHF radio signals Allow clear communication with minimal interference Trunking system –Allows routing of a transmission to the first available frequency Use multiple repeaters

10. 4-10 Communications Equipment

11. 4-11 Base Station A radio located at a stationary site such as a hospital, mountain top, or public safety agency

12. 4-12 Mobile Two-Way Radios Vehicle-mounted device Usually transmit at lower power than base stations (20 to 50 watts) Typical transmission range is 10 to 15 miles over average terrain

13. 4-13 Portable Radios Handheld device Typically have power output of 1 to 5 watts –Limited range

14. 4-14 Repeater Receives a transmission from a low-power device on one frequency and retransmits at a higher power on another frequency

15. 4-15 Digital Radio Equipment Pagers Mobile data computers (MDCs) Automatic vehicle locator (AVL) Global positioning system (GPS)

16. 4-16 Cellular Telephones Geographic “cells” Each cell has a base station to transmit and receive signals Transfer unit’s radio activity to the appropriate cell base station

17. 4-17 Transmission Modes One-way Simplex Duplex Multiplex

18. 4-18 9-1-1 –Official national emergency number in the United States and Canada Enhanced 9-1-1 –Routes call to 9-1-1 center closest to caller –Automatically displays caller’s phone number and address –Most 9-1-1 systems are Enhanced 9-1-1 systems

19. 4-19 Dispatch

20. 4-20 Computer-Aided Dispatch (CAD)

21. 4-21 Guidelines for Effective Radio Communication

22. 4-22 Guidelines for Effective Radio Communication Check equipment at the start of your shift Before speaking into the radio: –Make sure radio is on and the volume is properly adjusted –Reduce background noise as much as possible –Listen to make sure frequency is clear before speaking –Hold the radio’s microphone 2 to 3 inches away from your mouth –Locate and press the “push to talk” (PTT) button –Pause (with the PTT button depressed) for one to two seconds before speaking

23. 4-23 Guidelines for Effective Radio Communication Address unit being called by name and number Identify the name/number of your unit Wait for unit being called to signal you to begin Relay your message Speak clearly Keep transmissions brief “Clear” at the end of your message

24. 4-24 Guidelines for Effective Radio Communication Use plain English –Avoid use of “ten codes” and slang Avoid meaningless phrases, such as “Be advised” Do not use profanity on the air Avoid words that are hard to hear like “yes” and “no” –Use “affirmative” and “negative” Courtesy is assumed –No need to say “please,” “thank you,” and “you’re welcome” When transmitting numbers, give the number, then give the individual digits Do not offer a diagnosis of the patient’s complaint or injury

25. 4-25 En Route to the Call

26. 4-26 En Route to the Call Dispatch: –“Medic 51 (five, one), respond code 3 to 4321 (four, three, two, one) East Main Street for a report of difficulty breathing. Call number 987 (nine, eight, seven). Time out 1402 (one, four, zero, two).” Medic 51: –Dispatch, Medic 51 (five, one) received. Responding to report of difficulty breathing at four, three, two, one East Main Street.” Dispatch: –“Medic 51, Dispatch received, you are responding. Caller reports your patient is 70-year-old female in the kitchen of this address. The door will be unlocked. 1403.” Medic 51: –“Dispatch, Medic 51, received. 70-year-old female in the kitchen and the door will be unlocked.”

27. 4-27 Arrival at the Scene

28. 4-28 Arrival at the Scene Medic 51: –“Dispatch, Medic 51. We are on scene.” Dispatch Center: –“Medic 51, Dispatch received, on scene at 1406.”

29. 4-29 When to Notify Dispatch Receiving the call Responding to the call Arriving at the scene Leaving the scene for the receiving facility Arriving at the receiving facility Leaving the hospital for the station Arriving at the station

30. Communicating with the Patient Identify yourself Respectfully explain that you are there to provide assistance 4-30

31. Communicating with Individuals from Other Agencies Organized Concise Thorough Accurate 4-31

32. Communicating with Individuals from Other Agencies Hand-off report to ALS personnel: Identify yourself as an EMT Report the patient’s name (if known), age, gender, primary problem (chief complaint), and current condition Describe what happened and the position in which the patient was found Describe pertinent assessment findings, including vital signs Report any medical history you obtained from the patient Describe the emergency medical care that you gave Describe the patient’s response to the treatment given Orders received from medical direction (if applicable ) 4-32

33. 4-33 Communicating with Medical Direction

34. 4-34 Communicating with Medical Direction Communications should be: –Professional –Organized –Concise –Accurate –Pertinent “Echo” any orders received

35. 4-35 En Route to the Receiving Facility

36. 4-36 En Route to the Receiving Facility Receiving facility radio report –Identify unit and level of care provider (such as BLS, ALS) –Estimate time of arrival at facility –Patient’s age and gender –Chief complaint –Brief, pertinent history of present illness or problem –Major past illnesses –Mental status –Vital signs –Pertinent physical exam findings –Emergency medical care given –Response to emergency medical care

37. 4-37 Arrival at the Receiving Facility

38. 4-38 Arrival at the Receiving Facility Notify dispatch as soon as you arrive at the receiving facility. Medic 51: –“Dispatch, Medic 51. Arrival at Anytown Medical Center.” Dispatch Center: –“Received, Medic 51. Arrival at Anytown Medical Center at 1448.”

39. 4-39 Arrival at the Receiving Facility Verbal (“hand-off”) report –Introduce the patient by name (if known) –Patient’s chief complaint –Pertinent patient history –Emergency medical care given –Patient’s response to care given –Vital signs taken en route –Any additional information

40. 4-40 En Route to the Station

41. 4-41 En Route to the Station Notify dispatch when you are leaving the receiving facility and are en route to the station. Medic 51:“Medic 51 to Dispatch.” Dispatch:“Dispatch. Go ahead Medic 51.” Medic 51:“Dispatch, Medic 51 is leaving Anytown Medical Center en route to our station.” Dispatch:“Received, Medic 51. En route to your station. Time: 1510.”

42. 4-42 En Route to the Station Contact dispatch again on arrival at the station or when you enter your service area, per your agency’s guidelines. Medic 51:“Medic 51 to Dispatch.” Dispatch:“Dispatch. Medic 51 – go ahead.” Medic 51:“Dispatch, Medic 51 is back at our station and in service.” Dispatch:“Received, Medic 51. In station and available for service. Time: 1518.”

43. 4-43 Legal Considerations

44. 4-44 Legal Considerations Communication with a patient should always be: –Direct –Polite –Honest Health Insurance Portability and Accountability Act (HIPAA)

45. 4-45 Questions?