1. Power point presented by
Chapter 5
EMS Communications
Power point presented by
Dr. Samah Mohammed

2. Learning Outcomes
By the end of the session the student will be able to :
Define the communication .
Explain types of communication.
List phases of communication.
Discus element of communication.
Explain component of communication.
Identify Communication With hostile

3. INTRODUCTION
In EMS communication, information must move rapidly, efficiently, and effectively.
Know how to make communication as efficient as possible.
The EMD facilitates communication.
Therapeutic communication requires skill.

4. EMS Communication EMS System Communication needed to:
Definition of communication: The process of exchanging information between individuals.
EMS System Communication needed to:
Call for resources.
Transfer care of the patient.
Interact within the team structure.
Communication with other health care professionals
Team communication and dynamics

5. ROLE OF COMMUNICATION IN Ems

6. ELEMENTS OFCOMMUNICATION
Sender: The person Who Putting message in an understandable format.
Message: Information sent or expressed by sender
Channel: The medium through which a channel is transmitted.
Receiver: Is the person who receives and interprets the sender’s message.
Feedback: the receiver’s reaction to the message.

8. Five Phases of EMS Communication
Event occurs.
Need for emergency services detected.
Notification /emergency response.
EMS arrival, treatment, transport preparation.
Preparation for next emergency response. .

9. Codes Everyone must learn them. Some EMS services use radio codes to:
Maintain security.
Keep airtime brief.
Prevent patient from understanding what is being said.
To be effective:
Everyone must learn them.
Codes should be:
Simple and standardized Posted

10. Clarity of Transmission
Basic model of communication
Sender Clear message
Channel Receiver
5. Feedback
Communications equipment is designed to permit communication.
Many guidelines can improve clarity, such as:
Make sure the channel is clear.
Speak clearly and distinctly.
Keep calm and free of emotion.
Keep transmissions brief.

11. Content of Transmissions
Guidelines include:
Protect the patient’s privacy at all times.
Be impersonal.
Use clear text.
Question orders you did not hear/ but understand.

12. TYPES OF COMMUNICATION

13. TYPES OF COMMUNICATION

15. Factors to Improve Communication
Use simple language.
Show/ draw pictures.
Limit the amount of information provided & repeat it.
Produce/ use easy-to-read written material.
Confirm the patient’s understanding.
Create good environment.
Address the needs of patients with disabilities.

16. Importance of communication in EMS1
Achieve a positive relationship with patients and emergency team. 2
Transfer the patient’s care to physicians at hospital. 3
Collaborate effectively with the emergency team. 4
Get and give information. 5
Communicate problems and solutions 6
Improve patient safety and quality of healthcare.

17. Therapeutic Communication
Your job will involve daily interactions with people.
At least half of calls involve going in someone’s home.
See every invitation into a home as a personal honor.

18. Therapeutic Communication
Therapeutic communication uses various communication techniques and strategies
– Both verbal and nonverbal
– Encourages patients to express how they feel and achieves a positive relationship with patient
1. Asking questions: is a fundamental aspect of pre-hospital care.
•Open-ended questions require some level of detail. Use whenever possible.
Example: “What seems to be bothering you?”

19. Therapeutic Communication
Closed-ended questions:- require some level of detail in the response.
– Response is sometimes a single word like yes or no.
– Use if patients cannot provide long answers.
– Example: “Are you having trouble breathing?”
2. Touch is a powerful tool.
– Use it consciously and sparingly.
– Avoid touching the patient’s torso, chest, or face simply as a means of communication.

20. Therapeutic Communication
3. Active listening:-
- Repeat key parts of a patient’s response.
- Especially when taking notes.
- Helps confirm the information patients are providing
4. Use interviewing techniques e.g.
Make and keep eye contact at all times.
Provide your name and use patient’s proper name.
Tell patient the truth.

21. Therapeutic Communication
Use language the patient can understand.
Be careful what you say about patient to others.
Be aware of your body language.
Speak slowly, clearly especially patient as the hearing-impaired patient.
Allow the patient time to answer.
Act and speak in a calm, confident manner.

22. Therapeutic Communication
Try hard not to shout:
Reduce noise when possible.
Move the patient to a quiet area.
Speak close to the patient’s ear in a calm voice.
4. Complete all your history taking at once.
5. Ask personal questions quietly and in private.
6. Communication is critical in challenging environments.

23. Communication Tools Use the following tools: Reflection
Repeat a word or phrase a patient used to encourage more detail.
Interpretation
Vocalize what you think the patient said, and have him or her correct you.
Facilitation
Encourage hesitant ( uncertain) patients to provide more detail.

24. Communication Tools
There are many powerful communication tools that EMTs:-
Silence
Empathy
Simplification
summarization
Clarification
Redirection
Explanation

25. Communication With other Health Care Professionals
Effective communication between EMT and health care professional must be effective, efficient, and appropriate.
Your reporting responsibilities do not end when you arrive at the hospital.
Give oral report to hospital staff member who has at least your level of training.
Oral report components:

26. Communication With other Health Care Professionals
The following six component must be included in the oral report.
Opening information
Include patient name, age, gender, chief complaint, nature of the illness
2. Detailed information
Not provided during radio report.
3. Any important history

27. Communication With other Health Care Professionals
The patient response to treatment
Initial treatment that provided
Vital signs
Assess during transport.
Other information
Information gathered during transport
( medication )

28. Communicating with older patients
Old patients:-
older patients are harder to communicate with than anyone else.
Illnesses may be more complex.
May be differences in hearing, mobility, etc.
Older patients who express that are not well.

29. Communicating with older patients
Old patients:
Identify yourself.
Look directly at patient.
Speak slowly and clear
Explain what you are going to do before you do it.
Listen to the answer the patient gives you.
Show the patient respect.
Do not talk about the patient in front of him or her.
Be patient!

30. Communicating with children
Children can be difficult patients.
Practice skills to help improve these interactions.
Fear is cause severe anxiety in children.
Children may be fearful by:
Your uniform.
The ambulance.
A crowd of people gathered around them.
Let a child keep a favorite toy, doll, security blanket.
If possible, have a family member or friend nearby.
If practical, let parent hold child during evaluation and treatment.

31. Communicating with children
Maintain friendly eye contact.
Smile.
Give calm, and reassurance.
Minimize movements.
Lower your voice.
Keep eye level at or below child’s.
Be honest.
If possible, involve a parent with the care of a small child.

32. Special Considerations of Age
3. Adolescents:
May not want their parents present.
An adult who assists on monitoring.
Do not refuse, but
inform ED physician.
Offer options; honor their choices.
Modesty is especially important.
2. For young children:
Toys may be useful.
Create a toy to connect with the child

33. Communicating with hearing impaired
Patient who are hearing impaired are usually have disability.
It is the people around a hearing impaired person who have problems coping.

34. Communicating with hearing impaired
Remember the following five steps to efficiently communicate with patients who are hearing impaired
1. Have paper and a pen available.
2. If patient can read lips, you should face the patient and speak slowly.
3. Never shout.
4. Be sure to listen carefully, ask short question, and give short answer.

35. Communicating with visually impaired
Like hearing impaired patients.
Remember the following steps to efficiently communicate with patients who are visually impaired.
1. Explain every thing you are doing in detail.
2. Be sure to stay in physical contact with the patient.
3. Transport any mobility aids as stick.

36. Communicating with non English speaking
First step is to find out how much English the patient can peak.
Use short , simple question and simple words.
If the patient doesn’t speak any English , find a family member to act interpreter.
Avoid use medical terms.

37. MEDICAL TERMINOLOGY IN EMS
Medical terms are mainly derived from Latin.
Integrates comprehensive anatomic and medical terminology and abbreviations into written and oral communication with colleagues and other health care professionals.

38. Common Medical Terminology in EMS
meaning An
Without
Algia
Pain
Brady
Slow
Tachy
Fast
Neuro
Nerve
hyper
Above
hypo
under

39. NEW TECHENOLOGY IN EMS
Used to collect and exchange patient information electronically.
Reduces dependence on traditional means of verbal and written documentation.
May allow "real-time catch" of events and information.
Integrated with diagnostic technology.
May influence role of medical direction.
Advanced notification.
Save time in-hospital for diagnosis and therapy.

40. NEW TECHENOLOGY Legal-status electronic medical report
Same status as written documentation.
May not have a "paper record" of incident.
Security safeguards must be in place.

41. EMS Communications System and Equipment
Radio and telephone communication link you and your team with other members of the EMS.
This link helps the team to work together more effectively, provides safety and protection for each member of the team.
You must be able to use your system efficiently and effectively.
You must be able to send, accurate reports about scene, the patients condition and treatment provide

42. Communications Systems and Equipment
Base station radios.
Mobile and portable radios.
Repeater-based systems.
Digital equipment.
Cellular/satellite telephones.
Other equipment.

43. Communication System Equipment
Base station:
the dispatcher usually communicates with field units by transmitting through a fixed radio base station that is controlled from the dispatch center.
Base station: defined is any radio hardware containing transmitter and receiver that is located in a fixed place.
base station may inculde dispatch centers , fire stations, ambulance bases, or hospitals.
A two- way radio consists of two units: transmitter and receiver.

44. Communication System Equipment
2. Mobile and potable radio: is built up in ambulance
Used to communicate with:
Dispatcher
Medical control
An ambulance will often have more than mobile radio, each on a different frequency.
One radio may be used to communicate with the dispatcher or other public safety agencies
A second radio is often used for communicating patient information to medical control.

45. Communication System Equipment
3. Repeater based systems
is a special base station radio receives massage and signals on one frequency and then automatically retransmits them on a second frequency.
Advantages of repeaters
Permits communication over a large area.
Allows flexibility in areas with abnormal land.
Assures better communication.
Weak transmissions will be heard.
A repeater is able to receive low-power signals.

46. Communication System Equipment
4. Digital Equipment:
Digital signals are also apart of EMS communication
Voice is not the only EMS communication.
Some EMS systems use telemetry to send an electrocardiogram from the unit to the hospital.
Electronic signals are converted into coded.
Example: of telemetry is a fax message.
Digital signals are faster than spoken words and allow more choices and flexibility.

47. Communication System Equipment
5. Cellular/Satellite Telephones:
Cellular phone: (Be familiar), Simply low-power portable radios.
Satellite phones (sat phones) are another option, this phone use Satellite
Advantage of cellular/satellite telephones:
Know the location of dead spots.
Used for large areas.
Receives weak transmissions and relays to base station
6. Other communication equipment.

48. Communication System Equipment
Base station
Portable
Repeater
Digital

49. Modes of Radio Operation
Simplex: Uses one frequency to either transmit or receive. ( push to talk , release to listen) mode
Duplex: Uses two frequencies to transmit and receive together. ( talk and listen) mode
Multiplex: Combines signals to transmit together on one frequency.
Digital radio: helps clear up lost transmissions.
Digital trunked radios: have channels related by groups.

50. Radio Communications
The Federal Communications Commission (FCC) regulates all radio operations in the United States.
The FCC has five principal EMS include:-
Allocates specific radio frequencies for use by EMS provider.
Licenses base station and assigning appropriate radio call signs for those station.
An FCC license is usually issued for 5 years.

51. Radio Communications
Establishes licensing standards and operating specifications for radio equipment.
Establishes limitations for transmitter power output.
FCC regulates power to reduce radio interference between communication system.
Monitors radio operations

52. Dispatch
Definition of dispatch: The process of sending prehospital care (Emergency Medical Services or EMS) vehicles and personnel to respond to requests for medical aid.
Involves personnel, facilities, vehicles, and communications.

53. Dispatch Is a vital part of the paramedic team:
Obtains as much information as possible.
Directs appropriate vehicle(s) to the scene.
Provides caller with information.
Monitors and coordinates communication.
Maintains written records.

54. Dispatcher Responsibilities
The dispatcher has several important responsibilities:-
Answer the telephone immediately.
Identify himself or herself and the agency.
Speak directly into the mouthpiece. (speaker)
Observe telephone instructions.
Take charge of the conversation.

55. Information Received from Dispatch
Information which crew/vehicle to dispatch.
Depends on:
Nature and severity of injury, illness, or incident.
Location of incident.
Number of patients.
Responses by other agencies.
Special information.
Time dispatched.

56. Communicating With Dispatch
Report any problems during run.
Advise of arrival.
Communicate scene size-up.
Keep communications brief.

57. Giving the patient report
The report commonly includes seven elements:
1- Your unit identification and level of services e.g. BLS.
2. The receiving hospital and your estimated time of arrival.
3. Patient Age and gender.
4. Patient’s chief complaint
5.A brief history of present problem.
6. A brief report of physical findings.
7.A brief summary of the care given and any patient response.

58. Relaying Information to Medical Control
Communications with medical control should be concise and accurate.
Use a standard format.
Different methods as
Know protocol.

60. Special Interview Situations
Some situations require special techniques.
Difficult patients are especial.
General tips for caring for difficult patients:-
Be carful , maintain eye contact.
Introduce yourself; ask for the patient’s name.
Use open-ended questions.
Provide positive feedback.
Make sure patient understands you.
Continue to ask questions; rephrase if necessary.
Use patience, persistence.

61. People Who Are Hostile (inimical)
Additional tips include:
Identify escape routes.
Be carful.
Ask permission to interact with the patient.
Be wary for signs of impending attack.
Be prepared to escape if necessary.

62. Assessing Mental Status
Mental status is often indicator of the illness or injury.
AVPU is one of the rapid ways to asses:-
A: Alert to person, place, and day.
V: Verbal response.
P: Pain response.
U: Unresponsive.

63. Sexually Aggressive Patients
Follow your agency’s policies.
Make sure someone is always present.
Communicate professionally and politely.
Avoid sexually unclear words.
Document your interview.
Get witness names and signatures on notes.

64. Thank you