1. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Paramedic Care: Principles & Practice Volume 2 Patient Assessment

2. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Chapter 5 Communications

3. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Topics Basic Communication Model Verbal Communication Written Communication The EMS Response Communication Technology Reporting Procedures Federal Communications Commission (FCC)

4. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Introduction All aspects of prehospital care require effective, efficient communications. Communication is the key link in the chain that results in the best possible patient outcome. Effective communication optimizes patient care.

5. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Communication The process of exchanging information between individuals

6. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Basic Communication Model

7. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Basic Communication Model Sender has an idea or message Sender encodes message Sender sends message Receiver receives message Receiver decodes message Receiver gives feedback to sender

8. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Verbal Communication

9. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Verbal Communication Factors that enhance or impede effective communication may be either: –Semantic (the meaning of words) –Technical (communications hardware) Communication requires a mutual language.

10. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Verbal Communication “10” Codes –Many departments use plain English to avoid confusion. Receiver must be able to decode message

11. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Verbal Communication Technical considerations –Network must consist of reliable equipment designed to afford clear communication among all agencies within the system. –Developing hardware (equipment and network) and software (language) will be essential to improving emergency communications.

12. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Verbal Communications Technical Considerations Use of repeaters Band Frequency –UHF Less susceptible to interference –VHF Better over varied terrain

13. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Written Communication

14. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Written Communication An important aspect of EMS communications. A prehospital care report (PCR) is a written record of an EMS response. –Be objective –Write legibly –Thoroughly document –Use correct terminology

15. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ A PCR is a legal document, admissible in court.

16. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ The EMS Response

17. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ The EMS Response Detection and citizen access Call-taking and emergency response Pre-arrival instructions Call coordination and incident recording

18. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ The EMS Response Discussion with medical direction physician Transfer communications Back in service, ready for next call

19. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Detection and Citizen Response Someone must detect the problem and summon EMS. Public safety answering point (PSAP) Enhanced 911 system –ANI –ALI © On Scene Photography/Michael Grill

20. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Detection and Citizen Response NHTSA sponsored Automatic Collision Notification (ACN) –Collision sensors connected to in-vehicle systems automatically send a wireless alert signal to response centers. Technology for transmission and acceptance of ANI and ALI from wireless phones –Triangulation of a wireless signal

21. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Call Taking and Emergency Response Emergency Medical Dispatcher (EMD) Priority dispatching –Questions to elicit essential information about the chief complaint –Only the necessary resources are sent © Jeff Forster

22. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Prearrival Instructions Prearrival instructions complement the call screening process. Provide vital information to the patient and responding personnel. © Mark C. Ide

23. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Call Coordination and Incident Recording The emergency medical dispatcher’s main duties are support and coordination. He or she will provide additional units, record call information, and may facilitate communications with other entities

24. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Discussion With Medical Direction Communication with medical direction to discuss the case –Further orders for interventions May include radio, telephone, and cellular phone Provide clear, concise, controlled reports

25. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Transfer Communications Formal verbal briefing –Emergency physician or nurse Should include: –Patient’s vital information –Chief complaint –History and physical exam findings –Treatments rendered

26. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Communication Technology

27. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Communication Technology EMS systems use all of today’s various communication technologies. These include traditional forms of radio communication as well as innovations in radio technology and other media.

28. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Communication Technology Simplex technology Transmits and receives on same frequency Allows one-way communication

29. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Duplex transmissions allow simultaneous two-way communications.

30. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Multiplex systems can transmit voice and data at the same time.

31. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Communication Technology Trunking system –800-MHz pooled frequency Signal is routed to first available frequency Allows assignment of “groups” –Responders working the same incident

32. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Communication Technology Digital Communications Technology translates, or encodes, sounds into digital code for broadcast. –Faster, more accurate transmission Eases overcrowding of frequencies. Secures communications. –Requires decoder

33. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Cellular Phones

34. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Cellular Phones Communication less formal, promotes discussion, and reduces on-line time Widely available and highly reliable Digitized transmission –Allows voice and data Disadvantages –Congestion –Geography

35. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Other Digital Technologies Facsimile Computers

36. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ New Technology Touch pads Diagnostic technology –12-lead, pulse oximetry, capnography Legal guidelines still apply to electronic communications –Libel and slander concerns

37. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Reporting Procedures

38. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Reporting Procedures One of your most important skills will be gathering essential patient information, organizing it, and relaying it to the medical direction physician. Verbal communications give hospital staff information to prepare for the patient.

39. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Standard Reporting Format Identification of unit and provider Description of scene Patient’s age, sex, and approximate weight Patient’s chief complaint Brief pertinent history (OPQRST)

40. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Standard Reporting Format Pertinent past medical history (SAMPLE) Pertinent physical exam findings Treatment given so far/request for orders Estimated time of arrival at the hospital Other pertinent information

41. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Being concise, descriptive, and thorough are hallmarks of a professional.

42. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ General Radio Procedures Listen to channel first Press transmit for at least one second Speak 2–3” from the microphone Speak slowly and clearly Normal pitch Be brief Avoid 10-codes Don’t waste airtime Protect the patient’s privacy

43. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ General Radio Procedures Proper identification Do not use slang or profanity Standard transmitting formats Be concise Echo procedure Always write addresses, orders, and other important communications Obtain feedback that transmission was received

44. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Elements of Trauma Patient Report Paramedic identification Patient identification Mechanism of injury Injuries Plan

45. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Federal Communications Commission (FCC)

46. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Federal Communications Commission (FCC) The agency that controls all nongovernmental communications in the United States

47. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Federal Communications Commission (FCC) Licenses and allocates radio frequencies Establishes technical standards Monitors frequencies to assure appropriate usage Spot checks base stations and dispatch centers for appropriate licenses and records

48. Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Summary Basic Communication Model Verbal Communication Written Communication The EMS Response Communication Technology Reporting Procedures Federal Communications Commission (FCC)