Communications

Communications

• Communication System• CNS of EMS• Coordinates ALL essential activities between:

• Scene• Ambulance• Hospital

• Connection to medical direction • Notifies receiving hospital of impending arrival

System Components

• Base Station• Radio located at a stationary spot

• Public Safety Center, Hospital, Hilltop

• Provides hub for communication through EMS

System Components

• Mobile Two-Way Radio (transmitter/receivers)

• Radios contained within vehicles

• Mobile transmitter• Broadcast at lower

power than base stations (typically 20-50 watts)

System Components

• Portable Radios (transmitter/receiver)

• Handheld device• Typical power output of

1-5 Watts• Limited range

Repeater Systems

• Repeater Systems• Receive radio signal

from a low power radio on a certain frequency

• Rebroadcasts same signal at a higher power on another frequency

• Relay signals to dispatch center, base, hospital

• Place on high ground/buildings

Other Components

• Digital Radio Equipment

• Cell Phones

System Maintenance

• Checked periodically by a technician• As technology changes more tools become

available• i.e. Cell phones

• EMS system must provide a back up for contact of on-line medical control in case the main fails

FCC

• Federal Communications Commission (FCC)• Government agency• Regulates all aspects of radio communications in US

• Est. technical standards for radio equip• Allocates frequencies • Licenses and regulates use/repair

Communication Center

• Duties• Receives request for emergency assistance• Performs triage (determines priority of call)• Dispatches appropriate responders• Provides pre-arrival instructions to the caller• Notifies the hospital of the impending arrival of pt

• Receiving operator• Individual who receives call for assistance

• Dispatcher• Individual who communicates with field personnel

Emergency Medical Dispatch

• Gives basic 1st Aid instruction over the phone to the caller

• Based on US DOT EMS Dispatcher National Standard Curriculum

CommunicationsWhen?

• When to communicate with dispatch:

• Call is received• Unit responds/ en route• Arrival on scene• Leaving the scene/ en

route hospital • Arrival at hospital• Clear from hospital

Medical Direction

• EMT’s may need to call for orders/consultation• Must be organized, persistent, concise • Physician will decide treatment upon your report

• Be ACCURATE

• Upon approval/denial of order repeat it back WORD FOR WORD

• Unclear/inappropriate orders should be questioned

Pt Reporting Concepts

• Radio is on • Volume is appropriate• Limit background noise• Frequency is clear before starting• Use and EMS frequency for EMS

information• Press “press to talk” button and wait 1-2

sec• Speak with lips 2-3” away from mike• Address the unit being called and follow

up with the name/number of unit calling• i.e “Unit 310… this is Unit 311….”

• That unit will signal “go ahead” or “stand by”

• Speak clearly and slowly• Keep communications brief

• If longer than 30 sec, pause and allow emergency traffic

Pt Reporting Concepts Continued

• Use clear text• Avoid codes and meaningless phrases • Courtesy is assumed

• no please/thank you/etc• Give the number and then individual

digits if number can be confused• Airways are public. Scanners are

popular. NEVER use a pt name• Remain impartial• Use “we” instead of “I” • Don’t use profanity. FCC is not a fan…• Avoid “Yes/No” – Use

“affirmative/negative” • Indicate a transmission has ended

“Over”• Avoid offering a diagnosis of pt

Radio Pt Reports (en route)

• Unit #• Level of provider reporting• ETA• Pt age & sex• C/C• Brief, pertinent Hx of present illness• Mental Status• Baseline Vital Signs• Pertinent findings of physical exam• Emergency care given• Responses to care

Verbal Patient Report (arrival)

• Summarize info given over radio

• C/C• Hx not given previously

• Additional treatment given en route

• Additional vital sign taken en route

• Prehospital Care Report (PPCR)

Interpersonal Communication

• Make/keep eye contact with pt• When practical position yourself at

a level lower than the pt• Be honest• Use language the pt can

understand• Speak clearly, slowly, distinctly• Speak in calm, confident manner • Use the pt proper name and ask

what they prefer to be called• If pt has hearing problems speak

clearly with visible lips• Allow pt enough time to answer

before asking the next question

Special Populations

• Elderly• RESPECT• Gentle touch• Be sensitive to spouse

• let them ride

• Do not address pt with just 1st name unless you have permission

• Allow adequate time to respond

• Do not assume they are all hearing impaired

Special Populations

• Children/Peds• Doll/security blanket• Interact with parent & child• Allow parent to accompany child• Be honest• Approach child on level equal to theirs

Special Populations

• Hearing Impaired• React with normal

intelligence• Look DIRECTLY at pt

when talking• Write questions• Call attention/write

explanations to procedures

• Interpreter

Special Populations

• Visually Impaired • Maintain physical contact• Explain in detail what is

being done• Explain where the pt is

being moved• Make arrangements for

tx of service animal • Periodically inform pt of

status/activities

Special Populations

• Foreign Language• Translator• Manuals• Visual cues

• Altered Mental Status• Communicate in simple

terms• Try to confirm what is

causing the problem• Do not rush pt to respond• Reinforce pt• Assure pt can understand

and try not to insult them

Go forth and communicate!