Effective Communication in Paramedic Practice

Effective Communication in EMS

• Communication systems are crucial for public service agencies to exchange information during emergencies. They ensure scene safety and enable communication with personnel involved.
• The basic communication model involves an idea, encoding, sender, medium (channel), receiver, decoding, and feedback.
• Common obstacles to successful communication in emergency medical services (EMS) include attributes of the receiver, semantic issues, and time pressures.
• EMS communication should be clear, concise, and professional. It's essential to maintain patient confidentiality.

Components and Function of Dispatch Communications Systems

• An effective EMS dispatch system receives and processes calls for assistance.
• The system dispatches and coordinates EMS resources.
• It relays medical information and coordinates with public safety agencies.
• Emergency medical dispatchers determine the nature and priority of the call.
• Dispatchers dispatch appropriate responses.
• Dispatchers provide callers with prearrival instructions to help treat the patient until the responding EMS unit arrives.

Procedures for EMS Communications

• General guidelines include thinking before speaking, keying the microphone for 2-3 seconds prior to speaking, speaking at close range and clearly, speaking in a normal pitch without emotion, and being brief and concise.
• Avoid using codes unless they are system-approved; avoid slang.
• Advise the receiving party when the transmission is completed.
• Confirm that the receiving party has received the message.
• Always be professional, polite, and calm

Procedures for EMS Communications (Patient Information)

• Patient information relayed to the hospital or dispatcher should include unit and personnel identification.
• It should include the description the scene/incident.
• Relevant patient information should include age, gender, approximate weight (if needed for drug orders).
• Patient’s chief complaint or chief concern.
• Associated symptoms.
• Pertinent medical history, medications, and allergies.
• Pertinent physical examination findings.
• Any treatment given.
• Estimated time of arrival.

Procedures for EMS Communications (Communication with Medical Direction)

• When communicating with medical direction, the paramedic repeats all orders from the physician.
• Confirm unclear information and repeat drug orders for confirmation.
• Inform the hospital of any significant changes in the patient's status.

Procedures for EMS Communications (General Information)

• Protecting patient privacy.
• Using appropriate unit numbers, hospital numbers, and titles.
• Avoiding slang.
• Obtaining confirmation that the message was received.

Procedures for EMS Communications (Handoff)

• When performing a handoff of patient care to a receiving facility, the paramedic makes the final verbal report to the person assuming responsibility for the patient.

Effective Communication Strengths

• Effective communication strengthens patient autonomy and is essential for good medical practice.
• Effective communication enables rapport, trust, and confidence, improving information flow, and reducing complaints.
• Communication skills, combined with competence, empathy, and ethical behavior, are crucial for professional medical practice
• Good communication is essential for healthcare team leadership.

Effective Communication Weaknesses

• Communication breakdowns are the most common source of patient dissatisfaction in healthcare.
• Patients often criticize healthcare professionals for poor listening, inadequate explanations, or appearing disinterested.
• Patient autonomy is undermined when a doctor is a poor communicator or appears unapproachable.
• Obstacles may stem from a lack of or poor attitude to communication skills and factors in the clinical setting, or due to the patient.

HCP-related communication obstacles

• Lack of training in communication skills.
• Lack of insight into communication problems.
• Lack of sufficient time in clinical practice.
• Misapprehensions or subconscious anxieties.
• Attentions to emotional contents in the consultation
• Emotional and psychological problems of HCP's.

Obstacles in the clinical setting

• Adequacy of the waiting area and staff attitude.
• Physical surroundings of the consulting room and a lack of privacy.

Patient-related communication obstacles

• Differences between HCP and patient in age, gender, social class, education, ethnic background, and attitudes.
• Effects of illness or medication.
• Embarrassment, intimidation.
• Reluctance to ask questions or concern over time pressure.

The Use of Communication Skills in Medical Practice

• Most HCP-patient interactions occur during consultations.
• Communication skills are vital for history-taking, physical examination, diagnosis explanation, obtaining consent, patient education, effective prescribing, and counseling.

Active Listening

• An active listener focuses on the spoken and unspoken words, maintaining eye contact, using open-ended questions, and paying attention to tone of voice, demeanor, and body language.
• Nonverbal communication, such as body language conveys information.
• Silence, empathy, and summarization are crucial tools in active listening.

Starting a consultation

• An essential first step in starting the consultation involves ensuring the patient is aware that the healthcare professional has seen them as an individual.
• Introducing ones self by name should occur.

Communication when things go wrong

• In case of an adverse outcome or event, openness and frankness are needed in communication between healthcare professionals and patients.
• This should include acknowledging any patient distress and expressing concern without admitting wrongdoing.

Coping with angry patients

• Dealing with angry patients requires addressing the complaint promptly.
• Acknowledging their distress to facilitate genuine attempts at a positive resolution.
• Empowering patients in resolving their complaint.

Talking with the dying

• Effectively conveying bad news involves making time for the task, ensuring privacy, encouraging having a support person present, and offering a follow-up appointment.
• Common reactions to bad news include denial, anger, bargaining, depression, and acceptance.

Intra- and Inter-professional Communication & Relationships

• Poor communication between medical professionals can compromise patient care.
• Increased specialization and multiple professionals involved in a patient's care increase the risk of communication failures.

This quiz explores the critical role of effective communication in medical practice, particularly for paramedics. It covers aspects such as the impact on patient satisfaction, communication practices, and essential skills required for effective medical care. Test your knowledge on best practices and common pitfalls in paramedic communication.