Communication.pdf

1 Dr. Tarek Esmael LECTURER OF GENERAL & LAPAROSCOPIC SURGERY (M.D) GENERAL SURGERY  2  I.Communications Basics  A.System components ...

1 Dr. Tarek Esmael LECTURER OF GENERAL & LAPAROSCOPIC SURGERY (M.D) GENERAL SURGERY  2  I.Communications Basics  A.System components  1.Base station -a radio that is located at a stationary site such as a hospital, mountaintop, or public safety agency  2.Mobile two-way radios (transmitter/receivers)  a. Implies a vehicular mounted device  b.Mobile transmitters usually transmit at lower power than base stations (typically 20-50 watts).  c.Typical transmission range is 10-15 miles over average terrain.  3  3.Portable radios (transmitter/receivers)  a.Implies a hand-held device  b.Typically have power output of 1-5 watts, limiting their range  4.Repeater/base station-receives a transmission from a low-power portable or mobile radio on one frequency and retransmits at a higher power on another frequency  5.Digital equipment  6.Cellular telephones  4  B.Radio frequencies-assigned and licensed and regulated by the Federal Communications Commission (FCC)  C.System maintenance  1.Communication equipment needs to be checked periodically (e.g., to ensure that a radio is not drifting from its assigned frequency).  2.As technology changes, new equipment becomes available that may have a role in EMS systems (e.g., cellular phones).  3.Since EMT-Basics need to be able to consult on-line medical direction, an EMS system must provide a backup in case the usual procedures do not work. Example of an EMS System Using Repeaters  6 II.Communications Within the EMS System A.Basic principles 1.Be sure radio is on and volume is properly adjusted. 2.Listen to the frequency and ensure it is clear before beginning a transmission. 3.Press the "press to talk" (PTT) button on the radio and wait for 1 second before speaking.  7 4. Speak with lips about 2 to 3 inches from the microphone. 5. Address the unit being called, then give the name of the unit (and number if appropriate) from where the transmission is originating. 6. The unit being called will signal that the transmission should start by saying "go ahead" or some other term standard for that area. A response of "stand by" means wait until further notice. 7. Speak clearly and slowly, in a monotone voice. 8. Keep transmissions brief. If, on occasion, a transmission takes longer than 30 seconds, stop at that point and pause for a few seconds so that emergency traffic can use the frequency if necessary. 9. Use clear text. 10. Avoid codes, especially those not standardized. 11. Avoid meaningless phrases like "be advised.“ 12. Courtesy is assumed, so there is no need to say "please," "thank you," or "you're welcome."  8 13.When transmitting a number that might be confused (e.g., a number in the teens), give the number, then give the individual digits. 14.The air waves are public and scanners are popular. EMS transmissions may be overheard by more than just the EMS community. Do not give a patient's name over the air. 15.For the same reason, be careful to remain objective and impartial in describing patients. An EMT-Basic may be sued for slander if he or she injures someone's reputation in this way.  9 16.An EMT-Basic rarely acts alone. Use "we" instead of "I." 17.Do not use profanity on the air. The FCC takes a dim view of such language and may impose substantial fines. 18.Avoid words that are difficult to hear such as "yes" and "no." Use "affirmative" and "negative." 19.Use the standard format for transmission of information. 20.When the transmission is finished, indicate this by saying"over." Get confirmation that the message was received. 21.Avoid offering a diagnosis of the patient's problem. 22.Use EMS frequencies only for EMS communication. 23.Reduce background noise as much as possible by closing the window.  10 B.Response to the scene 1.The dispatcher needs to be notified that the call was received. 2.Dispatch needs to know that the unit is en route. 3.Other agencies should be notified as appropriate (e.g., local hospital). 4.Arrival at the scene-the dispatcher must be notified.  11 C.Communication with medical direction 1.In some systems, medical direction is at the receiving facility. In others, medical direction is at a separate site. 2.In either case, EMT-Basics may need to contact medical direction for consultation and to get orders for administration of medications. Radio transmissions need to be organized, concise, and pertinent. 3.Since the physician will determine whether to order medications and procedures based on the information given by the EMT-Basic, this information must be accurate. 4.After receiving an order for a medication or procedure (or denial of such a request), repeat the order back word for word. 5.Orders that are unclear or appear to be inappropriate should be questioned.  12 SBAR  S  Situation  B  Background  A  Assessment  R  Recommendation  13 D.Communication with receiving facilities 1.Notify dispatch when unit leaves the scene in order to allow hospital to prepare for a patient's arrival by having the right room, equipment, and personnel prepared. 2.When communicating with medical direction or the receiving facility, an oral report should be given. The essential elements of such a report, in the order they should be given, a.Identify level of provider (who and what) 14 b.Estimated time of arrival c.Patient's age and sex d.Chief complaint e.Brief, pertinent history of the present illness f.Major past illnesses g.Mental status h.Baseline vital signs i.Pertinent findings of the physical exam j.Emergency medical care given k.Response to emergency medical care 3.After giving this information, the EMT-Basic will continue to assess the patient. Additional vital signs may be taken and new information may become available, particularly on long transports. In some systems, this information should be relayed to the hospital. (See local protocol.) Information that must be transmitted includes deterioration in the patient's condition.  15 E.Arrival at and departure from the hospital 1.The dispatcher must be notified on arrival. 2.In some systems, the hospital should also be notified. 3.Leaving the hospital for the station-the dispatcher should be notified 4.Arrival at the station-the dispatcher should be notified.  16 F.Oral communication 1.After arrival at the hospital, give an oral report to the staff. a.Introduce the patient by name (if known). b.Summarize the information given over the radio. (1)Chief complaint (2)History that was not given previously (3)Additional treatment given en route (4)Additional vital signs taken en route c.Give additional information that was collected but not transmitted. G.Written communication-this is covered in the lesson on documentation. (Chapter 12)  17 Transferring patient care to another EMS provider  patient current condition , age, sex & chief complaint  short resent & past history  Vital signs  Emergency medical care was given & patient’s response  18 III.Team communication and Dynamics Taking Charge Radio codes Times Radio Terms  19 Therapeutic communication  Communication process.  Communication Responses.Clarification. Summary. Explanation. Reflection. Empathy. Confrontation. Facilitated communication  20 Basics of communicating with patients & patient contact 1.Make and keep eye contact with the patient. 2.When practical, position yourself at a level lower than the patient. 3.Be honest with the patient. 4.Use language the patient can understand. 5.Be aware of your own body language. 6.Speak clearly, slowly, and distinctly. 7.Use the patient's proper name, either first or last, depending on the circumstances. Ask the patient what he or she wishes to be called. 8.If a patient has difficulty hearing, speak clearly with lips visible. 9.Allow the patient enough time to answer a question before asking the next one. 10.Act and speak in a calm, confident manner.  21 Nonverbal Communication  Posture Distance Gestures Eye contact Haptics  22 Questions  Open ended questions Closed questions Consideration in Interviewing.. No leading questions. No interruption. No false assurance. No inappropriate advice. No why questions. Family preference issues  23 Special consideration. Transcultural consideration. Consideration for elderly 1.Potential for visual deficit 2.Potential for auditory deficit. Consideration for children