Paramedic Care: Principles & Practice Volume 2 Patient...
Transcript of Paramedic Care: Principles & Practice Volume 2 Patient...
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
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
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)
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.
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
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
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
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Verbal Communication
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.
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
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.
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
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Written Communication
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
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.
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
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
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
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
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
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
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
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
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
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
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Communication Technology
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.
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
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.
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.
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
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
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Cellular Phones
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
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
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
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 2: Patient Assessment, 3rd Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Reporting Procedures
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.
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)
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
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.
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
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
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
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)
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
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
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)