chapter 5 communication - long beach city...
TRANSCRIPT
Chapter 5
Communication
Copyright ©2010 by Pearson Education, Inc. All rights reserved.
Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich • Keith J. Karren
Objectives
1. Define key terms introduced in this chapter. 2. Discuss the purposes and characteristics of each of the
following EMS system communication components (slides 15-27): a. Base station b. Mobile radios c. Portable radios d. Digitalized radio equipment e. Mobile data terminals f. Cell phones
3. Describe the responsibilities of the Federal Communications Commission (slides 28-29).
Objectives
4. Explain the importance of EMS system communication equipment maintenance (slides 28-29).
5. Given a radio transmitter/receiver, demonstrate the standard ground rules for radio communications
(slides 30-35). 6. List key points in an EMS call at which you should
communicate with dispatch (slides 36-37). 7. Deliver a concise, organized radio report that clearly
conveys essential information to medical direction or the receiving facility (slides 38-43).
8. Describe the process of receiving and confirming an order from medical direction over the radio (slide 40).
Objectives
9. Identify situations in which you should make additional contact with medical direction or the receiving facility after providing an initial radio report.
10. Given a scenario, deliver an oral report to transfer care of the patient to a receiving facility or another EMS provider (slides 44-47).
11. Given a scenario, demonstrate effective communication that enhances team dynamics
(slides 48-50). 12. Discuss the advantages and disadvantages of using
radio codes (slides 51-52). 13. Convert back and forth between military time and
standard clock times (slides 53-54).
Objectives
14. Communicate using commonly used radio terms (slides 55-56).
15. Describe the components of the communication process (slides 57-61).
16. Discuss factors that can enhance or interfere with effective communication (slides 57-61).
Objectives
17. Give examples of each of the following techniques of therapeutic communication (slides 62-63): a. Clarification b. Summary c. Explanation d. Silence e. Reflection f. Empathy g. Confrontation
18. Given a scenario, engage in an effective communication process with a patient (slides 64-69).
Objectives
19. Recognize the potential messages that may be communicated via nonverbal behaviors (slides 70-72).
20. Describe the uses, advantages, and disadvantages of open-ended and closed questions (slides 73-74).
21. Analyze your communications with a patient in a scenario to recognize the following pitfalls in communication (slides 75-76): a. Leading or biased questions b. Interrupting the patient c. Talking too much d. Providing false assurance e. Giving inappropriate advice f. Implying blame
Objectives
22. Discuss considerations for each of the following situations (slides 75-83): a. Communicating with a patient’s family b. Getting a noncommunicative patient to talk c. Interviewing a hostile patient d. Cross-cultural communications e. Language barriers f. Communicating with children and elderly patients
Multimedia Directory
Slide 72 Nonverbal Communication Video Slide 83 Alternate Methods of Communication Video
Topics
" EMS Communication System " Communicating within the System " Team Communication and Dynamics " Therapeutic Communication
Dispatch
EMS Unit 2
Respond to 101 Bate Road for man bleeding in a driveway.
Time out 1128
Upon Arrival
• Semi-rural area • Find a 40s male sitting on a bench next to the
garage, clutching hand • See a workbench in the back of the garage • Right hand wrapped in blood-soaked rag; shirt
and pants blood-stained
How would you proceed?
Back to Topics
EMS Communications System
Components of an Emergency Communications System
Base Station
Back to Objectives
• High power • Power levels limited by FCC • Transmits to repeaters
Components of an Emergency Communications System
Mobile Radios
• Vehicle-mounted • Lower powered than
base station • 10- to 15-mile range • Transmission affected
by terrain
Components of an Emergency Communications System
Portable Radios
• Out of vehicle use • Very limited range • May be used by
hospital as well
Components of an Emergency Communications System
Repeaters
• Rebroadcast low power signals • Can be fixed or mobile
Repeaters
Components of an Emergency Communications System
Digital Equipment
• Encoder • Decoder • Mobile data terminal
Components of an Emergency Communications System
Cell Phones
• Operation • Benefits • Disadvantages
Components of an Emergency Communications System
Broadcast Regulations and System Maintenance
Back to Objectives
• FCC regulates functions • Appropriate system maintenance
Back to Objectives
Back to Topics
Communicating within the System
Ground Rules for Radio Communication
Back to Objectives
• Radio on, correct frequency • Listen before transmitting • Push the “press to talk” button; wait one
second before speaking • Speak with your lips two to three inches
from microphone • Address the unit being called by its name
and number, then identify your unit by name • “Go ahead” or “stand by” • Keep transmissions brief
• Keep your transmission organized and to the point
• Say the numerical digits if it would be confusing
• Avoid diagnosing the patient’s problem • Use the “echo” method • Always write down important information • No personal information; no profanity • Use “we” not “I” • Use “affirmative” and “negative” • Say “over” when finished
Phone/Cell Phone Communication
• Be familiar with technology • Be aware of dead spots
Communicating with Dispatch
Back to Objectives
• Acknowledge the call • En route • On Scene • Leave Scene • Arrival at hospital • Clear of hospital • Back at station
Communicating with Health Care Professionals
Communicating with Medical Direction
Back to Objectives
• Unit ID and level • Patient age and sex • Chief complaint • History of present
illness • Past medical history • Mental status • Vital signs • Physical exam • Care already
rendered • Current condition • Request for further
actions
• Repeat order word for word
• Ask for repetition if confused
• Don’t be afraid to question order
Back to Objectives
SBAR
• S – Situation • B – Background • A – Assessment • R – Recommendation
Communicating with Health Care Professionals
Communicating with the Receiving Facility
• Same as report to doctor
• Update hospital with any changes
Communicating with Health Care Professionals
The Oral Report
Back to Objectives
• Patient’s chief complaint • Vital signs en route • Treatment and response • Pertinent history
Communicating with Health Care Professionals
Transferring Care to Another EMS Provider
• Follow agency policy and protocols • Give a verbal report • Obtain information for your report prior to
departure
(©Maria A.H. Lyle)
Back to Topics
Team Communication and Dynamics
Taking Charge
Back to Objectives
• Be confident • Get report from responders on scene
Radio Codes
Back to Objectives
• Advantages • Disadvantages • Ten-Code system
Times
Back to Objectives
Military Time
• 1:00 a.m. to 12 Noon = 0100 to 1200hrs • 1:00 p.m. to Midnight = 1300 to 2400hrs
Radio Terms
Back to Objectives
Frequently Used Radio Terms • Break • Clear • Come in • Copy • ETA • Go ahead • Landline • Repeat • Stand by • 10-4
Back to Topics
Therapeutic Communication
Principles of Patient Communication
Back to Objectives
• Communication • Verbal versus nonverbal • Other factors
The Communication Process
• Encoding • Decoding • Feedback
Communication Responses
Back to Objectives
• Clarification • Summary • Explanation • Silence • Reflection • Empathy • Confrontation • Facilitated
communication
Communicating with the Patient
Back to Objectives
• Competence • Confidence • Compassion
Patient Contact
• First impressions critical
• Introduce yourself, your team, and ask for patient name
• Ask permission • Defense
mechanisms • Speak clearly • Use a professional
tone
• Limit interruptions • Be aware of body
language • Be courteous • Active listening • Be honest with the
patient
The Patient Interview
Nonverbal Communication
Back to Objectives
• Posture • Distance • Gestures • Eye contact • Haptics
Nonverbal Communication
Return to Directory
Click here to view a video on the topic of nonverbal communication.
Asking Questions
Back to Objectives
• Open-ended questions • Closed questions
Considerations in Interviewing
Back to Objectives
• Don’t ask leading questions • Don’t interrupt • Don’t give false assurances • Interviewing a hostile patient
Special Circumstances
Transcultural Considerations
• Culture • Ethnocentrism • Communicating
Special Circumstances
Considerations for Elderly Patients
• Be patient • Speak clearly • Don’t assume all
have problems
Special Circumstances
Considerations for Children
Back to Objectives
• Have patience • Parents may help
if they are calm • Get to eye level • Be honest
Return to Directory
Click here to view a video on the topic of alternate methods of communication with children.
Alternate Methods of Communication
Follow-Up
Primary Assessment • Male, mid-40s, alert • Blood-soaked rag but no dripping • No signs or symptoms of shock
currently
Secondary Assessment • Three-inch laceration across the base of
palm • Sterile dressing applied • Warm and moist extremity • BP: 148/86mmHg; HR: 92; RR: 14
Secondary Assessment • A: PCN • M: Denies • P: Denies • L: Coffee 15 minutes before incident • E: Denies anything unusual prior to
incident
• Patient remains alert and oriented • Report to hospital
– “Columbia Memorial, this is Craryville BLS Unit 2 en route to you with an ETA of ten minutes. We have a 46-year-old male with a three-inch laceration of the right hand caused by a sabre saw. The patient is alert and oriented. The patient says he is allergic to penicillin…
Reassessment and Transport
• Report to hospital, continued “…vital signs are blood pressure 146/84, radial pulse 80, respirations 14 and of good quality, skin normal, warm, and moist. We have dressed and bandaged the wound. Bleeding appears to have stopped, and patient acknowledges only slight pain from the wound.”
• Advise dispatch of arrival at hospital
Reassessment and Transport
• Assist patient into the hospital • Partner gives report to ER nurse • Nurse takes charge of the patient • You clean your unit and go back in
service
Arrival at Hospital
• 36-year-old female complaining of severe abdominal pain
• The patient is alert and oriented Vital signs: • BP: 88/64 mmHg • HR: 128 bpm with weak radial pulses • RR: 24 with adequate chest rise • Skin is pale, cool, and clammy • SpO2 is 96 percent on room air
Critical Thinking Scenario
SAMPLE history: • S – Feels light-headed and dizzy every
time she stands up; she’s also nauseated • A – No known allergies • M – Over-the-counter Claritin for allergies • P – No pertinent medical history; tonsils
removed when she was 10 years old • L – nothing to eat or drink for 7 hours • E – has “not felt real good” for a few days
Critical Thinking Scenario
Pain assessment: • O – pain began suddenly and has
progressively worsened; was sitting on the couch watching television when it began
• P – nothing makes it better or worse • Q – dull, aching, and intermittent • R – non-radiating • S – 8 out of 10 • T – four hours
Critical Thinking Scenario
Physical exam: • Pupils are equal and sluggish to respond • Breath sounds are equal and clear
bilaterally, no JVD • Abdomen is rigid and tender, no evidence
of trauma to the abdomen • Good motor and sensory function in all
four extremities, peripheral pulses are very weak
Critical Thinking Scenario
Repeat vital signs: • BP 82/62 mmHg • HR 134 bpm, radial pulses barely palpable • RR 26 with adequate chest rise • Skin is more pale, cool, and clammy • Pulse oximeter reading “error”
Critical Thinking Scenario
• En route to the hospital, the patient begins to close her eyes and you must verbally instruct her to open her eyes
• Your ETA to the hospital is 7 minutes
Critical Thinking Scenario
1. What techniques would you use to communicate with this patient?
2. Are there any special circumstances that you would consider when communicating with this patient?
3. Would you contact medical direction during your management of this patient?
Critical Thinking Questions
4. What information is important to relay in the radio report to the receiving facility?
5. What information would you provide in your oral report to the medical personnel at the receiving medical facility during the transfer of care?
6. What information would you report regarding the change in the patient’s condition?
Critical Thinking Questions
Reinforce and Review
Please visit www.bradybooks.com
and follow the myBradykit links to access content for the text.