11

Car 54 Car 54 Where Are Where Are

You?You?

2

Types of RadiosTypes of Radios

Types of CommunicationsTypes of Communications

Helpful Hints Helpful Hints

(to Stay Out of Trouble With (to Stay Out of Trouble With

Dispatch)Dispatch)

3

4

5

When in doubt of Treatment - When in doubt of Treatment - Call RampartCall Rampart

6

CommunicationsCommunications

Communication Communication is an essential is an essential piece of any piece of any EMS system and EMS system and a skill that must a skill that must be mastered by be mastered by the EMT.the EMT.

Fig. 34-01

7

Communications SystemCommunications System

►Complex NetworkComplex Network PeoplePeople FacilitiesFacilities EquipmentEquipment

►FunctionsFunctions Receive calls for assistance from publicReceive calls for assistance from public Dispatch and coordinate responseDispatch and coordinate response Provide for communication between scene Provide for communication between scene

and medical facilityand medical facility

8

Communications — Communications — EquipmentEquipment

►Base stationBase station

►Mobile two-way radiosMobile two-way radios

►Portable handheld radiosPortable handheld radios

►RepeatersRepeaters

9

Communications — Communications — EquipmentEquipment

► Base StationBase Station Located at a fixed site Located at a fixed site

such as a hospital or such as a hospital or dispatch centerdispatch center

Usually runs off Usually runs off community electrical community electrical power, not off a batterypower, not off a battery

Transmits at a much Transmits at a much higher rate than portableshigher rate than portables

Often has an alternate Often has an alternate power source (generator)power source (generator)

Fig. 34-02

10

Communications — Equipment Communications — Equipment (cont.)(cont.)

► Mobile Two-Way Mobile Two-Way RadioRadio Mounted in a vehicle Mounted in a vehicle Operates off of vehicle Operates off of vehicle

powerpower More powerful than More powerful than

portable radiosportable radios Broadcasts with much Broadcasts with much

less power than base less power than base stationstation

Normal range is less Normal range is less than 20 miles at strength than 20 miles at strength of 50 wattsof 50 watts

Fig. 34-03

11

Communications — Communications — Equipment Equipment (cont.)(cont.)

► Portable Handheld RadioPortable Handheld Radio Can be easily carried or wornCan be easily carried or worn Operates from a small batteryOperates from a small battery Transmits power generally under Transmits power generally under

5 watts5 watts Has a limited rangeHas a limited range Typically used for short-range Typically used for short-range

communicationcommunication Communication can take place Communication can take place

directly from the patient’s sidedirectly from the patient’s side Gives the EMT the freedom to Gives the EMT the freedom to

communicate without being communicate without being confined to the vehicleconfined to the vehicle

Fig. 34-04

12

Communications — Equipment Communications — Equipment (cont.)(cont.)

RepeatersRepeaters Allow radio broadcasts Allow radio broadcasts

to cover larger to cover larger distances and avoid distances and avoid significant obstaclessignificant obstacles

Unit receives a signal Unit receives a signal from another unit and from another unit and rebroadcasts it, rebroadcasts it, boosting strengthboosting strength

Signal can be sent by:Signal can be sent by:► RadioRadio► MicrowaveMicrowave► TelephoneTelephoneFig. 34-05

13

Communications — Radio Communications — Radio FrequenciesFrequencies

VHF low bandVHF low band 32 to 50 MHz frequencies32 to 50 MHz frequencies

Most susceptible to interferenceMost susceptible to interference

Able to curve and follow the shape of Able to curve and follow the shape of

earth or other obstaclesearth or other obstacles

Allow communication over long distancesAllow communication over long distances

14

Communications — Radio Communications — Radio Frequencies (cont.)Frequencies (cont.)

VHF high bandVHF high band

150 to 174 MHz frequencies150 to 174 MHz frequencies

Waves travel in a straight lineWaves travel in a straight line

Does not bend to follow the curve of the earth or Does not bend to follow the curve of the earth or around obstaclesaround obstacles

Limited to line of siteLimited to line of site

Less susceptible to interferenceLess susceptible to interference

15

Communications — Radio Communications — Radio Frequencies (cont.)Frequencies (cont.)

UHFUHF

450 to 470 MHz frequencies450 to 470 MHz frequencies

Almost interference freeAlmost interference free

Only travel short distancesOnly travel short distances

Limited to line of siteLimited to line of site

Used most often for telemetryUsed most often for telemetry

16

Equipment — Radio Equipment — Radio FrequenciesFrequencies

Telemetry allows the transmission of Telemetry allows the transmission of electrical signals such as electrocardiograms electrical signals such as electrocardiograms between the scene and the hospital.between the scene and the hospital.

Fig. 34-06

17

Equipment — Digital Radio Equipment — Digital Radio EquipmentEquipment

800 MHz Frequencies800 MHz Frequencies

Clean and interference freeClean and interference free

Trunking allows simultaneous communication Trunking allows simultaneous communication between different agencies or to same unitbetween different agencies or to same unit

Radio selects available channels as necessaryRadio selects available channels as necessary

Computer controlledComputer controlled

18

Equipment — 800 MHz Equipment — 800 MHz FrequenciesFrequencies

AdvantagesAdvantages►Highly reliable Highly reliable ►Error freeError free

DisadvantagesDisadvantages►CostlyCostly►Has the shortest rangeHas the shortest range►Requires numerous repeatersRequires numerous repeaters

19

Equipment — Cellular Equipment — Cellular TelephoneTelephone

Combines radio frequencies above 800 MHz Combines radio frequencies above 800 MHz range with telephone linesrange with telephone lines

AdvantagesAdvantages Cost effectiveCost effective Readily availableReadily available

DisadvantagesDisadvantages No protected channels or frequenciesNo protected channels or frequencies EMS must compete with general public for EMS must compete with general public for

accessaccess May be useless in disaster or during heavy May be useless in disaster or during heavy

usage periodsusage periods

20

Equipment — Automatic Equipment — Automatic Vehicle Locator (AVL)Vehicle Locator (AVL)

►A way to determine the ambulance A way to determine the ambulance closest to the medical emergencyclosest to the medical emergency

►A device forwards ambulance and A device forwards ambulance and emergency response vehicle locations emergency response vehicle locations to communications center to ensure to communications center to ensure faster responsefaster response

► Information is sent by 800 MHz Information is sent by 800 MHz trunking systemtrunking system

21

Equipment — Automatic Equipment — Automatic Crash Notification (ACN)Crash Notification (ACN)

► New technologyNew technology► Device sends data via wireless Device sends data via wireless

telecommunicationstelecommunications► Device contacts EMS providers and notifies Device contacts EMS providers and notifies

responders in less than 1 minuteresponders in less than 1 minute► Can direct EMS providers to exact location Can direct EMS providers to exact location

of vehicular crashof vehicular crash► Crash sensor instantly measures impact and Crash sensor instantly measures impact and

translates rating of injury probabilitytranslates rating of injury probability► EMT can use data to determine need for EMT can use data to determine need for

additional resources before arrivaladditional resources before arrival

22

Equipment — Automatic Equipment — Automatic Crash Notification (ACN) Crash Notification (ACN)

(cont.)(cont.)►Medical records of occupants can be Medical records of occupants can be

sent to EMT or EDsent to EMT or ED MedicationsMedications

Drug reactionsDrug reactions

AllergiesAllergies

Blood typeBlood type

►Devised to save time during an Devised to save time during an

emergencyemergency

23

Communications SystemCommunications System

PersonnelPersonnel►DispatchersDispatchers►Hospital staffHospital staff►Field personnelField personnel

EMTEMT ParamedicParamedic Fire personnelFire personnel OthersOthers

24

Public AccessPublic Access

Influenced by several factorsInfluenced by several factors►Capability of local telephone company Capability of local telephone company

equipmentequipment►Public service budgetsPublic service budgets►Formal politics between differing Formal politics between differing

jurisdictionsjurisdictions►Competition with single political Competition with single political

jurisdictions over control of public accessjurisdictions over control of public access

25

Public AccessPublic Access

►Seven-digit access numberSeven-digit access number

►911911

►Enhanced 911Enhanced 911

26

Public AccessPublic Access911 has become the standard number for 911 has become the standard number for public access to emergency services in the public access to emergency services in the United States. Although not yet in place in United States. Although not yet in place in every community, this number will every community, this number will eventually be in place everywhere.eventually be in place everywhere.

Fig. 34-07

27

Emergency Medical Dispatch Emergency Medical Dispatch — General Principles— General Principles

► Involves the dispatcher in the delivery Involves the dispatcher in the delivery of emergency medical careof emergency medical care

►Carefully designed questions and Carefully designed questions and directions provide instructions to directions provide instructions to callers until EMS arrivescallers until EMS arrives

►Not universally availableNot universally available►Some dispatchers make decisions Some dispatchers make decisions

about the priority or type of required about the priority or type of required EMS responseEMS response

28

Emergency Medical Dispatch Emergency Medical Dispatch — Dispatch Methods— Dispatch Methods

► Occur when the dispatch center receives a Occur when the dispatch center receives a request for EMS assistancerequest for EMS assistance

► Notification occurs in a variety of waysNotification occurs in a variety of ways Fixed locations (telephone lines, teletype Fixed locations (telephone lines, teletype

transmission, transmission, computers)computers) Out of base (radio or voice pager)Out of base (radio or voice pager)

► System status management methodSystem status management method Deploys EMS resources (people and vehicles) in a Deploys EMS resources (people and vehicles) in a

dynamic pattern based on anticipated call dynamic pattern based on anticipated call volume and locationvolume and location

Vehicles are constantly moving to provide Vehicles are constantly moving to provide maximum coverage with the least amount of maximum coverage with the least amount of resource expendedresource expended

29

Emergency Medical Emergency Medical Dispatch — En Route Dispatch — En Route

CommunicationCommunication►As the unit responds, notify the dispatch As the unit responds, notify the dispatch

center that you are en route.center that you are en route.►While en route to the scene, dispatch While en route to the scene, dispatch

may provide additional information may provide additional information obtained from the caller or others at the obtained from the caller or others at the scene.scene. Allows responding personnel to prepare Allows responding personnel to prepare

medically and mentallymedically and mentally

►On arrival at the scene, notify dispatch. On arrival at the scene, notify dispatch.

30

General Guidelines for Radio General Guidelines for Radio CommunicationCommunication

►ThinkThink

►TransmitTransmit

►TransferTransfer

►ObtainObtain

► InterpretInterpret

31

General Guidelines for Radio General Guidelines for Radio CommunicationCommunication

►Make sure the radio is turned on and Make sure the radio is turned on and properly adjusted.properly adjusted.

►Listen to the frequency to make sure there Listen to the frequency to make sure there is no other traffic before transmitting.is no other traffic before transmitting.

►Think about the message before the Think about the message before the transmit button is pushed; assemble notes transmit button is pushed; assemble notes for patient report.for patient report.

►Press the push-to-talk switch on the Press the push-to-talk switch on the microphone; wait 1 second before microphone; wait 1 second before speaking.speaking.

32

General Guidelines for General Guidelines for Radio Communication Radio Communication

(cont.)(cont.)►Use plain English; the use of codes in Use plain English; the use of codes in

modern systems is uncommon.modern systems is uncommon.►Keep transmissions brief; avoid the Keep transmissions brief; avoid the

use of unnecessary phrases such as use of unnecessary phrases such as “thank you” or “please.”“thank you” or “please.”

►Remember that every word is being Remember that every word is being transmitted and can be picked up by transmitted and can be picked up by anyone with a scanner (including the anyone with a scanner (including the general public and news media).general public and news media).

►Protect the patient’s privacy.Protect the patient’s privacy.

33

Communication with Medical Communication with Medical Direction or Destination Direction or Destination

FacilityFacilityPurposePurpose►Provides an opportunity to receive Provides an opportunity to receive

instructions or advice from a physicianinstructions or advice from a physician Direct or on-line medical directionDirect or on-line medical direction

►Notifies the receiving hospital and Notifies the receiving hospital and personnel so preparations can be made personnel so preparations can be made for the patientfor the patient Can dramatically reduce the time interval Can dramatically reduce the time interval

between patient arrival and definitive between patient arrival and definitive treatmenttreatment

34

Communication with Medical Communication with Medical Direction or Destination FacilityDirection or Destination Facility

Radio provides the connection between the Radio provides the connection between the EMT and medical direction. It also provides EMT and medical direction. It also provides the emergency department with advance the emergency department with advance warning about an impending patient arrival.warning about an impending patient arrival.

Fig. 34-08

35

Essential Elements and Essential Elements and Proper Sequence of Patient Proper Sequence of Patient

ReportReport►Unit number and level of providerUnit number and level of provider

►Estimated time of arrival (ETA) *Estimated time of arrival (ETA) *

►Age and sex of patientAge and sex of patient

►Chief complaintChief complaint

►Brief, pertinent history of present illnessBrief, pertinent history of present illness

►Major past illnessesMajor past illnesses

36

Essential Elements and Essential Elements and Proper Sequence of Patient Proper Sequence of Patient

ReportReport►Mental statusMental status

►Baseline vital signsBaseline vital signs

►Pertinent findings of physical examinationPertinent findings of physical examination

►Emergency medical care givenEmergency medical care given

►Response to interventionsResponse to interventions

37

Essential Elements and Proper Essential Elements and Proper Sequence of Patient ReportSequence of Patient Report

The EMT is responsible for presenting all The EMT is responsible for presenting all important patient information to the hospital important patient information to the hospital in a standard order.in a standard order.

Fig. 34-09

38

Communication En Route to Communication En Route to the Hospitalthe Hospital

►Notify dispatch when leaving the scene Notify dispatch when leaving the scene with the patient.with the patient. Inform dispatch that transport phase has Inform dispatch that transport phase has

begun.begun. Some systems may include prompts or Some systems may include prompts or

alarms in the dispatch center if a unit is alarms in the dispatch center if a unit is out of contact for too long a time.out of contact for too long a time.

► Inform dispatch that the transport Inform dispatch that the transport phase is completed and personnel can phase is completed and personnel can be reached at the hospital or by radio.be reached at the hospital or by radio.

39

In-Person Communication with In-Person Communication with Facility Staff — Verbal ReportFacility Staff — Verbal Report

The EMT’s verbal report to hospital personnel The EMT’s verbal report to hospital personnel is an essential component of transferring is an essential component of transferring responsibility for the patient to the responsibility for the patient to the Emergency Department.Emergency Department.

Fig. 34-10

40

In-Person Communication In-Person Communication with Facility Staff — Verbal with Facility Staff — Verbal

ReportReportEssential elementsEssential elements► Identify the EMT and unitIdentify the EMT and unit► Introduce the patient to hospital Introduce the patient to hospital

personnelpersonnel►Summarize the information provided on Summarize the information provided on

the radiothe radio►Chief complaintChief complaint►Pertinent history not previously relayedPertinent history not previously relayed►Additional treatment given en routeAdditional treatment given en route►Significant changes in vital signs or Significant changes in vital signs or

response to treatmentresponse to treatment

41

Essential Principles of Essential Principles of Interpersonal Interpersonal

CommunicationCommunication►Act and speak in a calm and confident Act and speak in a calm and confident

mannermanner►Make and maintain eye contact with Make and maintain eye contact with

the patientthe patient►Speak clearly, slowly, and distinctlySpeak clearly, slowly, and distinctly►Treat the patient with respect; ask Treat the patient with respect; ask

them how they would prefer to be them how they would prefer to be addressedaddressed

42

Essential Principles of Essential Principles of Interpersonal Interpersonal

CommunicationCommunication►Use words the patient can Use words the patient can

understand; avoid medical understand; avoid medical terminology or abbreviationsterminology or abbreviations

►Be honest and direct with the patientBe honest and direct with the patient►Be constantly aware of body Be constantly aware of body

language — the patient’s and the language — the patient’s and the EMTsEMTs

43

Essential Principles of Essential Principles of Interpersonal CommunicationInterpersonal Communication

Successfully Successfully

communicating with communicating with

patients requires that the patients requires that the

EMT keep general EMT keep general

principles of principles of

communication in mind at communication in mind at

all times.all times.Fig. 34-11

44

Communication with Special Communication with Special PatientsPatients

Hearing and/or Speech Impaired Hearing and/or Speech Impaired PatientsPatients

►Patients may be capable of reading lipsPatients may be capable of reading lips►Speak clearly with lips clearly visibleSpeak clearly with lips clearly visible►Consider learning and using basic sign Consider learning and using basic sign

languagelanguage►Communicate with written notes if Communicate with written notes if

possiblepossible

45

Communication with Special Communication with Special Patients (cont.)Patients (cont.)

Non-English Speaking PatientsNon-English Speaking Patients► Consider learning a second language if you are Consider learning a second language if you are

working in an area with a large non-English working in an area with a large non-English speaking populationspeaking population

► Use a family member or friend who can Use a family member or friend who can communicate with the patientcommunicate with the patient

► Advise the hospital of the patient’s languageAdvise the hospital of the patient’s language Many have interpreters on callMany have interpreters on call

► Be innovative and imaginative in communicationBe innovative and imaginative in communication Proceed slowly and cautiouslyProceed slowly and cautiously Use gestures to indicate what will be doneUse gestures to indicate what will be done

46

Communication with Special Communication with Special Patients (cont.)Patients (cont.)

ChildrenChildren►Children are usually emotionally Children are usually emotionally

overwhelmed with what is happening to overwhelmed with what is happening to them, making communication difficultthem, making communication difficult

►Children are not little adults, either Children are not little adults, either physically or emotionallyphysically or emotionally Win their trust and confidenceWin their trust and confidence

►A parent or sibling might be of helpA parent or sibling might be of help They might also aggravate the emotional They might also aggravate the emotional

situationsituation

47

Communication with Special Communication with Special Patients (cont.)Patients (cont.)

ElderlyElderly►Often (not always) have difficulty hearingOften (not always) have difficulty hearing

Speak louder or more clearlySpeak louder or more clearly

►May have poor visionMay have poor vision►Common diseases can contribute to Common diseases can contribute to

disorientation or confusiondisorientation or confusion►Take time to make sure that the patient Take time to make sure that the patient

understands what is being said and what understands what is being said and what is taking placeis taking place

48

Lesson SummaryLesson Summary►Communication is required throughout all Communication is required throughout all

phases of EMS.phases of EMS.►Communication systems include various Communication systems include various

types of radios, computer equipment, and types of radios, computer equipment, and specially trained personnel.specially trained personnel.

►Communication provides the opportunity Communication provides the opportunity for the EMT to receive on-line medical for the EMT to receive on-line medical direction from a physician.direction from a physician.

►Notifying the receiving hospital allows for Notifying the receiving hospital allows for advanced preparation.advanced preparation.

49

Lesson Summary (cont.)Lesson Summary (cont.)

►Radio communication with the receiving Radio communication with the receiving facility has essential components that facility has essential components that should be delivered in a specific order.should be delivered in a specific order.

►The EMT should keep the dispatch center The EMT should keep the dispatch center informed of the unit’s location and status informed of the unit’s location and status throughout the call.throughout the call.

►EMTs will often be exposed to situations EMTs will often be exposed to situations that present special communication that present special communication challenges.challenges.