Emt: Brady Emergency Care 11Th Edition - Chapter 13 - Communications

Front 1

What are the three types of communication an EMT will partake in?

Back 1

1) Radio communication

2) Verbal report at the hospital

3) Interpersonal communication

Front 2

Define "interpersonal communication" as it applies to the EMT.

Back 2

Communication with other EMTs, patients, family, bystanders, medical direction, and other members of the EMS system

Front 3

Define "base station."

Back 3

A two-way radio at a fixed site such as a hospital or dispatch center

Front 4

Define "mobile radio."

Back 4

A two-way radio that is used or affixed in a vehicle

Front 5

Define "watt."

Back 5

The unit of measurement of the output power of a radio.

Front 6

Define "portable radio."

Back 6

A handheld two-way radio

Front 7

Define "repeater."

Back 7

A device that picks up signals from lower-power radio units, such as mobile and portable radios, and retransmits them at a higher power. It allows low-power radio signals to be transmitted over great distances.

Front 8

Define "cell phone."

Back 8

I only put this here because it's listed as a term in the book. But I'm pretty sure we all know what a cell phone is.

Front 9

What is the usual output power of a mobile radio, and what's the effective range of such a radio?

Back 9

20-50 watts, 10-15 miles

Front 10

What's the usual output power of a portable radio?

Back 10

1-5 watts

Front 11

What kind of new radio technologies are being used in some areas?

Back 11

1) Microwave technology

2) Digital radio equipment

Front 12

What do you do in the event of a power failure or malfunction?

Back 12

Use back-up radio or alternative power supply. Also consider using portable radios or cell phones if your mobile radio fails.

Front 13

What federal organization assigns and licenses radio frequencies and monitors and regulates emergency radio traffic?

Back 13

The FCC

Front 14

What principles must be followed when using the EMS radio system?

(20 steps, this is a BIG one)

Back 14

1) Make sure that your radio is on and that the volume is adjusted properly.

2) Reduce background noise by closing the vehicle window when possible.

3) Listen to the frequency and ensure that it is clear before beginning a transmission

4) Press the "Press to talk (PTT)" button on your radio, then wait one second before speaking. This prevents cutting off the first few words of your transmission.

5) Speak with your lips 2-3 inches from the mic

6) When calling another unit or base station, use their unit number or name followed by yours -- e.g. "dispatcher, this is ambulance 2..."

7) The unit being called will signal that the transmission should start by saying "go ahead." e.g. "Ambulance 2, this is the dispatcher, go ahead." If they "stand by," wait for their go ahead.

8) Speak slowly and clearly

9) Keep transmission brief. If it takes longer than 30 seconds, pause for several seconds so that emergency traffic can use the frequency if necessary.

10) Do not use phrases like "be advised." These are implied and serve no purpose.

11) Use plain English. Avoid codes.

12) Courtesy is assumed -- don't use please and thank you.

13) When using numbers that could be easily misheard, say the number, then give the individual digits

14) Anything said over the radio can be heard by the public on a scanner. Do not use patient's name on the radio. Don't use inappropriate language.

15) Use "we," not "I."

16) Use "affirmative" and "negative" rather than "yes" and "no."

17) Give assessment information about your patient but avoid offering diagnosis.

18) After transmitting, say "over" and wait for acknowledgment that your transmission was heard.

19) Avoid slang or unauthorized abbreviations

20) Only use authorized EMS frequencies.

Front 15

Why is it important for the dispatcher to say and record what time it is after most transmissions?

Back 15

If the case goes to court, this information will be important. Also, this helps you fill in the time on your patient care record if necessary.

Front 16

At what times will there be transmissions between you and the dispatcher?

Back 16

1) Dispatch will contact you when dispatching your unit to a call.

2) You will contact dispatch once you've arrived at the staging area (This happens in the case of a dangerous scene. Otherwise, dispatch will direct you to the scene and you will proceed to step 4)

3) Dispatch will radio you when the scene is clear

4) You will radio dispatch when you arrive on the scene

5) You will radio dispatch when you're en route to a receiving facility

6) You will radio dispatch once you've assessed the patient's status and have an ETA to the receiving facility

7) You will radio dispatch upon arrival at the receiving facility

8) You will radio dispatch when you're leaving the facility -- and, depending on local regulations, once you're back in your district or quarters

(You might also radio dispatch between steps 4 and 5 if you need medical direction or additional resources)

Front 17

Why does the dispatcher frequently repeat a brief version of your transmissions back to you?

Back 17

This helps avoid confusion -- if two units were contacting dispatch simultaneously, this helps units determine who the dispatcher is responding to.

Front 18

What is the principle idea of making a medical report over the radio?

Back 18

The radio report is specifically structured to present pertinent facts about the patient without telling more detail than necessary.

Front 19

What are some ways to protect patient privacy when "radioing" in a report?

Back 19

Use the patient's home phone or your cell phone to keep the report off the airwaves. This practice varies from hospital to hospital and from company to company.

Front 20

What are the twelve components of any medical radio report?

Back 20

1) Unit identification and level of provider.
"St. Joseph's hospital, this is TRAA ambulance 3 en route to your location..."

2) Estimated time of arrival
"...with a 15 minute ETA..."

3) Age and sex of patient
"...we are transporting a 29-year-old female patient..."

4) Chief complaint
"...that complains of chest pains and shortness of breath..."

5) Brief, pertinent history of present illness.
"...onset of pain was 45 minutes ago, accompanied by nausea and vomiting..."

6) Major past illnesses
"...patient has no prior history of major illnesses..."

7) Mental status
"...she is alert and oriented, never lost consciousness..."

8) Baseline vitals
"...pulse is 110 and shallow, respirations 22 per minute and unlabored, skin pale and moist, blood pressure 88 over 60, Sp02 is 96 percent..."

9) Pertinent findings of the physical exam
"...chest pains are constant, palpation showed no change in pain. No physical trauma. Breath noises normal..."

10) Emergency care given
"...we are administering 100 percent oxygen via nonrebreather mask, has been placed in a position of comfort..."

11) Patient's response to emergency medical care
"...Level of pain during care showed no change. Mental status has showed no change. Vitals have showed no change..."

12) Contact medical direction if required or if you have any questions.

Front 21

What do you do after giving a medical radio report?

Back 21

Continue ongoing assessment. According to local protocols, you might radio in results of ongoing assessments as they come.

Front 22

What four guidelines must you follow in order to avoid misunderstanding and miscommunication with medical direction?

Back 22

1) Give the information to medical direction clearly and accurately, speaking slowly and clearly. PAINT A VERY CLEAR, CONCISE PICTURE.

2) After receiving an order from medical direction, repeat the order word for word.

3) If an order is unclear, ask the physician to repeat it. When you have a clear understanding of how to proceed, repeat the order to the physician.

4) If an order appears to be inappropriate, question the physician. There may have been a misunderstanding. Your questioning may prevent the inappropriate administration of a medication.

Front 23

You are en route to a call of unknown nature for an elderly patient. First responders arrived at the scene 5 minutes ago and you're still 10 minutes out. Dispatch has given you no updates. Why might this be the case, and how should you proceed?

Back 23

First responders may be too busy providing critical interventions, they may have forgotten to radio, or their radio may not work. Radio and ask for an update.

Front 24

A 17-year-old male drank a large amount of alcohol and then passed out, according to his friends that called 911. Upon arrival, the patient seems unresponsive to painful stimuli but starts slurring responses to questions soon thereafter. A few minutes after that, he withdraws from painful stimuli. How would you describe his mental status to the hospital while en route?

Back 24

Mention that the patient has consumed large amounts of alcohol. Note that the patient is currently responsive to painful stimuli, and mental status has varied.

Front 25

You are at the scene of a two-car motor vehicle collision and would like to give the local hospital some warning that you will be transporting a severely injured patient in a few minutes. Unfortunately, the hospital is unable to understand you when you radio them. How should you proceed?

Back 25

Back off and try to reduce background noise. Speak clearly and slowly. If it appears to be a radio problem, ask the dispatcher if they heard the transmission. If so, they could advise the hospital to radio or phone for you.

Front 26

You have just arrived at the scene of a 34-year-old diabetic male who is "out of it" according to the 911 caller. One of his friends, trying to be helpful, describes the patient as "conscious but unresponsive." Confused, you proceed to the patient and find him sitting in a chair, staring straight ahead silently. He doesn't do anything when you speak. He looks down at his arm when you pinch it. How can you describe this patient's mental status in a way that will give the hospital an accurate impression of what's going on?

Back 26

State "the patient is nonverbal but his eyes are open and he localizes pain by looking where painful stimulus is applied." Paint a picture.

Front 27

Upon arrival at the hospital, what's the first set of information you give to hospital personnel?

Back 27

Your verbal report, followed by a written report.

Front 28

What are the components of a verbal report during transfer of care?

Back 28

1) Introduce patient by name
2) Give chief complaint
3) History not given previously
4) Additional treatment given en route
5) Additional vitals taken en route

Front 29

What guidelines must you remember when communicating with a patient?

Back 29

1) Use eye contact

2) Be aware of position and body language

3) Use language that the patient can understand, and explain procedures before they're performed

4) Be honest

5) Use the patient's proper name

6) Listen

Front 30

How can you improve communication with a patient with a mental disability or a hearing problem.

Back 30

Speak slowly and clearly. In the case of a hard-of-hearing patient, make sure that they can see your lips.

Front 31

How can you improve communication with a patient with a sight problem?

Back 31

Explain anything that's happening that the patient can't see.

Front 32

What do you do when the patient doesn't speak the same language as you?

Back 32

Use an interpreter -- family member, friend, other EMT -- and if all else fails, check with medical direction or your communications center to see if there's somebody that can translate.