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EMS System Communications

9. EMS System Communications. Standard. Preparatory (EMS System Communication). Competency.

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EMS System Communications

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  1. 9 EMS System Communications

  2. Standard • Preparatory (EMS System Communication)

  3. Competency • Integrates comprehensive knowledge of EMS systems, the safety and well-being of the paramedic, and medical/legal and ethical issues, which is intended to improve the health of EMS personnel, patients, and the community.

  4. Introduction • In EMS, person-to-person communication, face-to-face, telephone, voice radio dialogue, cycles of telemetry data use, handwritten • Lag in development of EMS communications technology.

  5. Effective Communications • Emergency medical dispatcher (EMD): manages entire system of EMS response and readiness. • Patient, family, bystanders, others • Personnel from responding agencies (police, fire department, mutual aid ambulances)

  6. Effective Communications • Health care staff: physicians' offices, health care facilities, nursing homes. • Medical direction physician: interprets patient findings; makes medical decisions. • You must interact effectively with everyone involved in the call. • EMS is ultimate team endeavor.

  7. Basic Communication Model • Communication: exchanging information between individuals. • Language includes words, numbers, symbols, special codes. • Encode message; select medium for sending it. • Receiver must decode and understand message and give feedback.

  8. Communication occur when individuals exchange information through an encoded message.

  9. Communication occur when individuals exchange information through an encoded message.

  10. Verbal Communication • Semantic: meaning of words. • Technical: communications hardware. • Communication: mutual language. • U.S. Department of Homeland Security's SafeCom Program: plain English in emergency radio communications.

  11. Verbal Communication • Reporting Procedures • Relay all relevant medical information to receiving hospital staff. • Amount and type of information depends on: • Type of technology you use • Patient's priority • Local communication protocols

  12. Verbal Communication • Standard Format • Efficient • Helps physician assimilate information about patient's condition quickly. • Ensures medical information is complete.

  13. Verbal Communication • Standard Format • Identification of unit and provider • Description of scene • Patient's age, sex, approximate weight • Patient's chief complaint and severity • Brief, pertinent history of present illness or injury

  14. Verbal Communication • Standard Format • Pertinent past medical history, medications, allergies (SAMPLE) • Pertinent physical exam findings • Treatment given so far/request for orders • Estimated time of arrival at hospital • Other pertinent information

  15. Verbal Communication • General Radio Procedures • Radio transmissions must be clear and crisp, with concise, professional content. • Listen to channel before transmitting. • Press transmit button. • Speak at close range. • Speak slowly and clearly.

  16. Verbal Communication • General Radio Procedures • Speak in normal pitch. • Be brief. • Avoid codes unless part of EMS system. • Do not waste airtime. • Protect patient's privacy. • Use proper unit or hospital numbers and correct names or titles.

  17. Verbal Communication • General Radio Procedures • Do not use slang or profanity. • Use standard formats for transmission. • Be concise. • Use echo procedure. • Write down addresses, dispatch communications, physician orders. • Obtain confirmation that message received and understood.

  18. Written Communication • Prehospital care report (PCR): written or electronic, keyboard-/mouse-entered record of events. • Times, location, agency, crew, medical information • Legal record of incident • Part of patient's permanent medical record

  19. The prehospital care report is as important as the run itself. Complete it promptly and legibly.

  20. Written Communication • Be objective; write legibly. • Thoroughly document patient's assessment and care. • Use terminology accepted in medical community. • Illustrates your professionalism • National Emergency Medical Services Information System (NEMSIS) data dictionary

  21. Terminology • Medical field uses extensive list of terms, acronyms, abbreviations.

  22. Common Radio Terminology

  23. Terminology • Terminology considered plain English within discipline in which it is used.

  24. The Importance of Communication in EMS Response • Communication skills: empathy, confidence, self-control, authority, patience. • Clinical experience: which skills to use in any particular situation.

  25. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • Detection and citizen access • 911 or E911 (enhanced) • Automatic crash notification (CAN) • Public safety answering points (PSAPs)

  26. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • E911 technology works with landline systems. • One-third of 911 calls come from wireless/cell phones. • Wireless 911 calls that do not carry address database data cannot be routed to nearest 911 center.

  27. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • Wireless phones now located by terrestrial-based triangulation, global positioning systems (GPS), combination of the two. • Voice over Internet protocol (VOIP) • Next Generation 911 (NG-911)

  28. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • Advanced Automatic Crash Notification (AACN) • Predicting likelihood of serious injury • Decreasing response times • Assisting with field triage • Decreasing time for patients to receive trauma care

  29. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • Emergency Medical Dispatch • Emergency medical dispatcher (EMD): public's first contact with EMS system. • Priority dispatching: dispatcher follows established guidelines to determine appropriate level of response.

  30. The dispatcher determines the appropriate level of response according to established guidelines.

  31. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • Prearrival instructions: emergency measures to carry out while waiting for emergency responders to arrive. • Call coordination/incident recording:EMD's main duties are support and coordination.

  32. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • Contact medical direction physician to discuss case. • May give orders for interventions. • Taping for use later is advisable. • Relationship based on trust.

  33. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • Transfer care to receiving facility staff: give nurse or physician formal verbal briefing. • Hand-off: patient's vital information, chief complaint and history, physical exam findings, treatments rendered.

  34. The patient hand-off is an essential aspect of emergency care and ensures continuity of care between the prehospital and hospital environments.

  35. The Importance of Communication in EMS Response • Sequence of Communications in EMS Response • Never leave patient until you have completed formal transfer of care; may be charged with abandonment. • End PCR documentation with information about transfer of care.

  36. Information and Communications Technology • Situational awareness (SA) and common operating picture (COP) important considerations in EMS. • Address how prepared paramedic and team are to perform jobs effectively.

  37. Information and Communications Technology • No available systems for EMS providers to access real-time information. • Geographic information system (GIS): interfaces with smart phone/PDA/communication devices. • One information communications network linked with networks for fire, police, departments of transportation, responder colleagues

  38. Information and Communications Technology • Traditional communications technology: telecommunications engineers. • Data systems technology: hardware and software development professionals. • Information communications technology (ICT): new concept.

  39. Information and Communications Technology • Technology Today • Communication network consists of equipment for clear communication among all agencies within system. • Repeaters: receive transmissions from low-power source and rebroadcast them at higher power.

  40. Example of EMS repeater system.

  41. Information and Communications Technology • Technology Today • Radio bands and frequencies: • Ultrahigh frequency (UHF) • Very high frequency (VHF) • Geographically integrating communications networks would enable routine and reliable communication.

  42. Information and Communications Technology • Technology Today • Radio Communication • Simplex transmissions: transmit and receive on same frequency; cannot do both simultaneously. • Dispatch systems and on-scene communications

  43. Information and Communications Technology • Technology Today • Radio Communication • Duplex transmissions: simultaneous two-way communications by using two frequencies for each channel. • Works like telephone communications • Transmits voice messages or data

  44. Information and Communications Technology • Technology Today • Radio Communication • Multiplex systems: duplex systems with additional capability of transmitting voice and data simultaneously.

  45. Information and Communications Technology • Technology Today • Radio Communication • Trunked systems: pool all frequencies. • 800-MHz range • Computer routes transmission to first available frequency.

  46. Information and Communications Technology • Technology Today • Digital Communications • Digital radio popular in emergency services communication systems. • Translates (encodes) sounds into digital code for broadcast • Faster and more accurate than analog transmission

  47. Information and Communications Technology • Technology Today • Digital Communications • Ease overcrowding of radio frequencies • Mobile data unit (MDU): “ruggedized” or “hardened” laptop computer. • Voice communications will always have place in emergency services.

  48. Information and Communications Technology • Technology Today • Cellular telephone system: cost-effective way to transmit patient information to hospital. • Cellular technology in remote areas • Smart phones: voice capability of cell phone with ability to perform data messaging functions.

  49. Modern cell phones have amazing capabilities and are becoming increasingly more sophisticated.

  50. Information and Communications Technology • Technology Today • Broadband data capabilities expanding. • Cell and smart phones: communication less formal, promote discussion, reduce on-line times. • Voice communications not always reliable in commercial wireless systems.

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