Principles of Patient Assessment in EMS

1. Principles of Patient Assessment in EMS By: Bob Elling, MPA, EMT-P & Kirsten Elling, BS, EMT-P

2. Chapter 2 - Listening to Patients © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

3. Objectives • List the major components of the communication process. • Describe various methods for communicating a message. • Explain why making a proper introduction and identifying level of training is an important factor for patient communication. • Provide examples of how the EMS provider can establish trust with a patient. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

4. Objectives (continued) • Explain the EMS provider’s responsibility in maintaining the patient-EMS provider relationship. • List examples of both positive and negative facilitation. • Describe the techniques EMS providers may use to encourage feedback from a patient. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

5. Objectives (continued) • Identify two factors that tend to impede verbal communications. • Provide examples of special challenges the EMS provider may encounter in communicating with patients and some tips to manage each. • Describe verbal and nonverbal factors to consider when communicating with a patient with cultural differences. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

6. Introduction • Establishing a rapport with patient and family is important • Effective communication between EMS provider and patient takes practice • Obtaining a good history is often difficult, yet necessary • This chapter focuses on interpersonal dynamics and communications strategies © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

7. Communication is a 2-way process © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

8. The Feedback Loop • Sender • Receiver • Message • Encoding • Decoding • Feedback © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

9. Message is Communicated • Verbal – speaking and observing feedback • Non-verbal – use of body language • Non-verbal – understanding of one’s personal space • Listening – adjust the environment so it is possible to listen © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

10. Factors that Facilitate Effective Communication • Is the patient comfortable? • Consider your method of approach • Professional, respectful introductions • Addressing the patient: name and formality • Establishing trust • Consider the environment, modesty, emotional, and biological needs • Confidentiality © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

11. Communication Techniques • Facilitation – positive or negative • Open-ended questions • Closed questions • Reflection – echoing the patient’s words to encourage the flow of conversation © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

12. Communication Techniques (continued) • Clarification of confusing or ambiguous responses • Silence is sometimes helpful • Explanation to help put the patient more at ease © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

13. Barriers to Communication • Words and phrases the patient does not understand • Technical terms should be kept to a minimum (unless dealing with a health care worker) © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

14. Special Challenges • Hearing impairment • Visual impairment • Speech impairment • Non-English speaking • Developmental disability • Terminally ill © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

15. Special Challenges (continued) • Hostile patients • Anxious patients • Abused patients • Patients with multiple symptoms • Asymptomatic patients • Overly talkative patients © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

16. Communicating with Children • Your interview must be age appropriate • Kneel down to get to the child’s level • Involve the parent or caregiver in the interview © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

17. Communicating with the Elderly • Aging rate differs with the person so do not assume all elderly are visually or hearing impaired • Give the patient time to discuss the chief complaint • Verify information with a family member or caregiver as necessary © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

18. Cultural Considerations • Recognize cultural differences in your patients • Culture based preferences may conflict with usual medical practices • Don’t assume patients with a particular cultural background are different…take the time to learn about the culture • Consider verbal and non-verbal messages © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

19. Conclusion • Practice your listening skills • Do not judge • Demonstrate kindness, compassion, and empathy • Understanding basic communications skills is essential to EMS providers © 2003 Delmar Learning, a Division of Thomson Learning, Inc.