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Transcript
Car 54 Where
Are You?
1
Types of Radios
Types of Communications
Helpful Hints
(to Stay Out of Trouble With Dispatch)
2
3
4
When in doubt of Treatment Call Rampart
5
Communications
Communication is
an essential piece
of any EMS
system and a skill
that must be
mastered by the
EMT.
Fig. 34-01
6
Communications System
► Complex
Network
 People
 Facilities
 Equipment
► Functions
 Receive calls for assistance from public
 Dispatch and coordinate response
 Provide for communication between scene and
medical facility
7
Communications — Equipment
► Base
station
► Mobile
two-way radios
► Portable
handheld radios
► Repeaters
8
Communications — Equipment
► Base
Station
 Located at a fixed site such
as a hospital or dispatch
center
 Usually runs off community
electrical power, not off a
battery
 Transmits at a much higher
rate than portables
 Often has an alternate
power source (generator)
Fig. 34-02
9
Communications — Equipment
(cont.)
► Mobile
Two-Way Radio
 Mounted in a vehicle
 Operates off of vehicle
power
 More powerful than
portable radios
 Broadcasts with much less
power than base station
 Normal range is less than
20 miles at strength of 50
watts
Fig. 34-03
10
Communications — Equipment
(cont.)
►
Portable Handheld Radio
 Can be easily carried or worn
 Operates from a small battery
 Transmits power generally under 5
watts
 Has a limited range
 Typically used for short-range
communication
 Communication can take place
directly from the patient’s side
 Gives the EMT the freedom to
communicate without being confined
to the vehicle
Fig. 34-04
11
Communications — Equipment
(cont.)
Repeaters
 Allow radio broadcasts
to cover larger
distances and avoid
significant obstacles
 Unit receives a signal
from another unit and
rebroadcasts it,
boosting strength
 Signal can be sent by:
► Radio
► Microwave
Fig. 34-05
► Telephone
12
Communications — Radio
Frequencies
VHF low band
 32 to 50 MHz frequencies
 Most susceptible to interference
 Able to curve and follow the shape of earth or
other obstacles
 Allow communication over long distances
13
Communications — Radio
Frequencies (cont.)
VHF high band
 150 to 174 MHz frequencies
 Waves travel in a straight line
 Does not bend to follow the curve of the earth
or around obstacles
 Limited to line of site
 Less susceptible to interference
14
Communications — Radio
Frequencies (cont.)
UHF
 450 to 470 MHz frequencies
 Almost interference free
 Only travel short distances
 Limited to line of site
 Used most often for telemetry
15
Equipment — Radio Frequencies
Telemetry allows the transmission of electrical
signals such as electrocardiograms between the
scene and the hospital.
Fig. 34-06
16
Equipment — Digital Radio
Equipment
800 MHz Frequencies
 Clean and interference free
 Trunking allows simultaneous communication
between different agencies or to same unit
 Radio selects available channels as necessary
 Computer controlled
17
Equipment — 800 MHz
Frequencies
Advantages
► Highly reliable
► Error free
Disadvantages
► Costly
► Has the shortest range
► Requires numerous repeaters
18
Equipment — Cellular Telephone
Combines radio frequencies above 800 MHz
range with telephone lines
Advantages
 Cost effective
 Readily available
Disadvantages
 No protected channels or frequencies
 EMS must compete with general public for access
 May be useless in disaster or during heavy usage
periods
19
Equipment — Automatic Vehicle
Locator (AVL)
►A
way to determine the ambulance closest
to the medical emergency
► A device forwards ambulance and
emergency response vehicle locations to
communications center to ensure faster
response
► Information is sent by 800 MHz trunking
system
20
Equipment — Automatic Crash
Notification (ACN)
► New
technology
► Device sends data via wireless telecommunications
► Device contacts EMS providers and notifies
responders in less than 1 minute
► Can direct EMS providers to exact location of
vehicular crash
► Crash sensor instantly measures impact and
translates rating of injury probability
► EMT can use data to determine need for additional
resources before arrival
21
Equipment — Automatic Crash
Notification (ACN) (cont.)
► Medical
records of occupants can be sent to
EMT or ED
 Medications
 Drug reactions
 Allergies
 Blood type
► Devised
to save time during an emergency
22
Communications System
Personnel
► Dispatchers
► Hospital staff
► Field personnel




EMT
Paramedic
Fire personnel
Others
23
Public Access
Influenced by several factors
► Capability of local telephone company
equipment
► Public service budgets
► Formal politics between differing
jurisdictions
► Competition with single political jurisdictions
over control of public access
24
Public Access
► Seven-digit
access number
► 911
► Enhanced
911
25
Public Access
911 has become the standard number for public
access to emergency services in the United States.
Although not yet in place in every community, this
number will eventually be in place everywhere.
Fig. 34-07
26
Emergency Medical Dispatch —
General Principles
► Involves
the dispatcher in the delivery of
emergency medical care
► Carefully
designed questions and directions
provide instructions to callers until EMS
arrives
► Not
universally available
► Some
dispatchers make decisions about the
priority or type of required EMS response
27
Emergency Medical Dispatch —
Dispatch Methods
► Occur
when the dispatch center receives a request
for EMS assistance
► Notification occurs in a variety of ways
 Fixed locations (telephone lines, teletype transmission,
computers)
 Out of base (radio or voice pager)
► System
status management method
 Deploys EMS resources (people and vehicles) in a
dynamic pattern based on anticipated call volume and
location
 Vehicles are constantly moving to provide maximum
coverage with the least amount of resource expended
28
Emergency Medical Dispatch —
En Route Communication
► As
the unit responds, notify the dispatch
center that you are en route.
► While en route to the scene, dispatch may
provide additional information obtained from
the caller or others at the scene.
 Allows responding personnel to prepare
medically and mentally
► On
arrival at the scene, notify dispatch.
29
General Guidelines for Radio
Communication
► Think
► Transmit
► Transfer
► Obtain
► Interpret
30
General Guidelines for Radio
Communication
► Make
sure the radio is turned on and
properly adjusted.
► Listen to the frequency to make sure there
is no other traffic before transmitting.
► Think about the message before the
transmit button is pushed; assemble notes
for patient report.
► Press the push-to-talk switch on the
microphone; wait 1 second before speaking.
31
General Guidelines for Radio
Communication (cont.)
► Use
plain English; the use of codes in
modern systems is uncommon.
► Keep transmissions brief; avoid the use of
unnecessary phrases such as “thank you” or
“please.”
► Remember that every word is being
transmitted and can be picked up by anyone
with a scanner (including the general public
and news media).
► Protect the patient’s privacy.
32
Communication with Medical
Direction or Destination Facility
Purpose
► Provides an opportunity to receive
instructions or advice from a physician
 Direct or on-line medical direction
► Notifies
the receiving hospital and personnel
so preparations can be made for the patient
 Can dramatically reduce the time interval
between patient arrival and definitive treatment
33
Communication with Medical
Direction or Destination Facility
Radio provides the connection between the EMT
and medical direction. It also provides the
emergency department with advance warning
about an impending patient arrival.
Fig. 34-08
34
Essential Elements and Proper
Sequence of Patient Report
► Unit
number and level of provider
► Estimated
► Age
time of arrival (ETA) *
and sex of patient
► Chief
complaint
► Brief,
pertinent history of present illness
► Major
past illnesses
35
Essential Elements and Proper
Sequence of Patient Report
► Mental
status
► Baseline
vital signs
► Pertinent
findings of physical examination
► Emergency
► Response
medical care given
to interventions
36
Essential Elements and Proper
Sequence of Patient Report
The EMT is responsible for presenting all important
patient information to the hospital in a standard
order.
Fig. 34-09
37
Communication En Route to the
Hospital
► Notify
dispatch when leaving the scene with
the patient.
 Inform dispatch that transport phase has begun.
 Some systems may include prompts or alarms in
the dispatch center if a unit is out of contact for
too long a time.
► Inform
dispatch that the transport phase is
completed and personnel can be reached at
the hospital or by radio.
38
In-Person Communication with
Facility Staff — Verbal Report
The EMT’s verbal report to hospital personnel is an
essential component of transferring responsibility
for the patient to the Emergency Department.
Fig. 34-10
39
In-Person Communication with
Facility Staff — Verbal Report
Essential elements
► Identify the EMT and unit
► Introduce the patient to hospital personnel
► Summarize the information provided on the
radio
► Chief complaint
► Pertinent history not previously relayed
► Additional treatment given en route
► Significant changes in vital signs or
response to treatment
40
Essential Principles of
Interpersonal Communication
►Act
and speak in a calm and confident
manner
►Make
and maintain eye contact with the
patient
►Speak
clearly, slowly, and distinctly
►Treat
the patient with respect; ask them
how they would prefer to be addressed
41
Essential Principles of
Interpersonal Communication
►Use
words the patient can understand;
avoid medical terminology or
abbreviations
►Be
honest and direct with the patient
►Be
constantly aware of body language
— the patient’s and the EMTs
42
Essential Principles of Interpersonal
Communication
Successfully communicating
with patients requires that
the EMT keep general
principles of communication
in mind at all times.
Fig. 34-11
43
Communication with Special
Patients
Hearing and/or Speech Impaired
Patients
► Patients
► Speak
may be capable of reading lips
clearly with lips clearly visible
► Consider
learning and using basic sign
language
► Communicate
with written notes if possible
44
Communication with Special
Patients (cont.)
Non-English Speaking Patients
► Consider learning a second language if you are
working in an area with a large non-English speaking
population
► Use a family member or friend who can communicate
with the patient
► Advise the hospital of the patient’s language
 Many have interpreters on call
► Be
innovative and imaginative in communication
 Proceed slowly and cautiously
 Use gestures to indicate what will be done
45
Communication with Special
Patients (cont.)
Children
► Children are usually emotionally
overwhelmed with what is happening to
them, making communication difficult
► Children are not little adults, either
physically or emotionally
 Win their trust and confidence
►A
parent or sibling might be of help
 They might also aggravate the emotional
situation
46
Communication with Special
Patients (cont.)
Elderly
► Often (not always) have difficulty hearing
 Speak louder or more clearly
► May
have poor vision
► Common diseases can contribute to
disorientation or confusion
► Take time to make sure that the patient
understands what is being said and what is
taking place
47
Lesson Summary
► Communication
is required throughout all
phases of EMS.
► Communication systems include various types
of radios, computer equipment, and specially
trained personnel.
► Communication provides the opportunity for
the EMT to receive on-line medical direction
from a physician.
► Notifying the receiving hospital allows for
advanced preparation.
48
Lesson Summary (cont.)
► Radio
communication with the receiving facility
has essential components that should be
delivered in a specific order.
► The EMT should keep the dispatch center
informed of the unit’s location and status
throughout the call.
► EMTs will often be exposed to situations that
present special communication challenges.
49