Chapter 5 Communication

Transcription

1 Chapter 5 Communication Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights reserved.

2 Objectives 1. Define key terms introduced in this chapter. 2. Discuss the purposes and characteristics of each of the following EMS system communication components (slides 15-27): a. Base station b. Mobile radios c. Portable radios d. Digitalized radio equipment e. Mobile data terminals f. Cell phones 3. Describe the responsibilities of the Federal Communications Commission (slides 28-29).

3 Objectives 4. Explain the importance of EMS system communication equipment maintenance (slides 28-29). 5. Given a radio transmitter/receiver, demonstrate the standard ground rules for radio communications (slides 30-35). 6. List key points in an EMS call at which you should communicate with dispatch (slides 36-37). 7. Deliver a concise, organized radio report that clearly conveys essential information to medical direction or the receiving facility (slides 38-43). 8. Describe the process of receiving and confirming an order from medical direction over the radio (slide 40).

4 Objectives 9. Identify situations in which you should make additional contact with medical direction or the receiving facility after providing an initial radio report. 10. Given a scenario, deliver an oral report to transfer care of the patient to a receiving facility or another EMS provider (slides 44-47). 11. Given a scenario, demonstrate effective communication that enhances team dynamics (slides 48-50). 12. Discuss the advantages and disadvantages of using radio codes (slides 51-52). 13. Convert back and forth between military time and standard clock times (slides 53-54).

5 Objectives 14. Communicate using commonly used radio terms (slides 55-56). 15. Describe the components of the communication process (slides 57-61). 16. Discuss factors that can enhance or interfere with effective communication (slides 57-61).

6 Objectives 17. Give examples of each of the following techniques of therapeutic communication (slides 62-63): a. Clarification b. Summary c. Explanation d. Silence e. Reflection f. Empathy g. Confrontation 18. Given a scenario, engage in an effective communication process with a patient (slides 64-69).

7 Objectives 19. Recognize the potential messages that may be communicated via nonverbal behaviors (slides 70-72). 20. Describe the uses, advantages, and disadvantages of open-ended and closed questions (slides 73-74). 21. Analyze your communications with a patient in a scenario to recognize the following pitfalls in communication (slides 75-76): a. Leading or biased questions b. Interrupting the patient c. Talking too much d. Providing false assurance e. Giving inappropriate advice f. Implying blame

8 Objectives 22. Discuss considerations for each of the following situations (slides 75-83): a. Communicating with a patient s family b. Getting a noncommunicative patient to talk c. Interviewing a hostile patient d. Cross-cultural communications e. Language barriers f. Communicating with children and elderly patients

9 Multimedia Directory Slide 72 Nonverbal Communication Video Slide 83 Alternate Methods of Communication Video

10 Topics " EMS Communication System " Communicating within the System " Team Communication and Dynamics " Therapeutic Communication

11 Dispatch

12 EMS Unit 2 Respond to 101 Bate Road for man bleeding in a driveway. Time out 1128

13 Upon Arrival Semi-rural area Find a 40s male sitting on a bench next to the garage, clutching hand See a workbench in the back of the garage Right hand wrapped in blood-soaked rag; shirt and pants blood-stained

14 How would you proceed?

15 EMS Communications System Back to Topics

16 Components of an Emergency Communications System Base Station Back to Objectives

17 High power Power levels limited by FCC Transmits to repeaters

18 Components of an Emergency Communications System Mobile Radios

19 Vehicle-mounted Lower powered than base station 10- to 15-mile range Transmission affected by terrain

20 Components of an Emergency Communications System Portable Radios

21 Out of vehicle use Very limited range May be used by hospital as well

22 Components of an Emergency Communications System Repeaters

23 Repeaters Rebroadcast low power signals Can be fixed or mobile

24 Components of an Emergency Communications System Digital Equipment

25 Encoder Decoder Mobile data terminal

26 Components of an Emergency Communications System Cell Phones

27 Operation Benefits Disadvantages

28 Components of an Emergency Communications System Broadcast Regulations and System Maintenance Back to Objectives

29 FCC regulates functions Appropriate system maintenance Back to Objectives

30 Communicating within the System Back to Topics

31 Ground Rules for Radio Communication Back to Objectives

32 Radio on, correct frequency Listen before transmitting Push the press to talk button; wait one second before speaking Speak with your lips two to three inches from microphone Address the unit being called by its name and number, then identify your unit by name Go ahead or stand by Keep transmissions brief

33 Keep your transmission organized and to the point Say the numerical digits if it would be confusing Avoid diagnosing the patient s problem Use the echo method Always write down important information No personal information; no profanity Use we not I Use affirmative and negative Say over when finished

34 Phone/Cell Phone Communication

35 Be familiar with technology Be aware of dead spots

36 Communicating with Dispatch Back to Objectives

37 Acknowledge the call En route On Scene Leave Scene Arrival at hospital Clear of hospital Back at station

38 Communicating with Health Care Professionals Communicating with Medical Direction Back to Objectives

39 Unit ID and level Patient age and sex Chief complaint History of present illness Past medical history Mental status Vital signs Physical exam Care already rendered Current condition Request for further actions

40 Repeat order word for word Ask for repetition if confused Don t be afraid to question order Back to Objectives

41 SBAR S Situation B Background A Assessment R Recommendation

42 Communicating with Health Care Professionals Communicating with the Receiving Facility

43 Same as report to doctor Update hospital with any changes

44 Communicating with Health Care Professionals The Oral Report Back to Objectives

45 Patient s chief complaint Vital signs en route Treatment and response Pertinent history

46 Communicating with Health Care Professionals Transferring Care to Another EMS Provider

47 ( Maria A.H. Lyle) Follow agency policy and protocols Give a verbal report Obtain information for your report prior to departure

48 Team Communication and Dynamics Back to Topics

49 Taking Charge Back to Objectives

50 Be confident Get report from responders on scene

51 Radio Codes Back to Objectives

52 Advantages Disadvantages Ten-Code system

53 Times Back to Objectives

54 Military Time 1:00 a.m. to 12 Noon = 0100 to 1200hrs 1:00 p.m. to Midnight = 1300 to 2400hrs

55 Radio Terms Back to Objectives

56 Frequently Used Radio Terms Break Clear Come in Copy ETA Go ahead Landline Repeat Stand by 10-4

57 Therapeutic Communication Back to Topics

58 Principles of Patient Communication Back to Objectives

59 Communication Verbal versus nonverbal Other factors

60 The Communication Process

61 Encoding Decoding Feedback

62 Communication Responses Back to Objectives

63 Clarification Summary Explanation Silence Reflection Empathy Confrontation Facilitated communication

64 Communicating with the Patient Back to Objectives

65 Competence Confidence Compassion

66 Patient Contact

67 First impressions critical Introduce yourself, your team, and ask for patient name Ask permission Defense mechanisms Speak clearly Use a professional tone

68 Limit interruptions Be aware of body language Be courteous Active listening Be honest with the patient

69 The Patient Interview

70 Nonverbal Communication Back to Objectives

71 Posture Distance Gestures Eye contact Haptics

72 Nonverbal Communication Click here to view a video on the topic of nonverbal communication. Return to Directory

73 Asking Questions Back to Objectives

74 Open-ended questions Closed questions

75 Considerations in Interviewing Back to Objectives

76 Don t ask leading questions Don t interrupt Don t give false assurances Interviewing a hostile patient

77 Special Circumstances Transcultural Considerations

78 Culture Ethnocentrism Communicating

79 Special Circumstances Considerations for Elderly Patients

80 Be patient Speak clearly Don t assume all have problems

81 Special Circumstances Considerations for Children Back to Objectives

82 Have patience Parents may help if they are calm Get to eye level Be honest

83 Alternate Methods of Communication Click here to view a video on the topic of alternate methods of communication with children. Return to Directory

84 Follow-Up

85 Primary Assessment Male, mid-40s, alert Blood-soaked rag but no dripping No signs or symptoms of shock currently

86 Secondary Assessment Three-inch laceration across the base of palm Sterile dressing applied Warm and moist extremity BP: 148/86mmHg; HR: 92; RR: 14

87 A: PCN M: Denies P: Denies Secondary Assessment L: Coffee 15 minutes before incident E: Denies anything unusual prior to incident

88 Reassessment and Transport Patient remains alert and oriented Report to hospital Columbia Memorial, this is Craryville BLS Unit 2 en route to you with an ETA of ten minutes. We have a 46-year-old male with a three-inch laceration of the right hand caused by a sabre saw. The patient is alert and oriented. The patient says he is allergic to penicillin

89 Reassessment and Transport Report to hospital, continued vital signs are blood pressure 146/84, radial pulse 80, respirations 14 and of good quality, skin normal, warm, and moist. We have dressed and bandaged the wound. Bleeding appears to have stopped, and patient acknowledges only slight pain from the wound. Advise dispatch of arrival at hospital

90 Arrival at Hospital Assist patient into the hospital Partner gives report to ER nurse Nurse takes charge of the patient You clean your unit and go back in service

91 Critical Thinking Scenario 36-year-old female complaining of severe abdominal pain The patient is alert and oriented Vital signs: BP: 88/64 mmhg HR: 128 bpm with weak radial pulses RR: 24 with adequate chest rise Skin is pale, cool, and clammy SpO 2 is 96 percent on room air

92 Critical Thinking Scenario SAMPLE history: S Feels light-headed and dizzy every time she stands up; she s also nauseated A No known allergies M Over-the-counter Claritin for allergies P No pertinent medical history; tonsils removed when she was 10 years old L nothing to eat or drink for 7 hours E has not felt real good for a few days

93 Critical Thinking Scenario Pain assessment: O pain began suddenly and has progressively worsened; was sitting on the couch watching television when it began P nothing makes it better or worse Q dull, aching, and intermittent R non-radiating S 8 out of 10 T four hours

94 Critical Thinking Scenario Physical exam: Pupils are equal and sluggish to respond Breath sounds are equal and clear bilaterally, no JVD Abdomen is rigid and tender, no evidence of trauma to the abdomen Good motor and sensory function in all four extremities, peripheral pulses are very weak

95 Critical Thinking Scenario Repeat vital signs: BP 82/62 mmhg HR 134 bpm, radial pulses barely palpable RR 26 with adequate chest rise Skin is more pale, cool, and clammy Pulse oximeter reading error

96 Critical Thinking Scenario En route to the hospital, the patient begins to close her eyes and you must verbally instruct her to open her eyes Your ETA to the hospital is 7 minutes

97 Critical Thinking Questions 1. What techniques would you use to communicate with this patient? 2. Are there any special circumstances that you would consider when communicating with this patient? 3. Would you contact medical direction during your management of this patient?

98 Critical Thinking Questions 4. What information is important to relay in the radio report to the receiving facility? 5. What information would you provide in your oral report to the medical personnel at the receiving medical facility during the transfer of care? 6. What information would you report regarding the change in the patient s condition?

99 Reinforce and Review Please visit and follow the mybradykit links to access content for the text.