When reporting your patients condition to the medical direction physician you should use terminology that?

1.)  Identify the importance of communications when providing EMS.

In EMS communication, relaying information from one person to another becomes extremely urgent in the short time that you will have to care for a patient.  That information needs to move rapidly, efficiently, and effectively.  As a paramedic, you must be able to communicate with many other people effectively.  Being a good paramedic entails putting forth your bvest efforts at service- what the "S" in EMS stands for.  A professional demeanor and skilled communication techniques are key components of a successful patient-paramedic interaction.

2.)  Identify the role of verbal and electronic communications in the provision of EMS.

Communication with dispatch is important in facilitating all phases of EMS communications.  You need to know how to organize patient information into a brief, orderly verbal report that can be transmitted by radio or by telephone.  Just as important as communicating with the dispatcher and fellow health care professionals is communicating with the patient.  This is called therapeutic communication and it involves the art and skill of communicating with people on what may be one of the worst days of their life.

You must have a reliable method of sending and receiving information back and forth to medical direction.  Although this communication has mainly been accomplished by radio in the past, cellular devices and mobile data terminals are now helping in this endeavor.  The EMS system must be configured to allow 24-hour methods of contact with medical direction at local and regional facilities.

3.)  Describe the phases of communications necessary to complete a typical EMS event.

Communication during an emergency call has several phases that are essential to appropriate patient care and transportation.  You will be exchanging information with many people, including the patient, bystanders with valuable information, the patient's family, medical control, the receiving medical facility staff, your dispatch center, law enforcement officials, and other members of the EMS team.  One paramount responsibility in an emergency is communication with your partner.  Staying in constant touch will keep each of you on top of your responsibilities and working effectively as a team while caring for your patient.

DISPATCHING.

Receipt of the Call for Help - dispatch receives the call from someone in an emergency situation.

Information gathering - dispatch tries to gather information from the caller to inform the medic of the situation.

DISPATCH.

Obtains address, routes the medic accordingly with directions and instructions. 

Advice to the caller - tries to provide over the phone advice towards the situation until the medic arrives on scene.

4.)  Identify the importance of proper terminology when communicating during an EMS event.

When you relay information to the receiving medical facility, you can use the medical terminology you have learned to make your radio report clear.  Using medical terminology and avoiding slang terms shows your professionalism and respect for everyone you work with. 

Using medical terminology correctly is essential to EMS communications.  You should learn the established and accepted medical terms and abbreviations for your EMS operations.  Some EMS systems have specific approved lists of medical abbreviations and terms that must be used.  Be sure to know acceptable terms and words used in your EMS agency. 

5.)  List factors that impede effective verbal communications.

In communication, many things may go wrong, and not all of them are equipment failures.  You need to be prepared for such situations.  Radio communication is technical and technology driven.  At times, systems may have problems, such as radio tower issues, computer crashes, telemetry failure, and audio problems.  In these situations, you must be able to troubleshoot the device quickly and, if you cannot fix it, use your planned redundancy, Follow your local protocols regarding radio failure.

6.)  List factors that enhance verbal communications.

Therapeutic communication.

If you want people to tell you about their problems, convince them you want to hear what they have to say.  When it is time to communicate, communicate.  That means listen, do not just talk.  Listening is part of communicating too, in that it transmits information. 

Active listening.  Active listening is repeating the key parts of a patient's responses to questions.  Especially when you are taking notes at the same time, repeating key parts of the patient's responses helps you to assure the patient that you really want to hear what he or she is saying.

Developing rapport.  Start by trying to set an atmosphere of trust and comfort.  Try to put the patient at ease.  Find a commonality and try to conversate with the patient in a way that makes them feel comfortable. 

RESPECT AND PROTECT PEOPLE'S MODESTY.

Modest matters- no matter how acute the medical condition.  It is especially important to the elderly, adolescents, and sometimes, the very young.  If the patient is not personally sensitive to modesty (because of an impaired mental state, for example), family members most certainly are.

7.)  Identify technology used to collect and exchange patient and/or scene information electronically.

COMMUNICATIONS SYSTEM COMPONENTS.

Base station is a collection of radio equipment consisting, at minimum, of a transmitter, receiver, and antenna.

A mobile transmitter/receiver, or mobile transceiver, is a two-way radio mounted in a vehicle.

Portable, hand-held radios are useful when paramedics must work at a distance from their vehicle but need to stay in communication with the base or with one another.

A repeater is a miniature base station used to extend the transmitting and receiving range of a telemetry or voice communications system.

A remote console, usually located in the emergency department of a hospital, is a terminal that receives transmissions of telemetry and voice form the field and transmits messages back, usually through the base station.

MODES OF RADIO OPERATION.

Simples, portable units can transmit only in one mode (voice or telemetry) or receive (voice) at any given time.  Single radio frequency.

Duplex uses two different frequencies at the same time, to permit simultaneous transmission and reception (like a telephone).

Multiplex is two or more signals- such as the paramedic's voice and the patient's ECG- for simultaneous transmission on one frequency.

Digital radio has helped clear up distorted or lost transmissions.  Conventional radios operated on fixed radio frequency (RF) channels. 

Cell phones have improved EMS communications.

BIOTELEMETRY.

The capability of measuring vital life signs and transmitting them to a distant terminal.  Biotelemetry started with ECGs but often is used for other measurements.

8.)  Recognize the legal status of patient medical information exchanged electronically.

The first thing to remember when you get "on the air" is that your words are, quite literally, in the air, floating around for anyone to hear.  Remember, anyone may be listening.  Therefore, it is essential to protect the privacy of the patient at all times.  Do not use the patient's name on the air, and do not transmit personal information about the patient.  It is an issue that relates to the Health Information Portability and Accountability Act (HIPAA) guidelines on confidentiality.  Also, check local laws applicable to your EMS system.  Certain types of cases, such as rape or psychiatric problems and confidential communicable disease history (such as HIV status), are best identified on the air by an established code or given in face-to-face communications when you arrive in the ED.  Do not assume that your cellular telephone offers you protected conversations. 

9.)  Identify the components of the local EMS communications system and describe their function and use.

COMMUNICATIONS SYSTEM COMPONENTS.

Base station is a collection of radio equipment consisting, at minimum, of a transmitter, receiver, and antenna.

A mobile transmitter/receiver, or mobile transceiver, is a two-way radio mounted in a vehicle.

Portable, hand-held radios are useful when paramedics must work at a distance from their vehicle but need to stay in communication with the base or with one another.

A repeater is a miniature base station used to extend the transmitting and receiving range of a telemetry or voice communications system.

A remote console, usually located in the emergency department of a hospital, is a terminal that receives transmissions of telemetry and voice form the field and transmits messages back, usually through the base station.

Also answered more in previous questions.

10.)  Identify and differentiate among the following communications systems.

Simples, portable units can transmit only in one mode (voice or telemetry) or receive (voice) at any given time.  Single radio frequency.

Duplex uses two different frequencies at the same time, to permit simultaneous transmission and reception (like a telephone).

Multiplex is two or more signals- such as the paramedic's voice and the patient's ECG- for simultaneous transmission on one frequency.

Digital radio has helped clear up distorted or lost transmissions.  Conventional radios operated on fixed radio frequency (RF) channels. 

Cell phones have improved EMS communications.

BIOTELEMETRY.

The capability of measuring vital life signs and transmitting them to a distant terminal.  Biotelemetry started with ECGs but often is used for other measurements.

11.)  Identify components of the local dispatch communications system and describe their function and use.

The base station is a collection of radio equipment consisting, at minimum, of a transmitter, receiver, and antenna.  The base station serves as a dispatch and coordination area and ideally should be in contact with all other elements of the system.  Base stations generally use relatively high power output (45 to 275 W); the maximum allowable power is determined by the federal Communications Commission (FCC) and printed on the station's license.

Base station is a collection of radio equipment consisting, at minimum, of a transmitter, receiver, and antenna.

A mobile transmitter/receiver, or mobile transceiver, is a two-way radio mounted in a vehicle.

Portable, hand-held radios are useful when paramedics must work at a distance from their vehicle but need to stay in communication with the base or with one another.

A repeater is a miniature base station used to extend the transmitting and receiving range of a telemetry or voice communications system.

A remote console, usually located in the emergency department of a hospital, is a terminal that receives transmissions of telemetry and voice form the field and transmits messages back, usually through the base station.

12.)  Describe the functions and responsibilities of the Federal Communications Commission.

The FCC is the agency of the US government that regulates all radio and television communications in the United States.  For radio, the FCC issues licenses, allocates frequencies, establishes technical standards, and establishes and enforces rules and regulations for the operation of radio equipment.  FCC officials monitor transmissions on various frequencies and conduct spot checks of base stations to ensure that they are properly licensed.  They say that frequencies allocated for emergency medical use be confined to that use.  The use of obscenities and the transmission of messages unrelated to the provision of medical services are forbidden by the FCC.

13.)  Describe how an EMS dispatcher functions as an integral part of the EMS team.

The verb "to dispatch" means "to send out on a mission," but the EMD does a lot more than just send ambulances to emergencies.  The EMD functions as a vital part of the paramedic team who obtains as much information as possible about the emergency, then directs the appropriate vehicle to the scene, and provides the caller with whatever advice may be needed to manage the situation until help arrives.  The EMD also monitors and coordinates communication with the field and maintains written records pertaining to the response to the call.

14.)  Identify the role of the emergency medical dispatcher in a typical EMS event.

The verb "to dispatch" means "to send out on a mission," but the EMD does a lot more than just send ambulances to emergencies.  The EMD functions as a vital part of the paramedic team who obtains as much information as possible about the emergency, then directs the appropriate vehicle to the scene, and provides the caller with whatever advice may be needed to manage the situation until help arrives.  The EMD also monitors and coordinates communication with the field and maintains written records pertaining to the response to the call.

DISPATCHING.

Receipt of the Call for Help - dispatch receives the call from someone in an emergency situation.

Information gathering - dispatch tries to gather information from the caller to inform the medic of the situation.

DISPATCH.

Obtains address, routes the medic accordingly with directions and instructions. 

Advice to the caller - tries to provide over the phone advice towards the situation until the medic arrives on scene.

15.)  Identify the importance of pre-arrival instructions in a typical EMS event.

After directing you and any rescue crew(s) to the scene and alerting all of you to any special conditions, your EMD should return to the telephone and tell the caller what is being done ("An ambulance is on the way and should be there in about 5 minutes.")  If your EMD suspects your patient has a life-threatening emergency, your EMD should also provide instructions to the caller in simple terms about emergency care techniques (such as airway maintenance, Heimlich maneuver, hands-only CPR, hemorrhage control).  The caller is likely to be in an agitated state, so instructions must be clear and simple. 

16.)  Describe the purpose of verbal communication of patient information to the hospital.

The following list shows the items that should be included when reporting medical information:

The patient's age and sex.

The patient's chief complaint.

A brief, pertinent history of the present illness or injury.

Anything the physician needs to know about the patient's other medical history relative to the current situation, including major underlying medical conditions, medications, and important allergies.

The patient's level of consciousness and degree of distress.

The patient's mental status.

The patient's vital signs.

The pertinent physical findings in head-to-toe order.

ECG findings.

Treatment given so far and response to treatment.

Estimated time of arrival at receiving facility.

It is to give the hospital and treating staff all the available information to best assist the patient upon arrival to the ED.

17.)  List information that should be included in patient assessment information verbally reported to medical direction.

The following list shows the items that should be included when reporting medical information:

The patient's age and sex.

The patient's chief complaint.

A brief, pertinent history of the present illness or injury.

Anything the physician needs to know about the patient's other medical history relative to the current situation, including major underlying medical conditions, medications, and important allergies.

The patient's level of consciousness and degree of distress.

The patient's mental status.

The patient's vital signs.

The pertinent physical findings in head-to-toe order.

ECG findings.

Treatment given so far and response to treatment.

Estimated time of arrival at receiving facility.

18.)  Identify internal and eternal factors that affect a patient/bystander interview conducted by a paramedic.

Therapeutic communication and active listening, as previously discussed in this chapter's questions.

Some scenes are noisy, but try hard not to shout.  When you shout, so does everyone else.  And when people are shouting, the tend to get excited.  If you are answering a call in a noisy place such as a bar, ask the bartender to help by turning off the music, turning up the lights, and keeping an eye on the other patrons.  (In this type of situation, get your patient out of there as soon as you can.)  Move the patient to the back of the ambulance.  Try to talk close to your patient's ears in a calm voice.  It lets him or her know that you have your emotions under control, which helps him or her stay calm as well.  Try to ask personal questions quietly and in private.

19.)  Discuss the strategies for developing patient rapport.

Convey calm, unmistakable, genuine concern for someone you have never met. 

Smile and be calm.  Reassure the patient and if possible, take things a little slower than usual. 

Here are some tips for more positive communications:

Introduce yourself and obtain the patient's first name, then use it.

Make and keep eye contact.

Position yourself at their level, or slightly lower, but maintain safety.

Be honest.

Use language the patient can understand.

Be aware of your body language.

Speak calmly and clearly.

If the patient has hearing deficits, make sure your lips are visible.

Allow the patient time to answer.

Always act confident and professional.

20.)  Provide examples of open-ended and closed-ended questions.

Open-ended questions allows the patient to give you feedback and not only gives you information, but allows you to gauge mentation.  An example, "How are you feeling at this moment?" or "Can you tell me how this all started?"

Closed-ended question or direct questions is the type of question you are eliciting a specific answer from.  Examples, "What you were you born?" or "Does your arm hurt here?"

21.)  Discuss common errors made by paramedics when interviewing patients.

Never provide false assurance or make claims that are not likely to be borne out. 

Do not give advice.  Remember your role.  You are not a physician or counselor. 

Do not consider yourself an authority. 

Do not use avoidance language.  Be direct and honest.  In addition, stay away from professional jargon as much as possible; it may be tempting to use complicated medical terms, but the average person will not understand them.

22.)  Identify the nonverbal skills that are used in patient interviewing.

A professional appearance and demeanor is likely to instill confidence in patients.  Be patient.  An impatient paramedic will make the patient feel uncomfortable and stressed.  Try to avoid gestures, facial expressions, and "closed posture" because this sends negative signals.  Do not frown or smirk at answers.  Do not roll your eyes at your partner.  Maintain constant, nonjudgmental eye contact.  Keep your voice calm and neutral, and encourage answers; do not demand them.

Some people do not like to be touched at all; to others, it is a valuable assurance that someone cares about them.  Try gently touching patients on a neutral part of their body, such as a shoulder or arm, especially when you are trying to reassure them or to mitigate their fear.

23.)  Discuss strategies to obtain information from a patient.

Reflection - The repetition of a word or phrase that a patient has used in previous statements to encourage more detail.

Empathy - Feeling what the patient is feeling.

Confrontation - making your patients aware that you understand that something is not "right" or "consistent" with their story.

Interpretation - If you are not sure what a patient is trying to tell you, sometimes it helps to vocalize what you think he or she said and invite him or her to correct you.

Facilitation - If patients hesitate to answer questions completely, encourage them to provide you with more information.

Being quiet - If you sense that patients are trying to put something into words but are having trouble expressing themselves, never miss a good opportunity to shut up.  Let the patient talk.

Clarification - If you do not understand what patients have told you, ask them to explain what they mean.

Redirection - Sometimes patients will mention something in passing or will avoid answering a specific question.  you can politely redirect their attention to that question until you get them to answer it.

Simplification and Summarization - If patients give you a confusing or disorganized response, try putting their comments into simpler terms and see if they agree with your synopsis.

24.)  Summarize the methods to assess mental status based on interview techniques.

One of the quickest methods of establishing mental status is the AVPU method.  This procedure checks the patient's level of response:  Alert to person, place, and day; Verbal response; Pain response; and Unresponsiveness.

25.)  Differentiate the strategies a paramedic uses when interviewing a patient who is hostile compared to one who is cooperative.

It is important to acknowledge the hostile person's concerns and to empathize with him or her.  Remain calm and try to understand the person's arguments.  Use questioning, clarification, and summary to help the person feel heard and understood.  Always approach hostile or angry patients with caution and maintain eye contact.  Try not to interview an angry patient by yourself.  It is a good idea for your partner to be present, but have him or her stay a little farther back to prevent the patient from feeling crowded.

As you enter the scene, identify escape routes.

Approach the patient from the front, with your hands visible and open.

If safe to do so, assume the patient's level.

Ask permission to ask questions and touch the patient.

Be wary for signs of impending attack such as clenched fists, violent language, tensed neck and face muscles, and threatening gestures.

Always be prepared to escape if necessary.

26.)  Summarize developmental considerations of various age groups that influence patient interviewing.

Try not to presume that older people are any harder to communicate with than anyone else just because they are older.  You may note individual differences among the geriatric population related to hearing, eyesight, mentation, and mobility; and you will need to adapt to them. 

Children can be difficult patients because they pose communication challenges even to the best paramedics.  They tend to protest pain vigorously, they may be afraid of strangers, they can panic when separated form their parents, and their bodies may seem unfamiliar to you.  Equipment is not as important early in your contact with children as friendly eye contact; smiles; and calm, subdued explanations geared to match the child's age.  If possible, involve a parent in the hands-on care of a conscious small child.  When parents are not available, toys are useful for bridging the space between paramedics and some children.  Many crews stock their ambulances with teddy bears for toddlers. 

Adolescents may not want their parents present at all during questioning or examination.  In fact, an adult who insists on monitoring your conversation with an adolescent should raise concern in your mind.  Do not refuse the parent, but be sure you communicate the situation to the emergency department physician.  Give options and respect modesty.

27.)  Discuss unique interviewing techniques necessary to employ with patients who have special needs.

When you encounter a patient who has trouble communicating, remember that family members or primary caretakers who know these patients well can facilitate your efforts.  Just as importantly, they can also help you alleviate the patient's fear.

Many caregivers find that touch and eye contact are helpful bridging mechanisms when caring for these kinds of patients.

With patients with PDDs such as autism, they may have difficulty developing language skills and understanding what others say to them.  They may also have difficulty communicating nonverbally, such as through hand gestures, eye contact, and facial expressions.  Often, children with autism who can speak will say things that have no meaning or that seem out of context in conversation with others. 

28.)  Discuss interviewing considerations used by paramedics in cross-cultural communications.

If your service area features one or more populations whose culture differs from your own, learn as much as you can about them.  Remember manners.  Don't use slang.  Dress appropriately.  Hand gestures-  can vary wildly culture to culture.  Body language- can vary wildly culture to culture. 

When reporting your patients condition to the medical control physician you should use terminology?

What is another term for providing false assurance to your patient?

When you press the button on the radio to talk you should wait at least how long before speaking to avoid cutting off the first words of your transmission?

What information is typically included in a radio report?