COMMUNICATION

1. LESSON 4 COMMUNICATION

2. Introduction • Effective communication ensures critical resources reach the scene as quickly as possible • Clear communication with patients necessary to make correct assessments and provide treatment

3. Communication Within the EMS System • Calls to and from dispatch or medical direction • Verbal communication with other EMS personnel • Verbal communication at the scene with law enforcement and other responders • Written communication (documentation)

4. Factors That Make Communication Difficult • Noise and other distractions at the scene • Multiple people talking at once • Stress • Emotional patients, family members and bystanders

5. Principles of Communication • Maintain professionalism to build trust • Maintain confidentiality • Speak in plain English and avoid slang • Use medical language only when it is correct • Use exact, specific words • Make eye contact • Speak calmly • Control your body language • Be a good listener

6. Communication fromthe Dispatcher • Nature of the call and severity of problem • Name, location and callback number of the caller requesting assistance • Number and location of patient(s) • Other pertinent information

7. Radio and Telephone Communication • Speak slowly and clearly on the radio • Be concise and use the radio only as needed • Remember that others may be listening and maintain confidentiality • Ask dispatcher to repeat information if you are unsure • Stay in communication with dispatch • Report any delay in reaching the scene • Alert dispatch when you arrive • Report any observed hazards or needs for additional resources • Follow your local protocol for reporting in

8. Transferring Care of Patient • Give patient information that other responders do not know • Continuing patient care depends on your clear, detailed communication

9. Verbal Report to Responders • The patient’s current condition • The patient’s age and sex if not apparent • The chief complaint • A brief history of what happened • The patient’s condition as found

10. Verbal Report to Responders(continued) • Relevant information from the history • The patient’s vital signs • Relevant information from your physical examination • The treatment you have provided and the patient’s response

11. Importance of Documentation • Prehospital patient care report used by those continuing care • The report provides a permanent record • Documentation is a legal record: “If it’s not documented, it wasn’t done” • Documentation provides legal evidence of standards of care • Documentation often used in research to improve patient care

12. Principles of Documentation • Complete all documentation as soon as possible • Focus on factual, objective information • Identify sources of subjective information • Be as specific and detailed as possible with clinical data • With handwritten documentation, write clearly • If you make an error, correct it properly • With computerized documentation, maintain passwords and protect confidential patient information • Follow all local procedures

13. Information in the Call Report • Time of events • Assessment findings • Emergency medical care provided • Patient changes after treatment • Other observations at the scene • Patient disposition

14. Medical Terminology • Understand basic medical and anatomical terms • Medical terms are more precise • Use medical terms only when you are certain of their precise meaning

15. Principles of Medical Terminology • Most medical terms are based on Greek or Latin words • Many terms are composed of 2 or more parts • Prefix + Root + Suffix • Hypothermia (below normal body temperature) • hypo – prefix (being below or low) • therm/o – root (referring to temperature) • -ia – suffix (referring to a condition)

16. Patient Communication • Much needed information comes from responsive patients • Clear, effective communication is needed • With unresponsive patients, information from others is critical • Pain, discomfort and emotions make communication difficult • Therapeutic communication includes a caring attitude and reassurance

17. Effective Communicationwith Patients • Maintain professionalism • Speak in plain English • Use exact, specific words • Make eye contact • Speak calmly • Control your body language • Be a good listener

18. Guidelines for Patient Communication • Introduce yourself and other EMS personnel • Politely ask the patient’s name and use it respectfully • Ask for permission to provide care • Be reassuring and calming • For patients in a behavioral crisis use calming methods • Be honest with the patient • Maintain patient privacy • Respect cultural differences • Try not to invade the patient’s personal space • Position your face at the same level as the patient’s

19. Guidelines for Patient Communication (continued) • Control communication barriers • Use active listening skills • Paraphrase what the patient tells you • Give the patient time to speak • Tell the patient before touching his or her body • Explain what you are about to do • Pay attention to patient’s body language • Write notes about significant information • Use the same principles of effective communication to speak with family members

20. Barriers to Communication • Environmental distractions: • Noise • Bright lights or poor lighting • Medical equipment • Interference by others • Discomfort, pain • Lack or privacy or personal space

21. Barriers to Communication(continued) • Inattention to body language • Cultural differences • Language differences • Visual or hearing impairments • Judgmental attitude

22. Interviewing Techniques • Ask open-ended questions to gain information • Use closed-ended or direct questions for specific additional information • Ask only one question at a time • Give the patient time to answer • Use language the patient will understand • Observe closely that patient understands what you are asking

23. Avoid Duringthe Patient Interview • Don’t offer false assurance that everything will be OK • Don’t give advice • Don’t ask leading or biased questions • Don’t talk too much yourself • Don’t interrupt the patient • Don’t ask why the patient did what he or she did • Don’t be judgmental

24. Patients with Hearing Impairments • If in doubt, first ask if the person can hear you • If the patient uses a hearing aid, assist in locating or using it • Speak slowly and carefully, facing the patient who may read lips • Communicate with gestures and touch • Point to body areas and at equipment, pantomiming what will be done

25. Patients with Hearing Impairments(continued) • Involve family members • Eye contact is especially important • Do not shout or treat the patient like a child • For essential communication, write down simple phrases on a pad of paper

26. Patients with Visual Impairments • If in doubt, first ask if the person can see you well • If the patient uses eyeglasses or other aids, assist in locating them • Allow the patient’s guide dog to stay • Involve family members • Always tell the patient before you will touch him or her

27. Patients with Visual Impairments(continued) • Describe what is happening around the patient • Identify unusual sounds or other stimuli • Avoid long periods of silence when the patient may fear being left alone

28. Patients for Whom English Is a Second Language • First ask if patient speaks English (or a language you know) • Involve family members or an interpreter • Speak slowly and in simple words and phrases • Communicate with gestures and touch • Point to body areas and at equipment, pantomiming what will be done • Some people may not admit not understanding • If people in your area speak another language, take a conversational language course