S-SV EMS MICN Course Module 3 Communication, Documentation and Scene Safety

1. S-SV EMS MICN Course Module 3 Communication, Documentation and Scene Safety S-SV EMS Agency MICN Training (Updated 12-2018)

2. Communication and Documentation Procedures S-SV EMS Agency MICN Training (Updated 12-2018)

3. EMS Communications • EMS Communications Are Utilized To: • Dispatch EMS resources • Provide online medical control • Medical consultation • Pt. destination consultation • Pt. refusal of EMS treatment/transport consultation • Receiving hospital notification and pt. reporting • Control Facility (CF) patient distribution during an MCI S-SV EMS Agency MICN Training (Updated 12-2018)

4. EMS Communications • EMS Communication Methods • UHF radio (Mednet) • VHF radio • 800 MHz radio • Amateur radio (ham radio) • Blast phone/landline • Cellular telephone • EMResource *Not all EMS communication methods are utilized by all hospitals S-SV EMS Agency MICN Training (Updated 12-2018)

5. EMS Communications • EMS Dispatch • Receives/processes information • Emergency Medical Dispatch (EMD) used by some agencies • Determines/assigns resources • Medical Priority Dispatch System (MPDS) used by some agencies • Relays information to appropriate entities (EMS resources, hospitals, other dispatch centers, etc.) S-SV EMS Agency MICN Training (Updated 12-2018)

6. EMS Communications • Communication Rules • FCC rules/radio etiquette apply to hospitals and EMS providers • Utilize clear text • No profanity • Maintain professionalism S-SV EMS Agency MICN Training (Updated 12-2018)

7. EMS Communications • Radio Communication Etiquette • When utilizing any radio system, you must identify yourself • Goal is to convey information in a clear, concise and accurate manner • Avoid turning the receiver volume too low (incoming calls may be missed) • Think ahead, keep transmissions short and to the point to minimize airtime S-SV EMS Agency MICN Training (Updated 12-2018)

8. EMS Communications • Radio Communication Etiquette (cont.) • Listen to the radio channel and ensure it is clear before beginning transmission • Press Push To Talk (PTT) button on the radio and wait one second before speaking • Speak with your mouth about 2 – 3 inches away from the microphone S-SV EMS Agency MICN Training (Updated 12-2018)

9. EMS Communications • Radio Communication Etiquette (cont.) • Speak distinctly, at a moderate rate • Use plain language to describe a particular condition/event • Avoid words that are difficult to hear like “yes” and “no”, instead use “affirmative” and “negative” • Close the conversation appropriately so both parties are clear that the communication has ended S-SV EMS Agency MICN Training (Updated 12-2018)

10. EMS Communications • Radio Communication Etiquette (cont.) • When answering the radio, state: • Unit number of who is calling • Base hospital name • Current time (military time) • Your name (last name) • “go ahead” Example – “Medic 2 this is Mercy Redding, your time is 1530. This is MICN Smith, go ahead” S-SV EMS Agency MICN Training (Updated 12-2018)

11. EMS Communications • Cellular Telephone Communication • Preferred method by many prehospital personnel • Readily available • Easy to converse • More secure form of communication vs radio • Follow the same communication rules/etiquette as with the radio S-SV EMS Agency MICN Training (Updated 12-2018)

12. EMS Communications • Prehospital Pt. Report • Be ready to answer the call and listen carefully • Review the information provided • Did you receive enough information to prepare for the pts. arrival? • If more information is needed, ask pointed/clarifying questions • Keep conversation concise S-SV EMS Agency MICN Training (Updated 12-2018)

13. EMS Communications • Medical Consultation – Refusal of EMS Care • The following pts. refusing EMS care require base hospital consultation by prehospital personnel: • New altered LOC • Potentially life threatening condition, including but not limited to, pts meeting STEMI, stroke, or trauma triage criteria • Unstable vital signs • Disagreement between law enforcement and EMS personnel about whether or not the pt. requires EMS care S-SV EMS Agency MICN Training (Updated 12-2018)

14. EMS Communications • Medical Consultation – Refusal of EMS Care (cont.) • A pt. not legally responsible for their own healthcare being released to self or another individual on scene who is not their legally designated healthcare decision maker • Any other circumstance where EMS personnel believe that the involvement of the base hospital would be helpful • Pt. refusal consultation can normally be completed by an MICN, but may require physician consultation if there are concerns for the pts safety S-SV EMS Agency MICN Training (Updated 12-2018)

15. EMS Communications • Medical Consultation – Pt. Destination • EMS personnel are required to consult with the base hospital for destination of the following pts: • Trauma pts: • Mechanism of injury trauma criteria • Special considerations trauma criteria if they believe that a trauma center is the most appropriate destination • Adults meeting Anatomic &/or Physiologic Trauma Triage Criteria if a level III trauma center is closest • Pediatrics meeting Anatomic &/or Physiologic Trauma Triage Criteria if > 45 minutes to UCDMC or patient is too critical S-SV EMS Agency MICN Training (Updated 12-2018)

16. EMS Communications • Medical Consultation – Pt. Destination (cont.) • Other: • Burn pts meeting destination consultation criteria • VAD pts • Pts requesting transport to a further facility when ALS care has been established and they do not meet criteria for transport directly to a specialty care center • Suspected STEMI pts > 45 minutes from a STEMI receiving center or not confirmed by 12-lead ECG computer readout • Suspected stroke pts > 45minutes from a stroke receiving center S-SV EMS Agency MICN Training (Updated 12-2018)

17. EMS Communications • Medical Consultation – General • If prehospital personnel believe they need to do something that is not in their protocol, or are not sure what to do, they can ask for a medical consultation • If prehospital personnel ask for a medical consultation, provide them a physician as quickly as possible • If you believe that prehospital personnel should be doing something different than what the protocol outlines, quickly obtain a physician consult S-SV EMS Agency MICN Training (Updated 12-2018)

18. EMS Communications • Additional Communication Notes • The airways are public and radio scanners are popular – EMS communications may be overheard by more than just the EMS community • All radio and cellular telephone communications are recorded for QI and liability purposes S-SV EMS Agency MICN Training (Updated 12-2018)

19. EMS Communications • Radio Communication Examples • (Insert base hospital specific audio recording examples here) S-SV EMS Agency MICN Training (Updated 12-2018)

20. Documentation • Documentation Requirements • Base hospital specific documentation/logs are required to be completed by the MICN for all prehospital pt. reports and medical consultations • Follow hospital procedures for submitting/ maintaining completed MICN documentation • Prehospital documentation requirements: • Interim patient care report –left at receiving hospital • Electronic PCR – completed within 24 hours S-SV EMS Agency MICN Training (Updated 12-2018)

21. Prehospital EMS Scene Safety S-SV EMS Agency MICN Training (Updated 12-2018)

22. Prehospital EMS Scene Safety • Scene Safety • Primary concern of EMS responders • Determination of safety is based on information provided by dispatch as well as scene observations • GSW/stabbing/unsecure scene/hazardous materials incident • ‘Staging’ off scene may be necessary until cleared by law enforcement or other appropriate first responders (fire department, Haz Mat team, etc.) S-SV EMS Agency MICN Training (Updated 12-2018)

23. Prehospital EMS Scene Safety • Scene Safety • Goal is to ensure safety of responders, patients and bystanders • Scene safety issues may delay patient contact, treatment, transport, and/or base hospital notification S-SV EMS Agency MICN Training (Updated 12-2018)

24. Prehospital EMS Scene Safety • Scene Safety • S-SV Active Shooter/Mass Violence Policy (834) • Establishes guidelines for EMS response to an active shooter/mass violence events • Concept of properly trained and equipped medical personnel escorted by law enforcement into areas of mitigated risk (cleared but not secured), to execute triage, medical stabilization at the point-of-wounding, and provide for evacuation or sheltering in place S-SV EMS Agency MICN Training (Updated 12-2018)