EMS Foundations: Chapter 4: Communications and Documentation

Therapeutic communication

Verbal + nonverbal techniques to build trust and encourage expression

Barriers to communication

Noise, cultural/language differences, hearing/vision impairments, fear/anxiety

Avoiding jargon

Use simple, clear language so patients understand; avoid technical terms

Active listening

Show engagement by nodding, reflecting, paraphrasing, and clarifying

SBAR communication

Situation, Background, Assessment, Recommendation – structured handoff tool

SOAP documentation

Subjective, Objective, Assessment, Plan – used for PCR narratives

Importance of documentation

Provides continuity of care, is a legal record, used for research and QI

PCR narrative includes

Time of events, assessment, care provided, patient response, observations, disposition

Refusal of care documentation

Assess decision-making, explain risks, obtain signatures, document thoroughly

Radio communication essentials

Unit ID, age/gender, chief complaint, brief history, assessment, treatment, vitals, ETA

Base station

High-power fixed radio at hospital/dispatch used for EMS communications

Dispatcher role

Answer/screen calls, prioritize, dispatch units, give pre-arrival instructions

FCC role

Regulates EMS radio frequencies and licenses radio operations

Transfer of care

Give an oral report to hospital staff, complete written documentation

Communication with special needs

For hearing-impaired use notes/gestures; for language barriers use interpreters

Nonverbal communication

Eye contact, body language, facial expressions, posture all convey messages

Confidentiality

HIPAA requires patient info protection in communication and documentation

Base station

Radio hardware with a transmitter + receiver in a fixed location

Cellular telephone

Low-power portable radio using interconnected repeater stations (“cells”)

Channel

Assigned frequency or set of frequencies for voice/data communications

Closed-ended questions

Questions answered with a short or single word response

Communication

Transmission of information verbally or through body language

Cultural imposition

Forcing personal beliefs/values on another person because they seem superior

Digital messaging

Email, texts, social media used by EMS to send/receive information

Documentation

Written or electronic EMT record of patient interaction (part of medical record)

Duplex

Ability to transmit and receive simultaneously

Ethnocentrism

Belief one’s own cultural values are more important than others

Interoperable communications system

VoIP system allowing multiple agencies to share voice/data

MED Channels

VHF and UHF frequencies reserved exclusively for EMS

Mobile data terminal (MDT)

Computer terminal in ambulance that receives data from dispatch

Multiplex

Transmission of audio and data signals using multiple channels

Noise

Anything that interferes with the meaning of a message

Open-ended questions

Questions requiring detailed answers from the patient

Paging

Radio signal with voice/digital message sent to pagers or monitor radios

Patient care report (PCR)

Legal document recording all patient care activities (prehospital care report)

Rapport

Trusting relationship built with a patient

Repeater

Base station radio that receives on one frequency and retransmits on another

Scanner

Radio receiver that scans several frequencies until it finds a message

Simplex

Single-frequency radio; one-way-at-a-time communication

Standing orders

Written protocols from medical director outlining patient care directions

Telemetry

Electronic signals converted + transmitted to hospital for decoding

Trunking

System that uses computers to maximize frequency use

UHF (ultra-high frequency)

Radio frequencies between 300–3,000 MHz

VHF (very high frequency)

Radio frequencies between 30–300 MHz (high + low bands)