Communication in Emergency Medical Services

Four Types of Communication

  • Communication is essential for calls, impacting interactions between:
    • You and the patient.
    • You and your crew.
    • The patient and their surroundings.
  • Communication is the bedrock of how a call unfolds.

Defining Communication

  • Communication entails conveying information.
  • It's crucial to possess knowledge to communicate effectively.

Individuals Involved in Communication

  • Communication involves various individuals:
    • Patients.
    • Partners.
    • Other EMS personnel.
    • Fire personnel.
    • Law enforcement.
    • Bystanders.
    • Doctors.
    • Nurses.
    • Family members.
    • Friends of patients.

Stressful Situations

  • Stressful situations affect patients, responders, and bystanders.

Real-Life Example: Lesbian Female at McDonald's

  • A situation occurred involving a lesbian female who was assaulted at McDonald's.
  • يتعلق الامر بضروره التواصل مع الجميع المتورطون في الموقف.
  • يتعلق الامر بضروره التأكد من أن نقل المعلومات سيترك انطباعا كبيرا.

Impact of Communication

  • Communication profoundly affects the patient's family, potentially calming them down or causing alarm.

Communication with Patients

  • Approaching a patient with empathy is crucial, such as in the case of a 14-year-old with a minor cut.
  • Instead of panicking, address the situation calmly to reassure the patient and their family.
  • Acknowledge the situation and offer assistance:
    • "Let me take a look at that."

Communication with Bystanders

  • Handle bystanders with care, avoiding confrontational approaches.
  • Instead:
    • Tape off the area.
    • Request them to step away for safety reasons.

Impact on Other Responders

  • Clear communication prevents misalignment, especially between experienced and new personnel.
  • Minimizing miscommunication:
    • Be clear.
    • Be vocal.
    • Document.

Closed Loop Communication (Parodying)

  • Essential for emergency situations, especially cardiac arrests.
  • Involves repeating back instructions or information to ensure understanding.
  • Example:
    • Initiator: "Matt, I need you to set up a line for me."
    • Responder: "Set up a line for you."
  • Verbal confirmation is necessary to validate comprehension.
  • Use in various scenarios, such as:
    • Fire incidents.
    • Cardiac arrests.
    • Car extractions.

Verbal vs. Nonverbal Communication

  • Communication modes:
    • Verbal: words.
    • Nonverbal: body language and sounds.
  • Body language is equally or more impactful than verbal cues.

Importance of Body Language

  • Body language impacts communication:
    • Posture.
    • Visual cues.
  • Professionals should avoid inappropriate body language or words.

Therapeutic Communication

  • Therapeutic communication focuses on advancing physical and emotional well-being.

Example of Therapeutic Communication

  • Example: Assisting someone with a cut.
  • Involves walking them through the process:
    • Cleaning the wound.
    • Bandaging it.
    • Ensuring they feel better afterward.
  • Pain management:
    • Assessing pain levels before and after medication.
    • Asking if there's anything else you can do for them.

Objectives of Therapeutic Communication

  • Collecting information.
  • Assessing behavior.
  • Educating the patient.

Communication Process

  • Sender initiates communication.
  • Message conveys information.
  • Receiver receives the message.
  • Message can be verbal or nonverbal.

Body Language

  • Body language accounts for 55% of communication.
  • Includes gestures, expressions, posture, and physical manifestations.
  • Training in body language enhances perception.

Microexpressions

  • Microexpressions reveal underlying emotions.
  • Crow's feet indicate genuine happiness.
  • Amygdala controls fight, flight, or freeze response.
  • The modern brain dictates societal behavior.
  • Feet positioning indicates engagement or disinterest.
    • Feet towards the door suggest a desire to leave.

Nonverbal Cues

  • Nonverbal cues are critical, especially with patients who may not disclose everything.

Voice

  • Voice qualities influence communication:
    • Quality.
    • Tone.
    • Inflections.

Words and Terminology

  • Words used affect communication.
    • Appropriate usage of medical terminology and profanity.

Other Factors Affecting Communication

  • Hearing aids or loss of hearing.
  • Blindness.
  • Muteness.

Perceptual and Emotional Factors

  • Perceptual differences.
  • Emotional state.
  • Cultural and language barriers.
  • Gender.
  • Interpersonal issues.

Strategies for Clear Communication

  • Speak clearly and use understandable terminology.

Avoid Taking Patient Remarks Personally

  • Recognize that patients may not be in a stable state.
  • Patients may exhibit altered behavior due to:
    • Low blood sugar.
    • Intoxication.
    • Head injuries.

Active Listening

  • Active listening involves:
    • Eye contact.
    • Understanding patient.
    • Nodding.
    • Repeating back to show understanding.
  • Avoid passive hearing while documenting.

Assertiveness

  • Assertiveness is crucial, especially when safety is at stake.

Body Language Awareness

  • Recognize and manage body language.

Accepting Miscommunication

  • Accept that miscommunication is inevitable.
  • Communication is consistently a training topic.

Patient Interview Strategies

Introduction and Level of Training

  • Introduce yourself and your level of training.
  • Obtain patient's name early and use it frequently.

Positioning and Questioning

  • Position yourself at or below patient's eye level.
  • Ask one question at a time.
  • Listen carefully to the patient's answers.
  • Restate the patient's answer.

Adapting Communication

  • Notice what communication approaches work and what doesn't.
  • Adapt communication based on the patient's age and presentation.
  • Engage parents to gain the minor's trust.

Cultural Sensitivity

  • Demonstrate respect for different cultures and beliefs.

Translation Services

  • Use translation services cautiously and document usage.

Cognitive Disabilities

  • Consider cognitive disabilities and service animals.

Healthcare Literacy

  • Address healthcare literacy degrees.
  • Tailor communication to the patient's understanding.

Utilizing Support Systems

  • Use family members to help convince patients, especially in difficult situations.

Communication Process Review

  • Three parts of the communication process:
    • Sender.
    • Message.
    • Receiver.
  • Body Language impacts communication.
  • Name frequently, understand their verbiage.

Transfer of Care

  • Transfer of care involves verbal transfer.
  • Abandonment occurs if transferring to an unqualified individual.

Hospital Protocols

  • Hospitals have different protocols.

Continuum of Care

  • Continuum of care ensures consistency and appropriateness.
  • Includes communication, documentation, and proper handoff.

Verbal Report Elements

  • Verbal report elements:
    • Name.
    • Age.
    • Chief complaint.
    • Overview of actions taken.
    • Patient's response.

Abbreviated Report

  • Abbreviated reports are used in critical situations.
  • Convey essential information quickly.

Radio Communication

Radio Components

  • Transmitters.
  • Receivers.
  • Repeaters.
  • Dispatch centers.
  • Pagers versus handheld portable radios.

Radio Protocol

  • Radios require specific protocols when communicating with other systems.
  • Specify who you're contacting before stating your name.
  • Use common language, such as:
    • "En route."
    • "On scene."
    • "Message received."
  • Avoid using 10 codes.

Incident Command Structure (ICS)

  • ICS was developed post-Hurricane Katrina.
  • ICS provides a standardized communication framework.

Explaining Procedures

  • Explain procedures to patients to alleviate unknowns.
  • Disclose vitals, treatment plans, and expected changes.

Verbal and Nonverbal Cues

  • Verbal and nonverbal cues provide insight into the patient's condition.