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EMS COMMUNICATIONSEMS COMMUNICATIONS
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ObjectivesObjectives
Phases of CommunicationPhases of Communication
Role of Communications in EMSRole of Communications in EMS
Basic Model of CommunicationBasic Model of Communication
Communication SystemsCommunication Systems
Role of DispatchRole of Dispatch
Radio CommunicationRadio Communication
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EMS COMMUNICATION LINKSEMS COMMUNICATION LINKS
Sequence of EMS eventSequence of EMS event Occurrence of eventOccurrence of event Detection of eventDetection of event Notification and response of emergency personnelNotification and response of emergency personnel Treatment and preparation of patient for transportTreatment and preparation of patient for transport Transport and delivery of patient to receiving facilityTransport and delivery of patient to receiving facility Preparation for next eventPreparation for next event
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COMMUNICATION LINKSCOMMUNICATION LINKS
Notification of EMS systemsNotification of EMS systems 9-1-1, E 9-1-19-1-1, E 9-1-1 Radio report from another agencyRadio report from another agency
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COMMUNICATION LINKSCOMMUNICATION LINKS
Notification of response personnelNotification of response personnel Direct telephone link to crewsDirect telephone link to crews Radio dispatch of crewsRadio dispatch of crews PagersPagers Computer aided dispatchComputer aided dispatch
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COMMUNICATION LINKSCOMMUNICATION LINKS
Intermediate to medical controlIntermediate to medical control Patient report from field to hospitalPatient report from field to hospital Direct communication at hospitalDirect communication at hospital
Detailed verbal reportDetailed verbal report
Detailed written reportDetailed written report
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COMMUNICATION LINKSCOMMUNICATION LINKS
Notification of return to serviceNotification of return to service Ambulance restocked, cleaned, refueledAmbulance restocked, cleaned, refueled Infection control proceduresInfection control procedures
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http://www.youtube.com/watch?v=vev3NHU_Olk&feature=related
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What effects communication?What effects communication?
Attributes of the receiverAttributes of the receiver Cultural differencesCultural differences Language BarriersLanguage Barriers AgeAge AttitudeAttitude
ResponderResponder
DispatcherDispatcher
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Selective PerceptionSelective Perception Block out other informationBlock out other information Selective hearingSelective hearing
Semantic ProblemsSemantic Problems Words may have different meaningWords may have different meaning
Comatose Comatose
Time pressureTime pressure Message gets distortedMessage gets distorted Bypass normal communication channelsBypass normal communication channels
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COMMUNICATION SYSTEMS:COMMUNICATION SYSTEMS:
SimpleSimple Desk top radioDesk top radio PortablePortable Microphone and antennaMicrophone and antenna
ComplexComplex High-power transmittersHigh-power transmitters RepeatersRepeaters Satellite ReceiversSatellite Receivers
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Base stationBase station Located in High spotsLocated in High spots Principal transmitter and receiver for systemPrincipal transmitter and receiver for system 45 to 275 watts set by FCC45 to 275 watts set by FCC Multiple-channel capabilitiesMultiple-channel capabilities
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Mobile two-way radiosMobile two-way radios Vehicular mounted, 20 to 50 wattsVehicular mounted, 20 to 50 watts Range can depend on terrainRange can depend on terrain Multiple channel capabilitiesMultiple channel capabilities Biotelemetry capabilitiesBiotelemetry capabilities
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Portable radiosPortable radios Hand-held, 1 to 5 Hand-held, 1 to 5
watts, often used with watts, often used with repeatersrepeaters
Multiple channel Multiple channel capabilitiescapabilities
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Repeater systemsRepeater systems Receives weak signal and rebroadcasts at higher Receives weak signal and rebroadcasts at higher
powerpower Important for large geographical areasImportant for large geographical areas Can be vehicular mountedCan be vehicular mounted
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Advantages of repeatersAdvantages of repeaters Permits communication over a large areaPermits communication over a large area Allows flexibility in areas with abnormal terrainAllows flexibility in areas with abnormal terrain Assures better communicationAssures better communication Weak transmissions will be heardWeak transmissions will be heard
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Remote consolesRemote consoles Operation of base station from another locationOperation of base station from another location Use telephone lines or microwave linksUse telephone lines or microwave links
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Satellite receiversSatellite receivers Used for large areasUsed for large areas Receives weak transmissions and relays to Receives weak transmissions and relays to
base stationbase station
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Encoders and decodersEncoders and decoders Encoders activate decoders by sending out specific Encoders activate decoders by sending out specific
tones over the airtones over the air Decoders activated by the signalDecoders activated by the signal
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TECHNICAL ASPECTSTECHNICAL ASPECTS
Mobile telephonesMobile telephones Cellular technology is now cost-effectiveCellular technology is now cost-effective Capability to send biotelemetryCapability to send biotelemetry Dedicated lines for the EMT-IDedicated lines for the EMT-I
Digital ModesDigital Modes
ComputersComputers Data AccessData Access Send out informationSend out information
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RADIO COMMUNICATIONSRADIO COMMUNICATIONS
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RADIO WAVE TRANSMISSIONRADIO WAVE TRANSMISSION
Amplitude modulation - AMAmplitude modulation - AM Modifies radio transmission by varying the amplitude Modifies radio transmission by varying the amplitude
of the signalof the signal Poor quality, good rangePoor quality, good range
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RADIO WAVE TRANSMISSIONRADIO WAVE TRANSMISSION
Frequency modulation - FMFrequency modulation - FM Modifies radio transmission by varying the frequency Modifies radio transmission by varying the frequency
of the signalof the signal Good quality, poor rangeGood quality, poor range
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FREQUENCIESFREQUENCIES
Hertz (Hz)Hertz (Hz) The number of cycles per second in a radio signalThe number of cycles per second in a radio signal 1 Hz = 1 cycle per second; 1 Kilohertz (KHz) = 1,000 1 Hz = 1 cycle per second; 1 Kilohertz (KHz) = 1,000
cycles per secondcycles per second 1 Megahertz (MHz) = 1,000,000 cycles per second1 Megahertz (MHz) = 1,000,000 cycles per second 1 Gigahertz (GHz) = 1,000,000,000 cycles per second1 Gigahertz (GHz) = 1,000,000,000 cycles per second Most radio communications are 100 KHz to 3,000 Most radio communications are 100 KHz to 3,000
GHzGHz
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FREQUENCIESFREQUENCIES
BandBand A small segment of the total frequency spectrumA small segment of the total frequency spectrum Public safety bandsPublic safety bands
VHF low band - 30 MHz to 50 MHzVHF low band - 30 MHz to 50 MHz
VHF high band - 150 MHZ to 170 MHzVHF high band - 150 MHZ to 170 MHz
UHF - 450 MHz to 470 MHzUHF - 450 MHz to 470 MHz
New - 800 MHzNew - 800 MHz
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FREQUENCIESFREQUENCIES
TrunkingTrunking Computerized allocation of frequenciesComputerized allocation of frequencies Eliminates need to find open frequencyEliminates need to find open frequency
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FREQUENCIESFREQUENCIES
Med channelsMed channels Duplex pairs designed for ALSDuplex pairs designed for ALS Channels 1-8 for Intermediate to physicianChannels 1-8 for Intermediate to physician Channels 9-10 for EMS dispatching purposesChannels 9-10 for EMS dispatching purposes
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BIOTELEMETRYBIOTELEMETRY
The process of transmitting physiological data, such as The process of transmitting physiological data, such as ECG, over the radioECG, over the radio
A modulator electrically translates voltage changes A modulator electrically translates voltage changes (ECG) into sound waves(ECG) into sound waves The telemetry radio has a modulatorThe telemetry radio has a modulator
A demodulator translates sound waves back into voltage A demodulator translates sound waves back into voltage changeschanges The hospital base station has a demodulator The hospital base station has a demodulator
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BIOTELEMETRYBIOTELEMETRY
Common causes of interference in biotelemetry Common causes of interference in biotelemetry communicationscommunications Loose electrodesLoose electrodes Muscle tremorsMuscle tremors 60 Hz interference and power fluctuations60 Hz interference and power fluctuations Voice over EKGVoice over EKG
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TRANSMISSION TYPESTRANSMISSION TYPES
SimplexSimplex The ability to The ability to
transmit or receive transmit or receive only at one time only at one time
One frequency One frequency usedused
Most organizational Most organizational communications communications are simplexare simplex
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TRANSMISSION TYPESTRANSMISSION TYPES
Duplex Duplex Transmit and Transmit and
receive receive simultaneously simultaneously using two separate using two separate frequenciesfrequencies
Either party can Either party can interrupt the other interrupt the other during transmissionduring transmission
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TRANSMISSION TYPESTRANSMISSION TYPES
MultiplexMultiplex Transmit voice and EKG simultaneously over Transmit voice and EKG simultaneously over
the same frequencythe same frequency Allows the Paramedic to talk while sending an Allows the Paramedic to talk while sending an
EKG stripEKG strip
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EQUIPMENT MAINTENANCEEQUIPMENT MAINTENANCE
EMS communications equipment is fragile and EMS communications equipment is fragile and expensiveexpensive
Proper care and maintenance are important for long lifeProper care and maintenance are important for long life
Avoid mishandlingAvoid mishandling
Schedule regular cleaningSchedule regular cleaning
Have equipment repaired by a qualified technicianHave equipment repaired by a qualified technician
Keep batteries charged and spares readyKeep batteries charged and spares ready
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RULES AND OPERATING RULES AND OPERATING PROCEDURESPROCEDURES
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THE FEDERAL COMMUNICATIONS THE FEDERAL COMMUNICATIONS COMMISSIONCOMMISSION
Licenses agencies and transmittersLicenses agencies and transmitters
Allocates frequencies for useAllocates frequencies for use
Establishes technical standards for hardwareEstablishes technical standards for hardware
Licenses personnelLicenses personnel
Monitors frequencies for proper useMonitors frequencies for proper use
Conducts site checksConducts site checks
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DISPATCH PROCEDURESDISPATCH PROCEDURES
The EMS dispatcherThe EMS dispatcher Obtains informationObtains information Directs appropriate agencyDirects appropriate agency Monitors and coordinates communicationsMonitors and coordinates communications Gives pre-arrival instructionsGives pre-arrival instructions Maintains written recordsMaintains written records Manages systems resourcesManages systems resources
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RADIO CODESRADIO CODES
Communicate a large amount of information Communicate a large amount of information quicklyquickly
Allows for confidentialityAllows for confidentiality
Ten-code system ( Not so much anymore)Ten-code system ( Not so much anymore)
Using standard Plain EnglishUsing standard Plain English
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RADIO COMMUNICATION TECHNIQUESRADIO COMMUNICATION TECHNIQUES
Listen before talking, press and waitListen before talking, press and wait
Speak at close range, slowly and clearlySpeak at close range, slowly and clearly
Avoid emotionAvoid emotion
Be brief and do not waste air timeBe brief and do not waste air time
Protect patient privacyProtect patient privacy
Avoid slang, profanity, use standard formatsAvoid slang, profanity, use standard formats
Repeat all orders, confirm message receivedRepeat all orders, confirm message received
Write down specific informationWrite down specific information
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COMMUNICATION OF COMMUNICATION OF MEDICAL INFORMATIONMEDICAL INFORMATION
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VERBAL COMMUNICATION OF PATIENT VERBAL COMMUNICATION OF PATIENT INFORMATIONINFORMATION
Agency, unit designation, Intermediate name, Agency, unit designation, Intermediate name, and level of certificationand level of certification
Scene description/mechanism of injuryScene description/mechanism of injury
Patient’s age, sex, and weightPatient’s age, sex, and weight
Chief complaintChief complaint
Primary problemPrimary problem
Associated symptomsAssociated symptoms
Brief history of present illnessBrief history of present illness
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VERBAL COMMUNICATION OF PATIENT VERBAL COMMUNICATION OF PATIENT INFORMATION INFORMATION
Past medical historyPast medical history
Vital signs; level of consciousness; general Vital signs; level of consciousness; general appearance; glucose testing; any pertinent appearance; glucose testing; any pertinent physical exam findingsphysical exam findings
Treatment rendered and request for further Treatment rendered and request for further treatmenttreatment
ETAETA
Private physician’s namePrivate physician’s name
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GUIDELINES/COMMUNICATING WITH GUIDELINES/COMMUNICATING WITH MED CONTROL PHYSICIANMED CONTROL PHYSICIAN
Give an accurate and complete reportGive an accurate and complete report
Provide whatever information requested by Provide whatever information requested by physicianphysician
Repeat orders and question unclear ordersRepeat orders and question unclear orders
Report back and keep physician informedReport back and keep physician informed
Protect patient privacyProtect patient privacy
Consult and seek advice in unusual situationsConsult and seek advice in unusual situations
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WRITTEN COMMUNICATIONSWRITTEN COMMUNICATIONS
Record patient’s initial condition and careRecord patient’s initial condition and care
Becomes legal record of pre-hospital careBecomes legal record of pre-hospital care
Information for billing, chart auditsInformation for billing, chart audits
Document patient’s refusal of careDocument patient’s refusal of care
Defense against malpracticeDefense against malpractice
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http://www.youtube.com/watch?v=sShMA85pv8M