Chapter 17 (Communication and Documentation)

.docx

School

Solano Community College *

*We aren’t endorsed by this school

Course

MISC

Subject

Medicine

Date

Apr 3, 2024

Type

docx

Pages

Uploaded by CorporalFangJaguar22

Chapter 17 (Communication and Documentation) ● There are a number of components to any radio or communications system: base stations, mobile radios, portable radios, repeaters, cell phones, telemetry ○ Base station setup with two-way radios at a fixed site, such as a hospital or dispatch center. ○ Mobile radios are two-way radios that are used or affixed in a vehicle. Most are actually mounted inside the vehicle. These devices have lower transmitting power than base stations. The unit used to measure the output power of radios is the watt . The output of a mobile radio is generally 20–50 watts, with a range of 10–15 miles (about 16–24 km). ■ If the mobile radio in your ambulance malfunctions, portable radios or phones may be used in their place. ○ Portable radios are handheld two-way radios with an output of 1–5 watts. This type of radio is important because it will allow you to be in touch with the dispatcher, medical director, and other members of the EMS system while you are away from the ambulance. ○ Repeaters are devices that are used when transmissions must be carried over a long distance. Repeaters may be in ambulances or placed in various areas around an EMS system. The repeater picks up signals from lower-power units, such as mobile and portable radios, and retransmits them at a higher power. The retransmission is done on another frequency ■ Computers and tablets are being used to record information at the patient’s side. This information may be wirelessly transmitted to dispatch and to the hospital. ○ Cell phones are phones that transmit through the air to a cell tower. ○ Telemetry is the process of sending and receiving data wirelessly. In EMS, this may be an electrocardiogram (ECG), vital signs, or other patient-related data. ● To maintain order on the airwaves, the Federal Communications Commission (FCC) assigns and licenses radio frequencies. This prevents two or more agencies from trying to use the same frequency and interfering with each other’s communications. ➢ Radio Transmissions throughout the Call ● The initial call for help received by the emergency medical dispatcher (EMD) most often comes via telephone but may also be radioed from another agency, such as the police. ○ You respond to the assigned location, reporting your arrival to the dispatcher. ○ The dispatcher records all the times according to the 24-hour clock: the time of the original call, the time the ambulance was dispatched, the time when the ambulance reached the staging area, and finally the time when the ambulance arrived at the scene. ■ Should this case go to court, the records of the dispatch center, your care report, and the dispatch audiotape of the call may be subpoenaed. ■ You will call the hospital via radio or phone to advise staff there of the status of your patient and the estimated time of arrival (ETA). ○ After turning the patient over to the hospital staff and preparing the ambulance for the next run, you will advise the dispatcher that you are leaving the hospital.

Chapter 17 (Communication and Documentation) ○ In some EMS systems, simple standard communications such as being en route, arriving on the scene, and arriving at the hospital are transmitted by pushing a button on a mobile data terminal (MDT) mounted in the ambulance, rather than by verbal radio transmission. MDT use reduces congestion on busy radio frequencies. ■ Reports must be made to medical personnel as part of almost every call. These reports may be by radio, verbally (in person), in writing, or in all three ways. ○ In an effort to protect patient privacy, some hospitals encourage EMTs to use a cell phone en route to the emergency department rather than the radio. ○ If you have a critical patient, your radio report should make that clear. This can be done by describing the chief complaint, injuries, vital signs, treatments, and mechanism of injury. ○ Even with critical patients, you must keep a clear, steady tone to your voice. Resist the urge to talk fast or appear excited, as it will prevent effective communication. ● The purpose of a radio or phone report is to give the hospital staff sufficient information to determine where the patient should go (e.g., major trauma room) and to have the appropriate personnel there when the patient arrives. ■ You do not need to provide details like the patient’s medications or allergies, because this information will not change either of the items above. ○ A medical radio report has 12 parts. 1. Unit identification and level of provider “Memorial Hospital, this is Community BLS Ambulance 6 en route to your location . . . ” 2. Estimated time of arrival “. . . with a 15-minute ETA.” 3. Patient’s age and sex “We are transporting a 68-year-old male patient . . .” 4. Chief complaint “. . . who complains of diffuse pain in his abdomen.” 5. Brief, pertinent history of the present illness “The pain is sharp, started two hours ago, is rated 3/10 in severity, and is accompanied by slight nausea.” 6. Major past illnesses “The patient has a history of high blood pressure.” 7. Mental status “He is alert and oriented, never lost consciousness.” 8. Baseline vital signs “His vital signs are pulse 88 regular and full, respirations 20 and unlabored, skin normal, and blood pressure 134 over 88; oxygen saturation is 98 percent.”

Chapter 17 (Communication and Documentation) 9. Pertinent findings of the physical exam “Our exam revealed tenderness in both upper abdominal quadrants. They did not appear rigid.” 10. Emergency medical care given “For care, we have placed him in a position of comfort.” 11. Response to emergency medical care “The level of pain has not changed during our care. Mental status has remained unchanged. Vital signs are basically unchanged.” 12. Contact medical directions if required or if you have questions. “Does medical direction have any orders?” ➢ To avoid misunderstanding and miscommunication, use the following: ○ Give the information to medical direction clearly and accurately. Speak slowly and clearly. The physician’s orders will be based on what you report. ○ After receiving an order for a medication or procedure, repeat the order word for word. ○ If an order is unclear, ask the physician to repeat it. ○ If an order appears to be inappropriate, question the physician. There may have been a misunderstanding, and your questioning may prevent the inappropriate administration of medication. If the physician verifies the order, the physician may explain the order to you. ➢ The Verbal Report ● The first information you give to hospital personnel will be your verbal report. ○ As you transfer your patient to the care of the hospital staff, introduce the patient by name. Then summarize the same kind of information you gave over the radio, pointing out any information that is updated or different from your last radio report. ■ Chief complaint ■ History that was not given previously ■ Additional treatment is given en route ■ Additional vital signs were taken en route ● Interpersonal Communication ○ If a person has a mental disability or is hard of hearing, speak slowly and clearly. Do not talk down to the patient. Patients with a hearing disability may read lips. ○ For the visually impaired person, you will want to take extra effort to explain anything that is happening that the patient cannot see. ➢ Prehospital Care Report ● The record that you produce during a call is called a prehospital care report or, informally, a PCR. A.K.A: trip sheet or run report. ● This can take several forms. Laptops, tablets, and pen-based computers are commonly used. They allow the EMT to enter information about a call directly into the device. Receiving hospitals have data connections that allow for the transfer of information.

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help