1 EMS COMMUNICATIONS. 2 Objectives Phases of Communication Role of Communications in EMS Basic Model of Communication Communication Systems Role of Dispatch

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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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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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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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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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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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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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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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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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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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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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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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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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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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TrunkingTrunking Computerized allocation of frequenciesComputerized allocation of frequencies Eliminates need to find open frequencyEliminates need to find open frequency

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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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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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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

Documents

1 EMS COMMUNICATIONS. 2 Objectives Phases of Communication Role of Communications in EMS Basic Model of Communication Communication Systems Role of Dispatch