Chapter 4 Flashcards
What are the two types of communication?
Verbal & Nonverbal
______________ is the transmission of information to another person.
Communication
T/F: Verbal communications skills are important.
True
T/F: Verbal communication skills enables you to gather critical info, coordinate with other responders and interact with other health care professionals.
True
What is true about documentation? (Select all that apply)
A.) Includes patient’s permanent medical record
B.) Demonstrates appropriate care was delivered
C.) Can only be completed by medical directors
D.) Helps other provider’s in patient’s future care
A, B and D are correct.
C is incorrect, there are several types of providers who can document care, including EMTs.
What three things do complete patient records have?
1.) Guarantees proper transfer of responsibility
2.) Complies with requirements of health departments and law enforcement agencies.
3.) Fulfills your organization’s administrative needs
T/F: Computer, radio and telephone communications link the EMT to EMS, fire department and law enforcement.
True
What is important to know about computer, radio and telephone communications?
You must know what your system can and cannot do as well as how to use the system efficiently and effectively.
______________ communication uses various communication techniques and strategies (both verbal and nonverbal), encourages patients to express how they feel and achieves a positive relationship with each patient.
Therapeutic Communication
Explain the Shannon-Weaver communication model?
Sender takes a thought –> encodes it into a message –> sends the message to the receiver –> receiver decodes the message –> sends feedback to the sender.
What are some factors to consider during communication?
Age, body language, clothing, culture, education, environment, eye contact, facial expression, posture, voice tempo and volume.
T/F: Age, culture and personal experience influences how a person communicates?
True
T/F: Culture has minimal affect on body language and eye contact.
False; it is greatly affected.
T/F: In some cultures, expressing emotion is a weakness.
True
T/F: In some cultures, it is impolite to look away while speaking.
True
Which three things reflect the mood of the person and perceived importance of the message?
Tone, Pace and Volume
_______________ is considering your own cultural values more important than those of others.
Ethnocentrism
__________________ is forcing your values onto others.
Cultural imposition
T/F: Body language provides more information than words alone.
True, even without exchanging words you should be able to tell the mood of your patient.
What are three powerful communication tools?
1.) Facial expressions
2.) Body language
3.) Eye contact
When treating a potentially hostile patient, which of the following are good rules to follow? (Select all that apply)
A.) Assess the safety of the scene
B.) Do not assume an aggressive posture
C.) Make good eye contact, but do not stare
D.) Speak calmly, confidently and slowly
E.) If needed, verbally threaten the patient
A-D are correct.
E is incorrect. Never threaten a patient, either verbally or physically.
What are some things that can negatively impact communication.
Literal noise, lighting, distance and physical obstacles.
_______________ often dictate the amount of space or proximity between people when communicating.
Cultural Norms
T/F: Gestures, body movements and attitude toward the patient are critically important.
True
Asking ________________ is a fundamental aspect of prehospital care.
Questions
T/F: Try to use open ended questions as they require some level of detail.
True
___________ questions can be answered in very short responses, sometimes a single word.
Closed-ended
When is an appropriate time to use closed-ended questions?
If patients cannot provide long answers.
List some communication tools?
Facilitation, Pause, Reflection, Empathy, Clarification, Confrontation, Interpretation, Explanation and Summary
When interviewing a patient, consider using __________ to show caring and compassion.
Touch (Use consciously and sparingly, avoid torso, chest and face)
What are some interviewing techniques to avoid?
1.) Providing false assurance or reassurance
2.) Giving unsolicited advice
3.) Asking leading or biased questions
4.) Talking too much
5.) Interrupting
6.) Using “why” questions
7.) Using authoritative language
8.) Speaking in professional jargon
T/F: Friends and family may be valuable during the patient interview process.
True
T/F: Always allow family members to answer questions for patients first.
False; allow the patient to answer even if well-meaning family members attempt to answer for the individual.
What are the golden rules?
1.) Make and keep eye contact at all times.
2.) Provide your name and use the patient’s proper name.
3.) Tell the patient the truth.
4.) Use language the patient can understand.
5.) Be careful what you say about the patient to others.
6.) Be aware of your body language.
7.) Speak slowly, clearly and distinctly
8.) If the patient is hard of hearing, face the patient so he or she can read your lips.
9.) Allow the patient time to answer or respond.
10.) Act and speak in a calm, confident manner.
_________________ is the ability to understand and manage your emotions and properly respond to others’ emotions.
Emotional Intelligence
Which of the following does emotional intelligence help with? (Select all that apply)
A.) Defusing conflict
B.) Building rapport
C.) Communicating effectively
D.) Managing difficult situations
All of the Above
What are the attributes of emotional intelligence?
Self awareness, self regulation, motivation, empathy and social skills
Which of the following are ways to improve emotional intelligence? (Select all that apply)
A.) Assess how you react to a stressful situation.
B.) Practice mindfulness.
C.) Take responsibility for your actions.
D.) Consider how your actions affect others.
All of the Above
What model was developed by the FBI to manage hostage situations?
Behavioral change stairway model
When communicating with older patients which of the following should you do? (Select all that apply)
A.) Identify yourself
B.) Present yourself and competent, caring and confident.
C.) Assume the older patient is senile or confused.
A and B are correct.
C is incorrect. Do not assume the older patient is senile or confused.
Which of the following are true when communicating with older patients? (Select all that apply)
A.) You may encounter hostility, irritability and some confusion.
B.) Approach an older person slowly and calmly.
C.) Allow plenty of time for the patient to respond to your questions.
D.) Assume the patient is hard of hearing and shout to communicate with them.
A-C is correct.
D is incorrect.
T/F: When dealing with older patients, watch for signs of confusion, anxiety or impaired hearing or vision.
True
T/F: Older patients often feel more pain than younger patients.
False, older patients often do not feel much pain.
T/F: Older patients may not be fully aware of important changes in their body systems.
True
When older patients have to relocate to the hospital, when possible allow them to do these things before leaving: ______________.
Allow them to pack a few personal items, including hearing aids, glasses and dentures.
T/F: Older patients are often worried about the safety of their home, valuable items and pets.
True
T/F: Children are often not fearful in EMS situations.
False, fear is the most obvious and severe in children.
What are some example of things children may be afraid of in an EMS situation?
Uniform, ambulance and the crowd of people
What is something you can do to help a fearful child in an EMS situation?
Let a child keep a favorite toy, doll or security blanket
T/F: If possible, you should let the parent or guardian hold the child during eval and treatment.
True
T/F: Children easily see through lies or deception and it is best to be honest with them.
True
What are things that EMTs can do to make a child more comfortable?
1.) Speak in a professional, friendly way.
2.) Maintain eye contact.
3.) Position yourself at the child’s level.
Which of the following is true regarding patient’s who are hearing impaired? (Select all that apply)
A.) Most have normal intelligence and are not embarrassed by their disability.
B.) Position yourself so the patient can see your lips to understand what you are saying.
C.) Make sure hearing aids are not lost during an accident.
D.) Ask family members about the use of a hearing aid for the patient.
All of the Above
What are steps to efficiently communicate with patients who are hard of hearing?
1.) Have paper and pen available.
2.) If the patient can read lips, face the patient and speak slowly and distinctly.
3.) Never shout.
4.) Listen carefully, ask short questions and give short answers
5.) Learn ASL (American sign language)
What are some ways to communicate with visually impaired patients?
1.) Ask the patient if they can see at all.
2.) Expect the patient to have normal intelligence.
3.) Explain everything you are doing as you are doing it.
4.) Stay in physical contact with the patient as you begin your care.
5.) If the patient walks to the ambulance, please his or her hand on your arm.
6.) Transport mobility aids such as a cane with the patient to the hospital.
T/F: Guide dogs can be easily identified by special harnesses.
True
T/F: When possible it is always a good idea to transport a guide dog with the patient.
True, this alleviates stress for the patient.
Which of the following are methods to communicate with non-English speaking patients? (Select all that apply)
A.) Find out if the patient speaks some English first.
B.) Use short, simple questions.
C.) Point to parts of the body.
D.) Have a family member or friend interpret.
All of the above
T/F: You should request a translator at the hospital for any non-English speaking patients.
True
_____________________ is communications where disruption will result in failure of the tak at hand.
Mission-Critical Communications
A ___________________ is the picture an individual has in their head of “What’s going on”.
Mental Model
T/F: All team members must share a mental model.
True
What questions should be answered for the shared mental model?
1.) What is the focused priority for the patient?
2.) What is the history of prior care?
3.) What is the patient’s current state?
4.) What are the patient’s immediate needs?
T/F: Effective communication is essential to efficient, effective and appropriate patient care.
True
_________________ is transfer of pertinent patient info and responsibility for patient care.
Patient Care Hand-Over
Which of the following should be done when giving the hand-over report? (Select all that apply)
A.) Initiate eye contact
B.) Manage the environment
C.) Minimize noise, interruptions and distractions
D.) Ensure the ABCs
All of the above
What types of patient care hand-over reports exist?
SBAR
SBAT
What does SBAR stand for?
Situation, Background, Assessment, Recap/treatment
What does SBAT stand for?
Situation, Background, Assessment, Treatment
What should patient documentation include?
1.) Patient’s priority condition
2.) Prior care
3.) Current state
4.) Immediate needs
Which of the following should occur when receiving the hand-over report? (Select all that apply)
A.) Maintain eye contact
B.) Manage the environment
C.) Ensure understanding
D.) Summarize
E.) Gather supplementary patient documentation
All of the above
______________ is also known as a prehospital care report, is a legal document that records all care from dispatch to hospital arrival.
Patient care report (PCR)
What are the two types of PCRs?
Written & Electronic
What are the six functions of PCR?
1.) Continuity of care
2.) Compliance and legal documentation
3.) Administrative information
4.) Reimbursement
5.) Education
6.) Data collection for continuous quality improvement research
What types of information is collected on a PCR?
1.) Chief complaint
2.) Mechanism of injury and illness
3.) Level of consciousness or mental status
4.) Vital signs
5.) Initial and ongoing assessment
6.) Patient demographics
7.) Transport information
Administrative information gathered from a PCR includes when: ___________________(7 things)
1.) The incident was reported
2.) The EMS unit was notified
3.) The EMS unit arrived at the scene
4.) The EMS unit left the scene
5.) The EMS unit arrived at the facility
6.) Patient care was transferred
7.) The unit is back in service
T/F: Traditional written forms have checkboxes and a narrative section.
True
What does CHART method stand for?
C - Chief complain or chief concern
H - History
A - Assessment
R - Treatment (Rx)
T - Transport
What does SOAP note stand for?
S - Subjective
O - Objective
A - Assessment
P - Plan
All narrative sections should contain these 8 things.
1.) Time of events
2.) Assessment findings
3.) Emergency medical care provided
4.) Changes in the patient after treatment
5.) Observations at the scene
6.) Final patient disposition
7.) Refusal of care
8.) Staff person who continued care
______________ improves sharing of data between EMS and other health care providers.
HIEs (Health Information Exchanges)
HIEs (Health Information Exchanges) allow which of the following? (Select all that apply)
A.) Access to relevant health data
B.) Unnecessary duplication of effort in data entry
C.) Access to patient outcomes related to hospital care
D.) Contribution and access to electronic health information on a regular basis and during a disaster
All of the Above
T/F: Most HIEs follow the SAFR framework.
True
What does SAFR stand for?
S - Search (Hospital and other records)
A - Alert (Notifies hospitals of incoming patients)
F - File (Incorporates data directly into the patient’s health records)
R - Reconcile (Outcomes and other data provided to EMS agencies for billing and QI)
T/F: When it comes to reporting errors, if you leave something out or record it incorrectly, do not try to cover it up.
True
T/F: Falsification results in poor patient care and may result in suspension and/or legal action.
True
T/F: If you discover an error as you are writing your report, use white out on the error and don’t tell anyone.
False; If you discover an error as you are writing your report, draw a single horizontal line through the error, initial it and write the correct info next to it.
T/F: If an error is discovered after you submit your report, follow the same process of the horizontal line correct with an initial.
True
T/F: Documenting care is a common source of lawsuits.
True
T/F: You should document any assessment findings and emergency medical care given.
Ture
T/F: If you have a patient sign a refusal of care form, you should have a family member, police officer or bystander also sign as a witness, if possible.
True
What is the last step in documenting refusal of care?
Complete the PCR.
What are special reporting situations?
1.) Gunshot wounds
2.) Dog Bites
3.) Some Infectious diseases
4.) Suspected physical or sexual abuse
5.) Multiple-casualty incident (MCI)
T/F: Radio and telephone communications link you and your team with other members of the EMS, fire and law enforcement communities.
True
T/F: Radio and telephone communications create extra layers of risk for EMTs.
False, they provide an extra layer of safety and protection.
Base stations radios contain a __________ and ______________ in a fixed place.
Transmitter and Receiver
T/F: Two-way radio consists of a transmitter and a receiver.
True
T/F: A dedicated line, also known as a smartline, is used for specific point-to-point contact.
False, it is known as a hotline.
T/F: Mobile radio is installed in a vehicle.
True
Who is the mobile radio used to communicate with? ______________ & _________________.
Dispatcher and Medical Control
T/F: Ambulances often have only one mobile radio.
False, they often have more than one.
Portable radios are: ________________ devices.
Hand-held
T/F: Portable radios are essential at the scene of an MCI
True
What is beneficial about portable radios?
They allow EMTs to communicate (when away from the ambulance) with dispatch, another unit or medical control.
A ______________ is a special base station radio that receives messages and signals on one frequency and automatically retransmits them on a second frequency.
Repeater
T/F: A repeater allows two mobile or portable units that cannot reach each other directly to communicate using its greater power and antenna.
True
_______________ allows electronic signals to be converted into coded, audible signals.
Telemetry
T/F: Signals can be transmitted by radio or telephone to a receiver with a decoder at the hospital.
True
Data from cardiac monitors can be transmitted via ____________-enabled mobile devices.
Bluetooth
T/F: EMTs often communicate with receiving facilities by cellular telephone.
True
T/F: Satellite phones (satphones) are another option to cellular telephone communication.
True
A scanner is a radio receiver that scans across several _______________.
Frequencies
T/F: Scanner conversations can be easily overheard.
True
T/F: Ambulances usually have an external public address system.
True
What are the types of two-way radio hardware?
Simplex, Duplex and Multiplex
________________ is push to talk, release to listen.
Simplex
________________ is simultaneous talk-listen.
Duplex
______________ utilizes two or more frequencies.
Multiplex
___________ channels are reserved for EMS use.
MED channels
____________ systems assign many frequencies.
Trunking
An _________________ communications system allows all of the agencies involved to share valuable information in real time.
Interoperable
___________________ inside the ambulance receive data directly from dispatch center and allow for expanded communications capabilities.
Mobile data terminals
The ___________________ regulates all radio operations in the US.
Federal Communications Commission
Which of the follow are functions of the FCC? (Select all that apply)
A.) Allocates specific radio frequencies
B.) Licenses call signs
C.) Establishes licensing standards and operating specifications
D.) Establishes limitations for transmitter output
E.) Monitors radio operations
All of the Above
The _____________ receives and determines the relative importance of the 911 call.
Dispatcher
Who is responsible for assigning appropriate EMS response units after a 911 call?
Dispatcher
Which of the following are jobs of the dispatcher? (Select all that apply)
A.) Selects, dispatches and directs the appropriate EMS response units
B.) Coordinates with other public safety services
C.) Provides emergency medical instructions to the telephone caller
D.) Begins compressions and rescue breaths on the patient at 30/2 intervals.
A-C is correct.
D is incorrect.
T/F: EMTs report any problems that took place during a run to the dispatcher.
True
T/F: EMTs inform the dispatcher upon arrival at the scene.
True
T/F: The principal reason for radio communication is to facilitate communication between you and medical control
True
Medical control may be located where?
1.) Receiving hospital
2.) Another facility
3.) Another city or state
Which of the following are the purposes of medical control? (Select all that apply)
A.) Notifies the hospital of an incoming patient
B.) Provides an opportunity to request advice or orders from medical control
C.) Advises the hospital of special situations
D.) Exclusively be the driver of the ambulance
A-C are correct.
D is incorrect.
Giving a patient report commonly includes which ten elements?
1.) Your unit ID and level of services
2.) Any special alert indicated by the patient’s condition
3.) The receiving hospital and your ETA
4.) Patient age & gender
5.) Patient chief complaint
6.) Brief history of patient condition
7.) Brief report of physical findings
8.) Brief summary of care given
9.) Brief description of the patient’s response to treatment
10.) Any questions or orders from the receiving facility
T/F: Medical control is either off-line or online.
True
Which of the following situations would you need to call medical control for permission (Select all that apply)
A.) Administer certain treatments.
B.) Determine the transport destination of patients.
C.) Stop treatment and/or not transport a patient.
All of the above
T/F: In most areas, medical control is provided by the physicians working at the receiving hospital.
True
What are two other examples of medical control?
Freestanding center & Individual Physician
What are two ways to control access on ambulance-to-hospital channels?
1.) Dispatcher monitors and assigns appropriate, clear medical control channels
2.) Centralized medical emergency dispatch or resource coordination centers
T/F: When calling medical control, be precise and deliver important info.
True
T/F: Always use codes with calling medical control.
False, never use codes unless directed to do so by local protocol.
T/F: Repeat orders back word-for-word and then receive confirmation.
True
T/F: You should blindly follow orders, even if they don’t make sense to you.
False, do not blindly follow orders that do not make sense.
T/F: You may initiate communication with hospitals to advise them of an extraordinary call or situation.
True
What are some examples of special situations you may want to advise the hospital in advance of?
Hazardous material situations
Rescues in progress
Multiple-casualty incidents
T/F: The earlier the notification, the better.
True
T/F: It is important to provide the estimated number of patients to the hospital in advance.
True
T/F: Let the hospital know in advance of any special needs required for the patient.
True
T/F: You can make changes to your system’s plan as you see fit and disregard it as necessary.
False, always follow the system plan.
T/F: Radio equipment must be serviced every so often.
True
T/F: At the end of your shift, check the radio equipment.
False, at the beginning of your shift, check the radio equipment.
If radio equipment fails during a run what should you do?
Follow your backup plan.
