Chapter 4: Communications and Documentation Flashcards
1
Q
List the factors and strategies to consider during communication.
A
- Age
- Body Language
- Clothing
- Culture
- Education
- Environment
- Eye Contact
- Facial Expression
- Sex
- Posture
- Voice Tempo
- Volume
2
Q
List the information that should be included in a Patient Care Report (PCR).
A
- Patient’s name, gender, date of birth, address, insurance information
- Dispatched as (when ambulance was called, nature of call as reported by dispatch)
- Chief complain or chief concern
- Location of patient when first seen
- Rescue / treatment given prior to your arrival
- Signs / symptoms found during your assessment
- Care / treatment given by you at the site and during transport
- Vital signs
- SAMPLE History
- Changes in vital signs and condition
- Additional orders received from hospital
- Name of person receiving PCR
- Date of call
- Time of call
- Location of call
- Time of dispatch
- Time of arrival at scene
- Time of leaving the scene
- time of arrival at hospital
- Names / certification #s of EMTs who responded to call
- Type of run to the scene; emergency or routine
3
Q
What phrase or word matches this definition?
Telecommunication systems that allow a computer to maximize utilization of a group of frequencies.
A
Trunking
4
Q
What phrase or word matches this definition?
The transmission of information to another person- verbally or through body language.
A
Communication
5
Q
What phrase or word matches this definition?
The use of a radio signal and a voice or digital message that is transmitted to pagers or desktop monitor radios.
A
Paging
6
Q
Define the following emotional intelligence attribute.
Self-Awareness
A
The ability to recognize your own emotions and how they affect your thoughts and behavior.
7
Q
What phrase or word matches this definition?
The transfer of pertinent patient information and the responsibility for the patient’s care; often involves the physical movement of the patient and associated equipment; also known as handoff.
A
Handover
8
Q
What should the narrative section of the PCR include?
A
- Time of events
- Assessment findings
- Emergency medical care provided
- Changes in the patient after treatment
- Observations at the scene
- Final patient disposition
- Refusal of care
- Staff person who continued care
9
Q
What phrase or word matches this definition?
The recorded portions of the EMT’s patient interaction, either written or electronic. This becomes part of the patient’s permanent medical record.
A
Documentation
10
Q
What phrase or word matches this definition?
Questions that can be answered in short or single word responses.
A
Close-Ended Questions
11
Q
What phrase or word matches this definition?
The ability to understand and manage one’s own emotions and properly respond to the emotions of others.
A
Emotional Intelligence
12
Q
How should the EMS unit communicate during this phase?
On Scene
A
Report arrival at scene.
Check in (typically every 10-20 minutes).
Request additional resources, when needed.
Report leaving scene.
13
Q
When treating a potentially hostile patient, what steps should an AEMT consider following?
A
- Assess the safety of the scene.
- Do not assume an agressive posture.
- Make good eye contact, but do not stare.
- Speak calmly, confidently, and slowly.
- Never threaten the patient, either verbally or physically.
14
Q
Define the following therapeutic communication technique.
Summary
A
Providing the patient with an overview of the conversation and the steps you will take.
15
Q
List tips for communicating with non-English speakers.
A
- Find out how much English the patient speaks.
- Use short, simple questions and words.
- Avoid difficult medical terms.
- Point to specific parts of the body as you ask questions.
- Use an app to help you translate.
- Find an interpreter.
- Make sure to request a translator in your radio report.
16
Q
What role does the National Emergency Medical Services Information System (NEMSIS) play?
A
Conducts research on data collected linking prehospital records to hospital discharge outcomes explanding the knowledge base about what EMS providers actually do on a day-to-day basis and on what treament measures really make a difference.
17
Q
What phrase or word matches this definition?
Single-frequency radio; transmissions can occur in either direction but not simultaneously in both; when one party transmits, the other can only receive, and the party that is transmitting is unable to receive.
A
Simplex
18
Q
What phrase or word matches this definition?
The ability to transmit and receive simultaneously.
A
Duplex
19
Q
What phrase or word matches this definition?
A low-power portable radio that communicates through an interconnected series of repeater stations called “cells.”
A
Cell Phone
20
Q
What does the acronym mean?
MDT
A
Mobile Data Terminal
21
Q
How should the EMS unit communicate during this phase?
En Route to Call
A
Request assistance with directions, when needed.
Request additional resouces, when needed.
22
Q
What six functions does a patient care report (PCR) serve?
A
- Transfer of information and continuity of care.
- Compliance and legal documentation.
- Administrative information.
- Reimbursement.
- Education.
- Data collection for quality improvement and research.
24
Q
How should the EMS unit communicate during this phase?
Initial Receipt of Call
A
Acknowledge Call
Respond to the Call
25
# Define the following therapeutic communication technique.
Empathy
Being sensitive to the patient's feelings and thoughts.
26
# Define the following therapeutic communication technique.
Interpretation
Restate the patient's concern (a.k.a. complaint) to confirm your understanding.
27
What does the term "functional age" mean?
Functional age relates to a person's ability to function in daily activities, mental state, health status, and activity pattern.
28
# What phrase or word matches this definition?
Any communications where disruption will result in the failure of the mission at hand.
Mission-Critical Communications
29
# What phrase or word matches this definition?
A process in which electronic signals are converted into coded, audible signals; these signals can then be transmitted by radio or telephone to a receiver with a decoder at the hospital.
Telemetry
30
# Define the following emotional intelligence attribute.
Empathy
The ability to understand the concerns, emotions, and needs of other by picking up on communication and social cues and clues.
31
List tips for communicating with a visually impaired patient.
* Ask patient what their level of eye sight is.
* Explain everything in detail.
* Keep physical contact with patient. Keep hand on shoulder when possible.
* Avoid sudden movements.
* Be sure to transport any items (i.e. cane).
* Bring guide dog in ambulance if patient is stable. If unstable, care for dog per department policies / procedures.
32
# What phrase or word matches this definition?
This legal document used to record all patient care activities. This report has direct patient care functions but also administrative and quality control functions; also known as prehospital care reports.
Patient Care Report (PCR)
33
# What phrase or word matches this definition?
When one person imposes their beliefs, values, and practices on another because one believes their ideals is superior.
Cultural Imposition
34
# Define the following therapeutic communication technique.
Confrontation
Making the patient who is in denial or having an acute stress response focus on urgent and life-critical issues.
35
# Define the following therapeutic communication technique.
Pause
Giving the patient space and time to think and respond by refraining from speaking.
36
# What phrase or word matches this definition?
Written documents, signed by the EMS system's medical director, that outline specific directions, permissions, and sometimes prohibitions regarding patient care; also called protocols.
Standing Orders
37
# What phrase or word matches this definition?
Anything that dampens or obscures the true meaning of a message.
Noise
38
# What phrase or word matches this definition?
A radio receiver that searches or "scans" across several frequencies until the message is completed; the process is then repeated
Scanner
39
What are five steps to efficiently communicate with patients who are hard of hearing?
1. Have paper and pen available.
2. If the patient can read lips and you need to remove your mask, have a clear barrier mask ready to use. Face the patient and speak distinctly at a normal pace.
3. Never shout.
4. Be sure to listen carefully, ask short questions, and give short answers.
5. Learn some simple phrases in sign language.
40
# What phrase or word matches this definition?
The ability to transmit audio and data signals through the use of more than one communication channel.
Multiplex
41
What are the steps of the Behavioral Change Stairway model?
1. Employ active listening.
2. Display empathy.
3. Build a rapport.
4. Exert influence.
42
# What does the acronym mean?
HIE
Health Information Exchange
43
List therapeutic communication techniques that will assist an AEMT in gathering patient information.
* Faciliation
* Pause
* Reflection
* Empathy
* Clarification
* Cofrontation
* Interpretation
* Explanation
* Summary
44
# What phrase or word matches this definition?
Questions for which the patient must provide detail to give an answer.
Open-Ended Questions
45
# Define the following emotional intelligence attribute.
Motivation
The ability to motivate yourself and others in a postive direction, often deferring short-term rewards for long-term successes.
46
# What does the mnemonic mean?
SBAT
Information that should be provided in a patient handover:
* **_S_**ituation - concise statement of the problem
* **_B_**ackground - relevant, brief information about the patient condition
* **_A_**ssessment - findings and what you think
* **_T_**reatment - care provided
47
# What phrase or word matches this definition?
A special telephone line that is used for specific point-to-point communications; also known as hotline.
Dedicated Line
48
What legal implications do Patient Care Reports have?
PCRs are a legal document. Falsyfing information may result in suspension and/or revocation of certification or license. It may lead other health care providers to having a false impression of assessment findings or treatment given. This could lead to poor patient care and result in a malpractice lawsuit.
49
# What phrase or word matches this definition?
VHF and UHF channels that the FCC has designated for EMS use.
MED Channels
50
What is the most dangerous part of pre-hospital care according to the American College of Emergency Physicians and the World Health Organization? Why?
The patient handover because communication during the process is identified as a critical failure point that can cause "serious breakdowns in the continuity of care, inappropriate treatment, and potential harm to the patient.
51
# Define the following therapeutic communication technique.
Explanation
Provide factual information support a conversation.
52
# What phrase or word matches this definition?
The picture an individual has in their head of "what's going on" in a given situation.
Mental Model
53
# What phrase or word matches this definition?
Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.
Therapeutic Communication
54
What are the 10 Golden Rules that will help an AEMT calm and reassure their patient?
1. Make and keep eye contact with patient.
2. Provide your name and use the patient's proper name.
3. Tell the patient the truth.
4. Use language that the patient can understand.
5. Be careful what you say about the patient to others.
6. Be aware of your body language.
7. Always speak slowly, clearly, and distinctly.
8. If the patient is hard of hearing, face the person so that they can read your lips.
9. Allow time for the patient to answer or respond to quesitons.
10. Act and speak in a calm, confident, manner while caring for the patient.
55
Help
## Footnote
Reference: [https://www.lifeprint.com/asl101/pages-signs/h/help.htm](https://www.lifeprint.com/asl101/pages-signs/h/help.htm)
56
List tips for communicating with children.
* Let child keep favorite toy, doll, or security blanket.
* Keep a family member near by.
* When possible and if it will be helpful, allow the parent or guardian hold the child.
* Be honest.
* Keep them informed.
* Respect their modesty.
* Get down on eye level or below their eye level.
57
What should be included in a radio report to medical control?
* Your unit I.D. / level of service
* Any special alert indicated for patient (i.e. "Trauma Alert")
* Name of receiving hospital and ETA
* Patient's age / sex
* Patient chief complaint or your chief concern (problem / severity)
* Brief history of current problem (only pertinent info)
* Brief report of physical exam and vital sign findings
* Brief summary of care given / response to care - treatment
* Determine if receiving facility has additional questions / orders
58
What information should a dispatcher give the responding unit or units?
* Nature / severity of injury, illness, or incident
* Exact location
* Number of patients
* Responses by other public safety agencies
* Special directions or advisories
* Time at which the unit or units are dispatched
59
# What phrase or word matches this definition?
A system that allows EMS providers to access relevant health data (eg, past medical problems, medications, allergies, end-of-life decisions), avoid unnecessary duplication of effort in data entry, and view patient outcoms related to hospital care.
Health Information Exchange (HIE)
60
# What does the acronym mean?
FCC
Federal Communications Commission
61
# Define the following emotional intelligence attribute.
Social Skills
The ability to develop and maintain positive rapport and relationships through effective communications.
62
# What does the acronym mean?
PCR
Patient Care Report
63
# What phrase or word matches this definition?
A special base station radio that receives messages and signals on one frequency and then automatically retransmits them on a second frequency.
Repeater
64
Sick
## Footnote
Reference: [https://www.lifeprint.com/asl101/pages-signs/s/sick.htm](https://www.lifeprint.com/asl101/pages-signs/s/sick.htm)
65
What should you do if a patient refuses care?
* Document any patient assessment findings, emergency medical care given, your efforts to obtain consent, and the patient's response to your efforts.
* Have the patient sign the refusal form as well as a witness (i.e. family member, police officer, bystander).
* If patient refuses to sign have witness sign veryfying patient refused to sign. Inform medical control.
66
# What phrase or word matches this definition?
Radio frequencies between 30 and 300 MHz; this spectrum is further divided into high and low bands.
VHF (very high frequency)
67
What are the five attributes of emotional intelligence?
* Self-Awareness
* Self-Regulation
* Motivation
* Empathy
* Social Skills
68
# What does the acronym mean?
UHF
Ultra High Frequency
69
What part of the patient care report (PCR) is the most important?
The narrative section.
70
# What does the acronym mean?
VHF
Very High Frequency
71
# How should the EMS unit communicate during this phase?
Return to Service
Notify dispatch when the unit is available for another call.
72
What methods can be implemented while **giving** a patient handover report to prevent critical communication failures?
* Initiate eye contact.
* Manage the environement to ensure the person receiving is focused on the patient information.
* Ensure the ABCs.
* Provide a structured report.
* Provide documentation.
73
# Define the following therapeutic communication technique.
Facilatation
Encouraging the patient to talk more or provide more information.
74
# Define the following therapeutic communication technique.
Clarification
Asking the patient to explain what they meant by an answer.
75
# What phrase or word matches this definition?
The federal agency that has jurisdiction over interstate and international telephone and telegraph services and satellite communications, all of which may involve EMS.
Federal Communications Commission (FCC)
76
# What phrase or word matches this definition?
The reason a patient called for help; also, the patient's response to questions such as "What's wrong?" or "What happened?"
Chief Complaint
## Footnote
**Note:** Keep in mind that the patient isn't complaining. They have a concern(s). While talking to a patient consider using the work "concern" to show compassion and empathy!
77
What interview techniques should an AEMT avoid?
* Providing a false sense of hope or reassurance.
* Giving unsolicited advice.
* Asking leading or biased questions.
* Talking too much.
* Interrupting the patient.
* Using "why" questions.
* Using authoritative language.
* Speaking in professional jargon.
78
# What phrase or word matches this definition?
A trusting relationship that you build with your patient.
Rapport
79
# What phrase or word matches this definition?
The condition requiring the most urgent intervention as determined by the provider's assessment of the patient; it is not always the same as the chief complaint.
Chief Concern
80
What methods can be implemented while **receiving** a patient handover report to prevent critical communication failures?
* Maintain eye contact.
* Manage the environment to ensure that you are focused on the patient information being given.
* Ensure understanding by asking clarification questions and correct any issues.
* Summarize back the receiving clinician's mental model.
* Gather supplementary patient documentation.
81
Why should an AEMT question an order received by medical control if it does not seem appropriate?
The radio report may have been unclear due to language used, information given, or radio interference.
82
# What does the acronym mean?
NEMSIS
National Emergency Medical Services Information System
83
# How should the EMS unit communicate during this phase?
Arrival at Hospital or Point of Transfer
Notify dispatch of arrival at point of transfer.
84
# Define the following emotional intelligence attribute.
Self-Regulation
The ability to control impulsive emotions and behaviors and to manage emotions in positive ways.
85
List tips to make sure that radio communications are clear.
* Ensure clear frequency before speaking.
* Wait 1 second before speaking when holding down the press-to-talk button.
* Address the unit you are calling followed by the name of your unit.
* Wait until the unit you signalled replies.
* Use a clear / calm voice and speak at a reasonable pace.
* Keep transmission brief.
* Use clear text.
* Avoid use of codes or agency-specific terms.
* When transmitting numbers, provide the number and individual digits.
* Use "affirmative" and "negative" instead of "yes" and "no".
* Monitor background noise.
86
# What phrase or word matches this definition?
A communication system that use voice over internet protocol (VoIP) technology to allow multiple agencies to communicate and transmit data.
Interoperable Communications System
87
# What phrase or word matches this definition?
When a person considers their own cultural values as more important when interacting with people of a different culture.
Ethnocentrism
88
What is the purpose of a Patient Care Report (PCR)?
Ensures continuity of patient care.
89
# Define the following therapeutic communication technique.
Reflection
Restating a patient's statement made to you to confirm your understanding.
90
# What phrase or word matches this definition?
Any radio hardware containing a transmitter and receiver that is located in a fixed place.
Base Station
91
# What phrase or word matches this definition?
Radio frequencies between 300 and 3,000 MHz.
UHF (ultra-high frequency)
92
# What phrase or word matches this definition?
An assigned frequency or frequencies that are used to carry voice and/or data communications.
Channel
93
# What phrase or word matches this definition?
A small computer terminal inside the ambulance that directly receives data from the dispatch center.
Mobile Data Terminal (MDT)
94
# What phrase or word matches this definition?
Linked dispatch center computer consoles and vehicle-mounted mobile data terminals in which a computer collects and manages the call information and makes recommendations for which emergency medical services unit is closest based on existing dispatch policy.
Computer-Aided Dispatch (CAD)
95
# What does the acronym mean?
CAD
Computer-Aided Dispatch
96
# What phrase or word matches this definition?
The transmission of information via radio waves using native digital (computer) data or analog (voice) signals that have been coverted to a digital signal and compressed.
Digital Radio
97
# What phrase or word matches this definition?
A specially trained member of the emergency medical services team who receives information, makes decisions about resource allocation, and relays that information in an organized manner during an emergency.
Emergency Medical Dispatcher (EMD)
98
# What does the acronym mean?
EMD
Emergency Medical Dispatcher
99
# What phrase or word matches this definition?
A message that has been put into code before it is transmitted.
Encoded
100
# What phrase or word matches this definition?
An emergency communications system that collects information about 9-1-1 calls from the telephone network, such as the telephone number and location of the caller, and displays this information on the dispatcher's computer terminal.
Enhanced 9-1-1
101
# What phrase or word matches this definition?
The number of cycles (oscillations) per second of a radio signal.
Frequency
102
# What phrase or word matches this definition?
Communications system linked by wires, usually in reference to a conventional telephone system.
Landline
103
# What phrase or word matches this definition?
A standard used by Medicare to determine whether a patient's condition requires ambulance transport in a particular situation.
Medical Necessity
104
# What phrase or word matches this definition?
A radio that is mounted inside a vehicle and used to communicate with dispatch or medical control; it operates at lower power than a base station (20-50 watts) and is assigned to a specific radio frequency band.
Mobile Radio
105
# What phrase or word matches this definition?
Information that you observe and that is measurable, such as a patient's blood pressure.
Objective Information
106
# What phrase or word matches this definition?
A handheld two-way radio with a limited range and low power (1-5 watts).
Portable Radio
107
# What phrase or word matches this definition?
Instructions provided by the emergency medical dispatcher to an emergency caller to care for life-threatening emergencies until help arrives.
Prearrival Instructions
108
# What phrase or word matches this definition?
The study of space between people and its effects on communications.
Proxemics
109
# What phrase or word matches this definition?
Information that is told to you but that cannot be seen, such as the symptoms a patient describes.
Subjective Information
110
# What phrase or word matches this definition?
Computerized sharing of radio frequencies by multiple units, agencies, or systems.
Trunked Radios
111
What message do hands on hips send to people who are from Mexico and Argentina?
Considered a sign of hostility.
112
How is touching with the left hand perceived in Islamic and Hindu cultures?
It is considered rude and offensive to offer the left hand in greeting.
## Footnote
Islamic and Hindu cultures avoid touching with the left hand, as traditionally this hand was used for unclean functions.
113
How is direct eye contact perceived in most Asian, African, Latin American, and Caribbean cultures?
Direct eye contact is a sign of disrespect.
114
How is direct eye contact perceived in Somalian and Brazilian cultures?
These cultures believe that prolonged eye contact communicates honesty and interest in the recipient.
115
How does slouching come across in Japanese and Northern European cultures?
Considered rude.
116
How does a thumbs up sign differ in America compared to many Arabic and Latin countries?
American = "Everything is okay" or "ready to go"
Arabic/Latin Countries = Equivalent of extended middle finger in America
117
What does this sign mean in the following countries:
* America
* Latin Countries, Germany, Italy, Russia
* France
* Japan
America = "Good to go"
Latin countries, Germany, Italy, Russia = reference to the anus
France = zero or something is worthless
Japan = Evil eye
118
What does this sign mean in the following countries:
* America
* Japan
America = derogatory term (F*** You)
Japan = same significance as pointing with an index finger; Japanese people use the middle finger as Americans use the index finger.
119
# What distance/description best matches the space in American culture?
Intimate
| Proxemics for American Culture
Distance = <18 in (46cm)
Whispering
Touching
Must be invited
120
# What distance/description best matches the space in American culture?
Personal
| Proxemics for American Culture
Distance = 18 in to 4 ft (46cm to 1m)
Conversations with close friends or family
121
# What distance/description best matches the space in American culture?
Social
| Proxemics for American Culture
Distance = 4-10 ft (1-3m)
Conversations with acquaintances
122
# What distance/description best matches the space in American culture?
Public
| Proxemics for American Culture
Distance = 10-25 ft (3-8m)
Interacting with strangers
123
List tips for communicating with older adult patients.
124
What time format should be used in documentation and communication?
24 Hour Format
