EMS Chapter 4 - Communications and Documentation

Telemetry

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.

Scanner

A radio receiver that searches or "scans" across several frequencies until the message is completed; the process is then repeated.

Falsifying information on the PCR may result in suspension and/or revocation of your certification or license. T/F

True Correct. Falsifying information can lead to suspension and/or revocation of your certification or license.

You should inform online medical control when patients refuse care. T/F

True Correct. You should inform online medical control when patients refuse care.

________ radios operate between 300 MHz and 3,000 MHz. VHF UHF Multiplex Trunking

UHF Correct. UHF (Ultra high frequency) radios operate between 300 MHz and 3,000 MHz. VHF (very high frequency) most of these type of radios operate between 30 and 300 MHz

Radio hardware containing a transmitter and receiver that are located in a fixed place is known as what? Cell phone Interoperable communications system Mobile data terminal (MDT) Base station

A base station is radio hardware containing a transmitter and receiver that are located in a fixed place.

Interoperable Communications System

A communication system that uses voice-over-Internet-protocol (VoIP) technology to allow multiple agencies to communicate and transmit data.

Cellular Telephone

A low-power portable radio that communicates through an interconnected series of repeater stations called "cells".

Mobile Data Terminal (MDT)

A small computer terminal inside the ambulance that directly receives data from the dispatch center.

Repeater

A special base station radio that receives messages and signals on one frequency and then automatically retransmits them on a second frequency.

Dedicated Line

A special telephone line that is used for specific point-to-point communications; also known as a hotline.

Rapport

A trusting relationship that you build with your patient.

You are caring for a 52-year-old man who complains of chest discomfort. The patient is a retired paramedic and is very anxious because he thinks he is having a heart attack. Which of the following statements would be appropriate? Select one: A. "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow." B. "We need to take you to the ED stat. We will give you ASA and NTG en route and then reassess your vitals. Do you have any questions?" C. "This is nothing to worry about. Please try to stay calm. The physician at the hospital will probably not find any signs of a heart problem." D. "I notice that you are a retired paramedic, so I'm sure you will understand all of the things that we will be doing to you."

A. "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow."

You and your partner are attempting to resuscitate a middle-aged female in cardiac arrest. Because of the remote geographic location, you are unable to contact medical control. What should you do? Select one: A. Follow locally established protocols or standing orders. B. Ask the husband if he wants to continue resuscitation. C. Make continuous attempts to contact medical control. D. Perform CPR only and initiate immediate transport.

A. Follow locally established protocols or standing orders.

You are transporting a 54-year-old male in respiratory arrest. An EMR is driving the ambulance as you and your partner are caring for the patient. Which of the following is the MOST logical way of notifying the hospital? Select one: A. Have the driver contact dispatch and relay the patient information to the hospital. B. Call the receiving hospital with your cell phone while providing patient care. C. Wait until you arrive at the hospital and then quickly apprise the staff of the situation. D. Request that a police officer respond to the hospital to apprise the staff of your arrival.

A. Have the driver contact dispatch and relay the patient information to the hospital.

Which type of communications equipment functions as a radio receiver and searches across several frequencies? Select one: A. Scanner B. Mobile repeater C. Duplex station D. Simplex station

A. Scanner

Which of the following will help improve radio communications? Select one: A. Wait 1 second after pressing the transmit button before speaking. B. Answer questions with "yes" or "no." C. Hold the radio at least 6 inches from your mouth. D. Use codes to speed communication.

A. Wait 1 second after pressing the transmit button before speaking.

A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should: Select one: A. ask the father to hold the child so you can assess him while your partner tries to calm the mother. B. reassure the child's mother that seizures in children are very common and that there is nothing to worry about. C. attempt to calm the child's mother, but avoid separating her from her child because this will increase her anxiety. D. give the child a favorite toy or blanket to hold onto and perform your assessment to the best of your ability.

A. ask the father to hold the child so you can assess him while your partner tries to calm the mother.

At the scene of a motor vehicle crash, you determine that there are two critically injured patients and that another ambulance is needed. You attempt to contact the dispatcher with your portable radio but are unsuccessful. You should: Select one: A. use the mobile radio in the ambulance to contact dispatch. B. ask a police officer to call dispatch with his portable radio. C. make another attempt to contact dispatch from an area of higher terrain. D. place both patients in the ambulance and transport them at once.

A. use the mobile radio in the ambulance to contact dispatch.

Channel

An assigned frequency or frequencies that are used to carry voice and/or data communications.

What type of mode does an interoperable communications system use? Simplex Duplex Trunking Voice-over-Internet-protocol

An interoperable communications system uses a voice-over-Internet-protocol format to connect landlines, cell phones, and computers to create a seamless, reliable exchange of information among all parties.

Base Station

Any radio hardware containing a transmitter and receiver that is located in a fixed place.

Noise

Anything that dampens or obscures the true meaning of a message.

Which of the following incidents does NOT require a report to be filed with local authorities? Select one: A. Gunshot wounds B. Cardiac arrest C. Animal bites D. Spousal abuse

B. Cardiac arrest

Which of the following is NOT a function of the Federal Communications Commission (FCC)? Select one: A. Licensing base stations and assigning appropriate radio call signs B. Maintaining communications equipment on the ambulance C. Allocating specific radio frequencies for use by EMS providers D. Monitoring all radio traffic and conducting field spot checks

B. Maintaining communications equipment on the ambulance

Information included in a radio report to the receiving hospital should include all of the following, EXCEPT: Select one: A. a brief history of the patient's current problem. B. a preliminary diagnosis of the patient's problem. C. your perception of the severity of the problem. D. a brief summary of the care you provided.

B. a preliminary diagnosis of the patient's problem.

During your assessment of a 20-year-old man with a severe headache and nausea, you ask him when his headache began, but he does not answer your question immediately. You should: Select one: A. ask him if he frequently experiences severe headaches and nausea. B. allow him time to think about the question and respond to it. C. tell him that you cannot help him unless he answers your questions. D. repeat your question because he probably did not hear you.

B. allow him time to think about the question and respond to it.

A patient's refusal of EMS treatment and/or transport must be: Select one: A. witnessed by a notary. B. an informed refusal. C. reported to the police. D. authorized by a judge.

B. an informed refusal.

Immediately after being dispatched to a residence for an elderly patient with diabetic complications, you should: Select one: A. request that law enforcement secure the scene before you arrive. B. confirm with dispatch that you received the call information. C. ask the dispatcher to obtain a medical history from the caller. D. ask the dispatcher if the patient is conscious or unconscious.

B. confirm with dispatch that you received the call information.

Ethnocentrism is defined as: Select one: A. subconsciously forcing your cultural values onto a patient because you feel that your own values are more acceptable. B. considering your own cultural values to be more important when interacting with people of a different culture. C. understanding that people from different cultural backgrounds respond to pain and stress differently. D. suspecting that a person has an ulterior motive based on the tone of his or her voice when answering a question.

B. considering your own cultural values to be more important when interacting with people of a different culture.

During the alert and dispatch phase of EMS communications, the dispatcher's responsibilities include all of the following, EXCEPT: Select one: A. selecting and notifying the correct EMS response units and personnel. B. discouraging the caller from providing care until the EMS unit arrives. C. screening and assigning a priority to each call based on local protocols. D. coordinating responding EMS units with other public safety personnel.

B. discouraging the caller from providing care until the EMS unit arrives.

You are providing care to a 61-year-old female complaining of chest pain that is cardiac in origin. Your service utilizes a multiplex communication system. You wish to transmit the patient's electrocardiogram to the hospital. In order to accomplish this, you must: Select one: A. be aware that only audio or data transmissions can be sent at any one time. B. use the multiplex system to transmit the information . C. wait until you reach the hospital to transmit the information. D. send the electrocardiogram from the back of the ambulance.

B. use the multiplex system to transmit the information .

You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining—a traditional Asian healing practice in which hot coins are rubbed on the back. You should: Select one: A. advise the emergency department physician that you feel as though the child was intentionally abused by his parents. B. advise the child's parents that this is a harmful practice and is considered a form of child abuse in the United States. C. document this finding on your patient care report and advise the emergency department staff of what the child's parents told you. D. acknowledge and respect this practice as a cultural belief, but advise the child's parents that it has no healing power.

C. document this finding on your patient care report and advise the emergency department staff of what the child's parents told you.

Communicating with patients who are deaf or hard-of-hearing can be facilitated by doing all of the following, EXCEPT: Select one: A. providing pen and paper if the patient prefers to write his or her response. B. shining a light on your face when you are in a darkened environment. C. elevating the tone of your voice and exaggerating word pronunciation. D. placing yourself in a position to ensure that the patient can see your lips.

C. elevating the tone of your voice and exaggerating word pronunciation.

When you are communicating with an older patient, it is important to remember that: Select one: A. speaking loudly and distinctly will ensure that the patient can hear you. B. hostility and confusion should be presumed to be due to the patient's age. C. most older people think clearly and are capable of answering questions. D. your questions should focus exclusively on the patient's obvious problem.

C. most older people think clearly and are capable of answering questions.

As you are wheeling your patient through the emergency department doors, you receive another call for a major motor vehicle crash. You should: Select one: A. leave a copy of the run form with a nurse and then respond to the call. B. place the patient in a high-visibility area and then respond to the call. C. respond only after giving a verbal patient report to a nurse or physician. D. inform the admissions clerk of the situation and then respond at once.

C. respond only after giving a verbal patient report to a nurse or physician.

General guidelines for effective radio communications include all of the following, EXCEPT: Select one: A. speaking in a clear, calm, monotone voice. B. acknowledging a transmission as soon as possible. C. using 10 codes to ensure radio traffic confidentiality. D. holding the microphone about 2 to 3 inches from your mouth.

C. using 10 codes to ensure radio traffic confidentiality.

When providing a patient report via radio, you should protect the patient's privacy by: Select one: A. refraining from objective statements. B. using coded medical language. C. withholding medical history data. D. not disclosing his or her name.

D. not disclosing his or her name.

After receiving online orders from medical control to perform a patient care intervention, you should: Select one: A. perform the intervention as ordered. B. confirm the order in your own words. C. ask the physician to repeat the order. D. repeat the order to medical control word for word.

D. repeat the order to medical control word for word.

You are caring for a 56-year-old male patient complaining of abdominal pain. Your service has recently switched to an electronic PCR system (ePCR). When completing the ePCR, it is important to be aware that: Select one: A. the ePCR is relatively unsecured and should not contain patient-specific information. B. the ePCR does not contain the same level of information as the written version and your verbal report should be expanded. C. a written patient care record will need to be completed on arrival at the hospital. D. the ePCR allows patient information to be transmitted directly to the receiving hospital's computers.

D. the ePCR allows patient information to be transmitted directly to the receiving hospital's computers.

When a person considers his or her own cultural values as more important when interacting with people of a different culture, what is this referred to? Stereotyping Ethnocentrism Cultural imposition Rapport

Ethnocentrism is when a person considers his or her own cultural values as more important when interacting with people of a different culture.

Encouraging this patient to provide more information about his injury is an example of which therapeutic communication technique? Facilitation Reflection Clarification Interpretation

Facilitation encourages the patient to talk more or provide more information.

When completing a PCR, you should include your opinions about the mechanism of injury and which injuries are most severe. T/F

False Correct. You should only write fact-based findings.

Open-Ended Questions

Questions for which the patient must provide detail to give an answer.

Closed-Ended Questions

Questions that can be answered in short or single word responses.

VHF (very high frequency)

Radio frequencies between 30 and 300 MHz; the VHF spectrum is further divided into "high" and "low" bands.

UHF (ultra-high frequency)

Radio frequencies between 300 and 3,000 MHz.

Which of the following is included in the narrative section in a PCR? Patient name and address Time the EMS unit was notified Refusal of care Supportable personal opinions

Refusal of care should be included in the narrative section of a PCR.

Simplex

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.

Trunking

Telecommunication systems that allow a computer to maximize utilization of a group of frequencies.

Duplex

The ability to transmit and receive simultaneously.

Multiplex

The ability to transmit audio and data signals through the use of more than one communications channel.

Federal Communications Commission (FCC)

The federal agency that has jurisdiction over interstate and international telephone and telegraph services and satellite communications, all of which may involve EMS activity.

Patient Care Report (PCR)

The legal document used to record all patient care activities. This report has direct patient care functions but also administrative and quality control functions. PCRs are also known as prehospital care reports.

If you discover an error as you are writing your PCR, what should you do? Draw a single horizontal line through the error, initial it, and write the correct information next to it. Erase the erroneous information and insert the correct information. Cover the error with correction fluid and initial it. Tell your supervisor about the error.

The proper way to correct a PCR is to draw a single horizontal line through the error, initial it, and write the correct information next to it.

Documentation

The recorded portion of the EMT's patient interaction, either written or electronic. This becomes part of the patient's permanent medical record.

Communication

The transmission of information to another person-verbally or through body language.

Paging

The use of a radio signal and a voice or digital message that is transmitted to pagers ("beepers") or desktop monitor radios.

What is therapeutic communication? A means by which a patient can efficiently relate levels of pain. Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship. Anything that dampens or obscures the true meaning of a message. The recorded portion of an EMT's patient interaction, either written or electronic, that becomes part of the patient's permanent medical record.

Therapeutic communication involves verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.

Evaluation and continuous quality improvement are factors in writing a PCR. T/F

True Correct. Evaluation and continuous quality improvement are factors in writing a PCR.

MED Channels

VHF and UHF channels that the Federal Communications Commission has designated exclusively for EMS use.

Therapeutic Communication

Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.

What should you do if a patient refuses treatment or transport? Contact medical control. Ask law enforcement to take him into custody. Immediately stop patient care and leave. Find another person to continue medical care.

When a patient refuses treatment or transport, you should contact medical control.

Ethnocentrism

When a person considers his or her own cultural values as more important when interacting with people of a different culture.

Cultural Imposition

When one person imposes his or her beliefs, values, and practices on another because he or she believe his or her ideals are superior.

Standing Orders

Written documents, signed by the EMS system's medical director, that outline specific directions, permissions, and sometimes prohibitions regarding patient care; also called protocols.

After you submit the electronic PCR for a call, you realize that you accidentally documented the wrong vital signs. What should you do? Leave the record as it is and seek legal advice. Notify your agency's information technology department. Follow your agency's directions for making an amendment. Say nothing and hope that the error goes unnoticed.

You should follow your agency's directions and make an amendment to the PCR.

As you radio the hospital to give a report on your patient, which of the following should you do? Provide as much detail as possible. Use code words to protect the patient's identity. Speak as quickly as possible. Remain objective and impartial.

You should remain objective and impartial.