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Principles of Patient Assessment in EMS . By: Bob Elling, MPA, EMT-P & Kirsten Elling, BS, EMT-P. Chapter 2 - Listening to Patients. © 2003 Delmar Learning, a Division of Thomson Learning, Inc. . Objectives. List the major components of the communication process.

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principles of patient assessment in ems

Principles of Patient Assessment in EMS

By:

Bob Elling, MPA, EMT-P

&

Kirsten Elling, BS, EMT-P

chapter 2 listening to patients

Chapter 2 - Listening to Patients

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

objectives
Objectives
  • List the major components of the communication process.
  • Describe various methods for communicating a message.
  • Explain why making a proper introduction and identifying level of training is an important factor for patient communication.
  • Provide examples of how the EMS provider can establish trust with a patient.

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

objectives continued
Objectives (continued)
  • Explain the EMS provider’s responsibility in maintaining the patient-EMS provider relationship.
  • List examples of both positive and negative facilitation.
  • Describe the techniques EMS providers may use to encourage feedback from a patient.

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

objectives continued5
Objectives (continued)
  • Identify two factors that tend to impede verbal communications.
  • Provide examples of special challenges the EMS provider may encounter in communicating with patients and some tips to manage each.
  • Describe verbal and nonverbal factors to consider when communicating with a patient with cultural differences.

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

introduction
Introduction
  • Establishing a rapport with patient and family is important
  • Effective communication between EMS provider and patient takes practice
  • Obtaining a good history is often difficult, yet necessary
  • This chapter focuses on interpersonal dynamics and communications strategies

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

communication is a 2 way process
Communication is a 2-way process

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

the feedback loop
The Feedback Loop
  • Sender
  • Receiver
  • Message
  • Encoding
  • Decoding
  • Feedback

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

message is communicated
Message is Communicated
  • Verbal – speaking and observing feedback
  • Non-verbal – use of body language
  • Non-verbal – understanding of one’s personal space
  • Listening – adjust the environment so it is possible to listen

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

factors that facilitate effective communication
Factors that Facilitate Effective Communication
  • Is the patient comfortable?
  • Consider your method of approach
  • Professional, respectful introductions
  • Addressing the patient: name and formality
  • Establishing trust
  • Consider the environment, modesty, emotional, and biological needs
  • Confidentiality

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

communication techniques
Communication Techniques
  • Facilitation – positive or negative
  • Open-ended questions
  • Closed questions
  • Reflection – echoing the patient’s words to encourage the flow of conversation

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

communication techniques continued
Communication Techniques (continued)
  • Clarification of confusing or ambiguous responses
  • Silence is sometimes helpful
  • Explanation to help put the patient more at ease

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

barriers to communication
Barriers to Communication
  • Words and phrases the patient does not understand
  • Technical terms should be kept to a minimum (unless dealing with a health care worker)

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

special challenges
Special Challenges
  • Hearing impairment
  • Visual impairment
  • Speech impairment
  • Non-English speaking
  • Developmental disability
  • Terminally ill

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

special challenges continued
Special Challenges (continued)
  • Hostile patients
  • Anxious patients
  • Abused patients
  • Patients with multiple symptoms
  • Asymptomatic patients
  • Overly talkative patients

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

communicating with children
Communicating with Children
  • Your interview must be age appropriate
  • Kneel down to get to the child’s level
  • Involve the parent or caregiver in the interview

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

communicating with the elderly
Communicating with the Elderly
  • Aging rate differs with the person so do not assume all elderly are visually or hearing impaired
  • Give the patient time to discuss the chief complaint
  • Verify information with a family member or caregiver as necessary

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

cultural considerations
Cultural Considerations
  • Recognize cultural differences in your patients
  • Culture based preferences may conflict with usual medical practices
  • Don’t assume patients with a particular cultural background are different…take the time to learn about the culture
  • Consider verbal and non-verbal messages

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

conclusion
Conclusion
  • Practice your listening skills
  • Do not judge
  • Demonstrate kindness, compassion, and empathy
  • Understanding basic communications skills is essential to EMS providers

© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

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