The Role of Communication in EMS
Effective radio communication is essential for coordinating care between EMS providers, dispatch, and receiving hospitals. A clear, concise hospital notification can activate a trauma team, prepare a cardiac catheterization lab, or alert a stroke team before the patient arrives, significantly reducing treatment delays. Conversely, poor communication leads to misunderstandings, delays, and potentially adverse patient outcomes.
EMS communication occurs through multiple channels: dispatch radio communication, inter-unit communication, and hospital notification. Each has its own conventions and expectations, but all share the same fundamental principles of clarity, brevity, and accuracy.
Radio Communication Basics
Follow these principles for clear radio communication:
- Listen before transmitting: Ensure the frequency is clear before keying the microphone to avoid talking over other traffic.
- Plan your message: Know what you want to say before you press the transmit button. Pauses and "umm" waste airtime and convey uncertainty.
- Use plain language: Most EMS systems have moved away from 10-codes in favor of plain language to reduce confusion, especially during mutual aid events with agencies that use different code systems.
- Speak at a moderate pace: Fast speech is difficult to understand over radio, especially with background noise. Slow down and enunciate clearly.
- Confirm receipt: Wait for acknowledgment before proceeding with your message. If no acknowledgment is received, repeat after 30 seconds.
Hospital Notification Using SBAR
The SBAR format provides a structured framework for delivering patient reports to receiving hospitals:
Situation: Identify yourself, your unit, and provide a brief overview. "County Medic 7, we are transporting a 62-year-old male with chest pain."
Background: Relevant history, medications, and events leading to the call. "Patient has a history of hypertension and type 2 diabetes. He was watching television when the chest pain started approximately 45 minutes ago."
Assessment: Your findings and vitals. "Patient is diaphoretic and pale. Vitals: BP 148/92, HR 110, RR 22, SpO2 95% on room air. 12-lead shows ST elevation in leads II, III, and aVF."
Recommendation: What you need from the hospital. "Requesting STEMI activation. Our ETA is approximately 12 minutes. We have administered aspirin 324 mg and started an IV of normal saline."
Communication During Mass Casualty Incidents
During mass casualty incidents (MCIs), communication discipline becomes even more critical. Use the Incident Command System (ICS) structure to organize communications. Avoid freelancing on the radio. Keep transmissions short and factual. Include your unit identifier with every transmission. Report patient counts by triage category (red, yellow, green, black) rather than giving detailed individual patient reports. Request specific resources rather than general help. Clear communication during MCIs directly impacts how quickly patients receive definitive care.