Crisis Management for Paramedics

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Crisis Management for Paramedics

• Week 1
• Fundamentals of Communication Therapeutic
  Approach
• Concepts of Crisis Stress

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Good communications!
Critical for us!!
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Service

• You all stated you want to help people and that
  you are people persons...so here is your chance
  to shine
• Patients deserve our best efforts at service
  they are the reason we exist
• What the S in EMS stands for

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What makes a good communicator?

• Internal Factors
• not about you
• natural desire to help
• Defecate in our ambulance
• Vomit on our shoes
• Bleed on our uniforms
• Heads up if these feelings are not sincere your
  patients will sense it and you will have a short
  career

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Effective Communication

• External Factors
• Look the part of a professional
• Pay attention to you appearance
• Inspire respect
• Consider it an honour to be asked into a
  patients home

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• Consider the following
• How does communication occur?
• What are the components of communication
• How do we as care givers attempt to communicate
  with people in crisis and what can hinder the
  communication

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CommunicationTherapeutic Approach

• What is communication?
• The exchange of common symbols
• Written, spoken, signing and body language
• Basic elements the sender, the message and the
  receiver

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• Verbal
• Voice quality, diction, pitch, rate of speech and
  volume
• Body language
• Provide your undivided attention
• LISTEN dont just talk

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• Successful communication occurs if, by way of the
  response, the sender believes that the message
  was received accurately

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Effective listening

• An active skill
• Requires complete attention
• Focus on the messenger
• Never finish the other persons sentence
• Do not consider your response until the other
  person has finished speaking
• Requires practice!!

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• Remember
• A good communicator needs patience and
  flexibility!

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Trust and Rapport

• There is a certain amount of trust implied in
  being a paramedic
• You need to earn the trust
• First you establish the trust, then the rapport
  follows.
• With good rapport the person you are helping will
  follow your lead

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Developing Rapport

• Introduce yourself and your partner
• Address the patient formally Mr., Mrs., etc.
• Use the patients name
• Get to the level of the patient
• Use a professional but compassionate tone of
  voice
• Explain what you are doing and why

Patient should believe they are your priority
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Nonverbal communication skills

• Eye contact
• Touch and Gentleness
• Posture
• Demeanour/Smile
• Important to look at your patients body language

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Eye contact

• Can be a very powerful source of effective
  communication
• Take your sunglasses off!!
• Can be very important in tense or difficult
  situations
• Remember, eye contact means the patient is
  looking at you!

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Compassionate touch

• The holding of a hand, touch of an arm or
  shoulder
• May be awkward at first watch for response
• May help to calm the patient
• Be careful to touch appropriately consider the
  patients age, gender, cultural background and
  current setting

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Posture

• Gestures, mannerisms and postures by which a
  person communicates with others
• Includes distance between you and the patient,
  whether you are at eye level or not and your
  stance

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Demeanour Therapeutic Smile

• Pleasant demeanour absolutely necessary when you
  are dealing with people in crisis they need to
  feel safe and assured that you can help
• Smile can send the message that all will be
  well but consider the crisis

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Interviewing Techniques
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Questioning

• Use open-ended questions
• Use closed questions only when necessary
• Ask only one question at a time
• Listen to the patients complete response before
  asking the next question
• Use language the patient can understand
• Do not ask leading questions

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Payoff Questions

• Have you felt like this before?
• Have you been upset about anything lately?
• Are you afraid of someone? save this one for the
  privacy of the ambulance
• Have you been thinking about hurting yourself?
• What happened the last time you felt this way?

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Strategies to Elicit Useful Responses to Questions

• Facilitate the response
• Be quiet - never miss a good opportunity to shut
  up
• Clarify the response
• Redirect the response
• Interpret the response
• Simplify and summarize the response

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Common Interviewing Errors

• Assume Nothing
• Giving Medical advice
• Providing false hope
• Assuming excessive authority
• Sidestepping the truth
• Distancing yourself from patients as people

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Assessing Mental StatusObserving the patient

• Appropriate Humour
• Timing of Responses to Questions
• Memory
• Ability to obey simple Commands

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Unique interview situations

• People who are unmotivated to talk
• People who are hostile
• People who are very old OR very young
• People who live with special challenges
• Cross cultural communications
• Manners, gestures and body language
• Cultural sensitivity and cultural diversity

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How does failure to communicate occur?

• Prejudice do not paint all with the same brush
• Lack of empathy
• Lack of Privacy
• External distractions
• Internal Distractions

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• Remember to bring closure to the call
• Say good bye

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Whole messages
See
Feedback
DO
Think
Want
Feel