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CASE REVIEW Customer Service Opportunity Patients with concerns about heart problems can have high degrees of anxiety and require the highest level of communication skill by EMTs. Any verbal and nonverbal communication from the EMS crew can be interpreted by the patient and a concerned family as representing life or death for the patient. Manage encounters with patients with potential cardiac issues with professional communication, honest information, and a direct plan for evaluation, treatment and transportation. The dialogue with the patient about a destination is one that can communicate the degree of concern an EMS crew has for the risk of heart or other critical problems. Many EMS systems now have specifc transport protocols for patients with problems ranging from heart disease and strokes to trauma, burns, pediatric problems and childbirth. Many communities now have a media smorgasbord of messages regarding where to go if you think you're having a heart attack or other problems. EMS providers will help many patients by portraying and delivering a confdent message regarding the decision to transport to a specialty hospital. and they notify the wife and share the destination change with the dispatch center. The dispatcher alerts the hospital that a patient will be arriving in about 15 minutes who meets criteria for a cardiac alert. The patient receives two nitroglycerin, and his discomfort decreases. The monitor shows an ongoing sinus rhythm, and his blood pressure is stable. En route to the hospital, the paramedic gives a report directly to the ED. Hospital Management The ED is prepared for the patient's arrival. The paramedic gives the emergency physician the history, introduces the patient and shares the two 12-lead EKGs. The physician asks if the crew will keep the patient on their stretcher and monitor. Quickly nurses apply an armband, draw some tubes of blood for lab tests, and lead the patient and EMS crew to the hospital's cardiac intervention lab. That lab has been prepared for the patient, and he is immediately loaded onto its table. The cardiologist introduces himself, and the entire lab crew goes to work. The Attack One crew returns to the ED to prepare their patient care report and clean their equipment. As they fnish, the ED charge nurse comes into the EMS room and says, "Great news. The cardiac lab called and said that man had a very high-grade blockage in one of his coronary arteries, which they have opened. They have some more work to do but think he's going to do well. They are grateful for your work." The patient, in fact, does well in the cardiac lab. He had only the one blockage and is admitted for a short observation period before being released home. Improve your patient care skills. Courses from the National Association of Emergency Medical Technicians (NAEMT) provide high quality, cost effective, evidence-based education to help you better care for your patients. Strengthen your skills and knowledge by taking a PHTLS, AMLS, EPC, TCCC or EMS Safety course. All courses are CECBEMS accredited and meet NREMT recertiļ¬cation requirements. Learn more today. www.naemt.org | 1-800-346-2368 For More Information Circle 18 on Reader Service Card 22 JUNE 2013 | EMSWORLD.com Serving our nation's EMS practitioners