Tuning In: An Intro to the Radio

Last updated on September 4th, 2024 at 01:59 pm

As an EM physician, you may find yourself being thrust into situations with no time to prepare and little prior experience to fall back on. Although these are times we tend to shine as a specialty, my first time answering a radio call-in from EMS was most definitely not a “shining” moment.

Scene: A busy shift with the senior resident, attending, and upper level resident busy with a trauma; the radio sounds ~ “EMS ### to Hospital #” … (Me looking around, realizing I am the only provider near the radio) … (Me looking at the the nurses and techs who are simultaneously looking at me) … (Me slinking over to the radio) … “Uh… hello.”

You get the point – we rarely get taught some of these valuable auxiliary skills, but that is exactly what this post is for. So let’s keep it clear and concise: here is a quick intro on how to use and communicate effectively on a radio (or what we lovingly call at GW, “The Box”).

Radio Anatomy

Let’s cover the basic anatomy of the radio with the antenna facing to the left, left to right, top to bottom:

• Antenna
• “Panic Button”/Orange button
  • This is the button you should never push – it’s an SOS signal for personnel in the field that doesn’t have any utility in the ED
• Channel selection knob/Knob with numbers in the middle of the top of the radio
  • This is a knob that you will likely never need to adjust unless someone accidentally changes it; it is set so that EMS is able to reach you, in our shop – the correct settings are written on the paper in front of the radio
• Volume and power knob/Large knob with single indicator marking opposite the antenna
  • This is the second most used part of the radio for you – clockwise turns on and increases the volume, counterclockwise decreases the volume and eventually turns off the radio (you will hear/feel a subtle*click* if you do this)
• Microphone
  • The microphone is difficult to distinguish, and you usually won’t have to given that as long as you are within about a foot of the radio you will be audible; in our shop’s radio it is located right where the “Motorola” logo is when the screen is facing you
• Front screen/keypad
  • Just like the channel selection knob, there is no real reason for you to adjust anything on this
• Programmable buttons #1
  • You won’t use this
• Transmission button/Large rectangular button outlined in green on the side
  • The most used button – your “push to talk” button, remember to hold it down, and wait a second for the “chirp” before you begin to speak
• Programmable button #2, #3
  • Same as programmable button #1
• Speaker
  • The speaker makes up the top half of the back of the radio

Etiquette

You have one primary objective when communicating through the radio – to obtain the information you need to allocate the appropriate resources for whatever is coming in. This sounds simple, but in practice this can be tricky – EMS is dealing with all sorts of things that are invisible to us (dodging traffic, active CPR in the back of the ambulance, etc), so asking for a detailed HPI is unrealistic in most cases. Here are a couple things to remember about etiquette:^​1​

• Be polite, respectful, and patient – this is not the time to criticize or air your frustrations with the system, debrief later
• Acknowledge the report – EMS starts with “This is EMS #, for hospital #”, and will wait for you to respond/acknowledge; a brief “This is hospital #, go ahead” will do
• Ask EMS to “standby” if you want someone else to hear the call in with you so you don’t have to play telephone later, if you can’t get someone else in a reasonable amount of time, take the report; you can also do this if you are in a noisy environment and need to move away to hear the radio
• Grab a piece of paper or use a computer’s notepad function to jot down details and allow EMS to finish their transmission before you interrupt/ask any clarifying questions
• Speak slowly and clearly, having to repeat yourself over and over again is time consuming and frustrating
• Avoid jargon, use plain language – do not use 10 codes (“10-4”) or acronyms/speech that is institution specific (say “glucose” or “sugar” instead of “d-stick”)
• Be concise – “Can you repeat the heart rate?” is easier understood than “Did you say the heart rate already and was it above 110 and did they say that’s their normal rate?”; stick to asking one specific question at a time
• If you are unsure or surprised by something in the report, repeat it back
• Make sure to note the estimated time of arrival (ETA)
• Have a sign off that acknowledges the report and ends the encounter – mine is “Hospital # copies thank you, we’ll see you when you get here, call us if anything changes”

Specific Scenarios

Lastly here are some scenarios and the specifics you’ll want to make sure you ask about:

• Possible stroke/TIA
  • Last known well
  • Glucose
  • Prior strokes/TIA/CVA history and any residual deficits as well as other chronic medical problems
  • Blood thinners
• Trauma
  • Injuries & hemorrhage control
  • Blood thinners
  • Mechanism of injury specifics
    • You’ll develop a script for this – motorcycle/bike accidents ~ helmeted, motor vehicle ~ seatbelts/windshields/passengers, etc
  • Loss of consciousness
  • GCS/Mental status
• Chest pain/Possible MI
  • EKG findings, ability to send EKG to the ED
  • Aspirin/nitro administration
  • Blood thinners
  • Previous MI or other cardiac conditions
• Medical alerts/ROSC/CPR in progress
  • Where the patient is coming from (ex – nursing home)
  • Downtime
  • Initial rhythm
  • Length of resuscitation
  • Interventions done
  • Code status
  • Family/Significant others on the way

Communicating effectively with EMS over the radio is an important skill that is rarely taught to EM providers. When things go right, the transition between pre-hospital and ED care is seamless and serves to elevate the patient’s care while avoiding unnecessary confusion and frustration between providers.

Cite this post: Timothy Harmon, MD, Arman Hussain, MD. “Tuning In: An Intro to the Radio”. GW EM Blog. May 4, 2024. Available at: https://gwemblog.com/tuning-in-an-intro-to-the-radio/.

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