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Category: EMS Operations

Topic: Therapeutic Communication

Level: Paramedic

14 minute read

Factors that affect communication with patients include both internal factors and external factors.

INTERNAL FACTORS for effective communication include

  • accepting others as people,
  • exercising empathy,
  • being a good listener, and
  • proper introductions.

INTRODUCTIONS can go a long way in facilitating effective communication with patients and family members.

EMS professionals should always introduce themselves and their partners and team members, when applicable, and follow this by allowing or requesting that the patient introduce himself/herself.

During each patient encounter, the EMS professional should always

  • make and keep eye contact,
  • position themselves a lower level than that of the patient or on the same level,
  • always be honest with the patient,
  • use language that the patient can easily understand while avoiding medical jargon,
  • be aware of their own body language, and
  • speak calmly, clearly, slowly and distinctly.


  • All patients should be addressed with their proper name, either first or last, depending on the circumstances.
  • EMS professionals should be aware of a patient that has difficulty hearing and should speak clearly with their lips visible when encountering this situation.
  • EMS should always allow the patient adequate time to answer a question before asking another one and should act and speak in a calm, confident manner.

EXTERNAL FACTORS for effective communication include protecting patient privacy and minimizing interruptions of any kind, especially that of the physical environment.

Lighting, noises and outside interference, distracting equipment, distance, and a difference in height between the EMS professional and the patient are all easily corrected and should be applied effectively.

The physical appearance of the EMS professional is often the first judgment passed by a patient on the provider; every EMS professional should be dressed in a neat and clean uniform and exhibit good personal hygiene.

Finally, during patient interviewing, EMS professionals may take notes to remember pertinent information.


Communication Adjustment Strategies

Communication strategies should be adjusted for

  • age-appropriateness,
  • stage of development,
  • patients with special needs (i.e., hearing-impaired patients), and
  • differing cultures.

EMS professionals will encounter patients of all ages including pediatric (infants, preschoolers, school-age children, and adolescents), adults, geriatrics, and diverse cultures.

PEDIATRIC: For young children, the parent and caregiver should always be highly involved in the interview process. It is important that the EMS professional use clear explanations and is always honest.

Agitation and anxiety should not be considered dangerous emotions when dealing with the pediatric family population.  The family's reaction should be considered normal considering the circumstances. An explanation by a team member of what and how things are being done will be very beneficial to the family to help them understand the processes they are seeing, yet it will not require the crew to have to rush proper treatment. 

GERIATRIC: Communication with elderly patients can require that the EMS professional obtain the patient's assisting devices for them, such as glasses, hearing aids, or walkers, due to the potential for a visual deficit, auditory deficit, and the need for assistance during walking.

CULTURAL: Enormous diversity in populations of all cultures requires special communication skills of the EMS professional.



DIVERSITY: a term, once used to describe racial awareness, now refers to differences of any kind:

  • race,
  • class,
  • religion,
  • gender,
  • sexual preference,
  • personal habit, and
  • physical ability.

Good healthcare depends on sensitivity toward these differences. Experiences of health and illness vary widely because of different beliefs, behaviors, and past experiences and may conflict with the EMS professional’s learned medical practice.

By revealing an awareness of, and respect for, cultural issues, the EMS professional will convey interest, concern, and respect.

When dealing with patients from different cultures, remember that the individual is the foreground and the culture is the background, different generations and individuals within the same family may have different sets of beliefs, not all people identify with their ethnic background, and all people share common problems or situations.

Respect the integrity of cultural beliefs and realize that while people may not share your explanations of the causes of their ill health, they may accept conventional treatments. The EMS professional does not have to agree with every aspect of another’s culture, nor does the person have to accept everything about the EMS professionals’ culture for effective and culturally sensitive healthcare to occur.

EMS professionals should recognize their own personal cultural assumptions, prejudices, and belief systems and should not let them interfere with patient care.

Regardless of the patient’s cultural background, educational status, occupation, or ability to speak English, most patients will be anxious during an emergency event.

Attempt to communicate in English first to determine whether the patient understands or speaks some English words or phrases. Bystanders, coworkers, or family members may be available to provide assistance.

If the patient does not speak or understand English, EMS professionals should attempt to communicate with signs or gestures. EMS professionals should also notify the receiving hospital as soon as possible to arrange for an interpreter.

If time permits, all assessment procedures should be performed slowly and with the patient’s permission. Be aware that “private space” is culturally defined.

Pointing to the area of the body to be examined before touching the patient is best. Always respect the patient’s need for modesty and privacy at the scene and during transport.