The Well-Being of the EMT-Basic

1. 1 The Well-Being of the EMT-Basic

2. 2 Emotional Aspects of Emergency Care: CAUSES OF STRESS: Multiple casualty incident (MCI). Calls involving infants and children. Severe injuries. Abuse and neglect. Death of a coworker Stress can be caused by a single event or build up over time.

3. 3 Signs and Symptoms of Stress:(Recognize warning signs) Irritability with family, friends, and coworkers. Inability to concentrate Changes in daily activities such as: difficulty sleeping loss of appetite loss of interest in sexual activity indecisiveness guilt isolation loss of interest in work

4. 4 Dealing with Stress

5. 5 Life Style Changes: Helpful for “job burnout.” Change diet. Reduce sugar, alcohol, and caffeine intake. Avoid fatty foods. Increase carbohydrates. Exercise. Practice relaxation techniques, meditation, visual imagery. Balance work, recreation, family, and health.

6. 6 EMS Personnel and Family and Friends Response: Lack of understanding. Fear of separation and being ignored. On-call situations cause stress. Can’t plan activities. Frustration caused by wanting to share.

7. 7 Work Environment Changes: Request shifts allowing more time to relax with family and friends. Request a rotation of duty assignments to a less busy area. Seek/ refer professional help.

8. 8 Critical Incident Stress Debriefing (CISD): A team of peer counselors and mental health professionals who help EMT’S deal with critical incident stress. Meeting is held within 24 to 72 hours of a major incident. Open discussion of feelings, fears, and reactions. Not an interrogation or investigation. All information is confidential. CISD leaders and mental health personnel evaluate the information and offer suggestions on overcoming the stress.

9. 9 CISD. Cont.... Designed to accelerate the normal recovery process of experiencing a critical incident. Works well because feelings are vented quickly. Debriefing environment is non-threatening. How to access local system, find out from coworkers or employers.

10. 10 Death and Dying: Stages. Denial Anger Bargaining Depression Acceptance

11. 11 Denial: Not me - defense mechanism creating a buffer between shock of dying and dealing with the illness.

12. 12 Anger: Why me? EMT’S may be the target of the anger. Don’t take the anger or insults personal. Be tolerant. Do not become defensive. Employ good listening and communication skills. Be empathetic.

13. 13 Bargaining: OK, but first let me…. agreement that, in the patients mind will postpone death for a short time.

14. 14 Depression: OK, but I haven’t. Characterized by sadness and despair. Patient is usually silent and retreats into own world.

15. 15 Acceptance: OK, I am not afraid... Does not mean the patient will be happy about dying. The family will usually require more support during this stage than the patient.

16. 16 Dealing with Patient’s Family Members: Patient needs include dignity, respect, sharing, communication, privacy, and control. Family members may express rage, anger, and despair. Listen empathetically. Do not falsely reassure. Use a gentle tone of voice. Let the patient know everything that can be done to help will be done. Use a reassuring touch, if appropriate. Comfort the family.

17. 17 Scene Safety: Pathogens are organisms that cause infection, such as viruses and bacteria. They can be spread through the air or by contact with blood or other body fluids. This is why Body substance isolation or (BSI) precautions should be taken.

18. 18 BSI and Bio-Hazard: EMT’S and patients safety. Handwashing Eye protection If prescription eyeglasses are worn, then removable side shields can be applied to them. Goggles are required

19. 19 Gloves: Gloves (vinyl and latex) Needed for contact with blood or bloody body fluids. Should be changed between contact with different patients. Gloves (utility) - needed for cleaning vehicles and equipment.

20. 20 Gowns: Gowns. Needed for large splash situations such as with field delivery and major trauma. Change of uniform is preferred.

21. 21 Masks: Surgical - type for possible blood splatter (worn by care provider). High Efficiency Particulate Air (HEPA) respirator if patient is suspected of or diagnosed with Tuberculosis (worn by care provider). Airborne disease - surgical type mask (worn by patient). Requirements and availability of specialty training. Statutes/regulations reviewing notification and testing in an exposure incident.

22. 22 Bio-Hazard, Fines, Immunizations; Red bio bags and yellow laundry bags. Tetanus - an injection developed which should be updated every 5 years. Hepatitis-B Series of three injections within a 6 month period. Tuberculosis - there is no current immunization but there is a test which will tell if you have been exposed. It is the (PPD TEST) Purified Protein Derivative. MMR - Common immunizations against measles, mumps, and Rubella. There is no current injection to protect you from Aids.

23. 23 Personal Protection: Hazardous materials (incident). Identify possible hazards. Binoculars. Placards. Hazardous Materials, The Emergency Response Handbook, published by the DOT.

24. 24 Protective Clothing: Hazardous materials suits. SCBA’S Hazardous materials scenes are controlled by specialized Haz-Mat teams. EMT-B’S provide emergency care only after the scene is safe and patient contamination limited. Requirements and availability of specialized training.

25. 25 Rescue: Identify and reduce potential life threats. Electricity Fire Explosion Hazardous Materials

26. 26 Protective Clothing: Turn-out gear. Puncture-proof gloves. Helmet. Eye wear. Dispatch rescue teams for extensive/heavy rescue.

27. 27 Violence: Scene should always be controlled by law enforcement before EMT-B provides patient care. Perpetrator of the crime. Bystanders. Family members. Behavior at crime scene (covered in detail later). Do not disturb the scene unless required for medical care. Maintain chain of evidence.