Chapter 2 The Well-Being of the EMT-Basic

Chapter 2 Emotion and Stress Scene Safety Personal Protection

Emotion and Stress

Death and Dying Stages Denial Anger Bargaining Depression Acceptance

Death and Dying Patient and Family Needs Dignity & Respect Sharing Communications Privacy Control

Death and Dying Reaction of Family Rage Anger Despair

Death and Dying Dealing with Patient and Family Listen empathetically. Use a gentle tone of voice. Use a reassuring touch, if appropriate. Do not falsely reassure.

EMS Stressful Situations: Mass-Casualty Incidents

EMS Stressful Situations: Infant and Child Trauma

EMS Stressful Situations: Amputations

EMS Stressful Situations Death or injury of a coworker Infant/elderly/spouse abuse

Stress: Warning Signs Irritability toward coworker, family, friends Inability to concentrate Insomnia and/or nightmares (Continued)

Stress: Warning Signs Anxiety Indecisiveness Guilt Loss of Appetite (Continued)

Stress: Warning Signs Loss of interest in sex Isolation Loss of interest in work

Stress Management Lifestyle Changes Change diet. (Continued) Reduce sugar, caffeine, & alcohol. Avoid fatty foods. Increase carbohydrates. (Continued)

Stress Management Lifestyle Changes Exercise Relaxation Meditation, visual imagery Balance work, family, recreation, and health

Stress Management Environmental Changes Request shifts that allow more time with family & friends. Request duty assignment to a less busy area.

Stress Management Seek professional help if needed.

Stress: Reactions of Family and Friends Lack of understanding Fear (of separation, being ignored) Stress (caused by on-call situations) Frustration (wanting to share)

Critical Incident Stress Debriefing (CISD)

Critical Incident Stress Debriefing Within 24-72 hours post-incident Open discussion (feelings, fears, reactions) All information confidential (Continued)

Critical Incident Stress Debriefing Not an investigation or interrogation. CISD team offers suggestions on overcoming stress.

Scene Safety

Body Substance Isolation Protects EMT-B and patient. Assumes all body substances are infectious. Procedures set by OSHA and local policy.

The biohazard symbol identifies potentially infectious items.

Wash hands thoroughly, even if gloves were used.

Wear latex, vinyl, or synthetic gloves.

Use protective eyewear.

Gowns protect clothing from fluid splatter.

Mask/eyeshield combination offers protection from fluid splatter.

High-Efficiency Particulate Air (HEPA) respirator protects you from tuberculosis.

Infectious Disease Prevention Preventive vaccines Immune status verification (Titer) Testing (Tuberculin PPD)

Personal Protection

Hazardous Materials Incidents EMT-B identifies situations. Specialized teams control scene. EMT-Bs treat patients after contamination is limited.

Identify situations from a distance.

Placards help identify hazardous materials.

DOT Emergency Response Guidebook (Hazardous Materials Reference)

Rescue: Identify Threats Electricity Fire Explosion Hazardous materials

Protective Clothing Turnout gear Puncture-proof gloves Helmet Eyewear

Wear protective equipment at rescue scenes.

VIOLENCE The police are responsible for securing the scene from violence.

Violence Scene Dangers From: Patients Perpetrators of crimes Bystanders Family members

Indicators of Danger Crime scenes/known violence Alcohol or drug use Prior calls or violence in area Weapons (Continued)

Indicators of Danger Hostile crowds Broken glass, bloodstains Pets Disputes/fighting

Response to Danger: RETREAT Leave the scene immediately. Get far enough away. Radio for police.

CONCEALMENT hides your body.

COVER hides and protects your body.

Body armor may offer additional protection.

Describe the stages of death & dying. REVIEW Describe the stages of death & dying. List some possible reactions of the patient & family. Describe some methods for dealing with a dying patient and his/her family. (Continued)

List situations that may cause EMS stress. REVIEW List situations that may cause EMS stress. Describe methods of dealing with EMS stress. (Continued)

What is a critical incident stress debriefing (CISD)? REVIEW What is a critical incident stress debriefing (CISD)? List the types of substance isolation equipment. Give examples of when each should be used. (Continued)

Describe ways to protect yourself in the following situations: REVIEW Describe ways to protect yourself in the following situations: HazMat Rescue Violence