WELL-BEING of the EMT-B
A Dead or Injured EMT is of Little or No Use to a Patient.
Physically or Mentally
WELL-BEING of the EMT-B
OVERVIEW
- Body Substance Isolation (BSI)
- Protect Yourself From Transmitted Disease
- Impact That Dying Patients Have On You and Others
- Stress In EMS
- You
- Fellow EMT’s
- Family & Friends
BODY SUBSTANCE ISOLATION
- BSI, BSI, BSI, BSI
- Get the Idea
- Say It, Repeat It, Dream It, Live It
- Protect Yourself, Protect Your Patient
- Barrier to Stop Bio-Hazards
BODY SUBSTANCE ISOLATION
- Number 1 Defense
- Wash Your Hands
- Warm Water AND Soap
- Remove Jewelry
- Briskly – All Over
- Rinse
- Dry
BODY SUBSTANCE ISOLATION
- Gloves
- Latex
- Vinyl
- Blood
- Body Fluids
- Allergy to Latex ?
- Ask Patient
BODY SUBSTANCE ISOLATION
- Not For BSI
- Personal Protective Equipment
- Hand Protection for Heavier Work
- Rescue
- Fire
- Glass
BODY SUBSTANCE ISOLATION
- Eye Protection
- Safety Glasses
- Prescription
- Place Side Shields
- Kill 2 Birds…
- Mask w/ Eye Shield
BODY SUBSTANCE ISOLATION
- Gowns
- Protect Clothing
- U ½ 2 Work Shift
- Not Meant to be a Fashion Statement
BODY SUBSTANCE ISOLATION
- Masks
- Surgical
- Blood Protection
- EMT Wears
- Airborne Disease
- Patient Wears
- High Efficiency Particulate Air
- HEPA
- Tuberculosis
PERSONAL PROTECTION
- More Than Just an EMT Uniform
- Personal Protective Equipment
BODY SUBSTANCE ISOLATION
- HEPA Masks Require Special Fitting
- OSHA & State Regulate BSI Measures
- Regulations In Place Concerning:
- Notification
- Reviewing
- Testing
- Services Have an Infection Control Contact
Infectious Disease Prevention
- Written Exposure Control Plan
- OSHA Required
- Preventive Vaccines
- Hepatitis
- Immune Status Verification (titer)
- Testing (tuberculin PPD)
- Not Required in PA EMS…Yet
WELL-BEING of the EMT-B
- Death & Dying
- Everyone Must Go Through It
- EMT’s Manage & Deal With Death
- "It’s Our Job"
STAGES of DEATH & DYING
- Denial
- "Not Me"
- Defense Mechanism
- Creating a Buffer
- Shock of Dealing w/ Dying
- Anger
- "Why Me"
- EMT May Become Target
- Be Tolerant
- Don’t Become Defensive
- Listen & Communicate
- Be Empathetic
STAGES of DEATH & DYING
- Bargaining
- "OK, but first let me"
- Postpone Death
- Depression
- "OK, but I haven’t"
- Sadness & Despair
- Silent
- Retreats to His Own World
STAGES of DEATH & DYING
- Acceptance
- "OK, I’m Not Afraid"
- Patient is Not Happy About Dying
- Family Members May Need More Support
DYING PATIENTS & FAMILY
- Patient’s Needs
- Dignity
- Respect
- Sharing
- Communication
- Privacy
- Control
DYING PATIENTS & FAMILY
- Family Members
- Rage
- Anger
- Despair
DYING PATIENTS & FAMILY
What To Do – The Little Things Count
- Listen Empathetically
- Do Not Falsely Reassure
- Gentle Voice
- Reassuring Touch (if appropriate)
- Comfort the Family
- Everything That Can Be Done, Will Be
STRESS IN EMS
- Mental or Emotional Pressure
- EMS – Hours of Boredom Laced With Minutes of Sheer Chaos
3 Stages of Stress
1st Stage – Alarm Stage
"Fight or Flight"
2nd Stage – Resistance
Adaptation & Coping
3rd Stage – Exhaustion
Serious illnesses may occur
3 Types of Stress Reactions
Acute Stress Reaction
Quick onset
Overwhelmed feeling
Delayed Stress Reaction
May occur days, weeks, or months later
- Cumulative Stress Reaction
- Buildup of low stress over long period
STRESSFUL RESPONSES
- Mass Casualty
- Infant & Child Trauma
- Amputations
- Abuse – Young, Old, Spousal
- Death / Injury of Co-worker / Public Safety
- Who???
- EMT’s, Patients, Bystanders, Safety Personnel
STRESS MANAGEMENT
- Irritability
- Co-Workers
- Family & Friends
- Concentration Problem
- Insomnia
- Nightmares
- Anxiety
- Indecisiveness
- Guilt
- Loss of Appetite
- Loss of Sexual Interest
- Isolation
- Loss of Work Interest
LIFE-STYLE CHANGES
- Don’t Worry Be Happy
- Balance
- Work
- Recreation
- Family
- Health
LIFE-STYLE CHANGES
- Prevent Job Burn-Out
- Change Diet
- Reduce Sugar, Caffeine & Alcohol
- Avoid Fatty Foods
- Increase Carbohydrates
- Exercise
- Relaxation, Meditation, Visual Imagery
RESPONSE of FAMILY & FRIENDS
- Lack of Understanding
- Fear of Separation
- Being Ignored
- Stress From On-Call Situations
- Can’t Plan Activities
- Frustration – Wanting to Share
- You want to share w/ them
- They want to share w/ you
MORE HELP
- Work Environment
- Request Different Shifts to Allow Free Time
- Rotation to Less Busy Station
- Seek Professional Help
Critical Incident Stress Debriefing
Within 24–72 hours post-incident
Open discussion (feelings, fears, reactions)
All information confidential
- Not an investigation or interrogation
- CISD team offers suggestions on overcoming stress
SCENE SAFETY
HAZARDOUS MATERIALS
- Recognize & Identify – From a Distance
- DO NOT ENTER
- Call the Experts – Haz-Mat Team
- Treat Patients After Decontamination
- Don’t Compound the Problem
- Remember, If You’re Dead, You’re Useless !
SCENE SAFETY
Hazardous Material Identification
- Binoculars
- Placards
- May Be Wrong
SCENE SAFETY
SCENE SAFETY
Hazardous Material Identification
- Guidebook for Initial Phase of Incident
EMERG. RESPONSE GUIDEBOOK
- White Pages
- Read & Review – Explains How to Use Book
- Yellow Pages – ID Number
- Blue Pages – Alphabetical
- Orange Pages – Guides
- Green Pages – Isolation Guide
Specialized Threats
- Electrical
- Fire
- Explosion
- Hazardous materials
Violence
The police are responsible for securing the scene from violence.
Planning for Safety
Wear protective clothing.
Preparing equipment:
Not cumbersome/bulky
Flashlight
Carry a radio.
Assign safety roles.
Protective Clothing
Turnout gear
Puncture-proof gloves
Helmet
Eyewear
Non-slip footwear
Safety Observations
Crime scenes/known violence
Alcohol or drug use
Prior calls or violence in area
Weapons
- Hostile crowds
- Broken glass, blood stains
- Pets
- Disputes/fighting
Reacting to Danger
Leave the scene (Retreat):
Get far enough away
2 obstacles between you & patient
- Get rid of bulky equipment.
- Cover & conceal.
- Radio for police/Reevaluate