The WellBeing of the EMTBasic

1

CHAPTER 2
The Well-Being of the EMTBasic
2

BodySubstanceIsolation
3

Body Substance Isolation

• Protects EMTB and patient
• Assume all body substances are infectious
• Procedures set by OSHA and local policy

4

The biohazard symbol identifies potentially
infectious items.
5

Best protection is to wash handsthoroughly, even
if gloves were used.
6
When soap and water are not immediately
available, use an alcohol- based cleaning gel.

7

Wear latex, vinyl, or synthetic gloves.
8

Use protective eyewear.
9

Gowns protect clothing from fluid splatter.
10

Mask/eye shield combination offers protection
from fluid splatter.
11
Two NIOSH-approved respirators designed to
protect caregivers against airborne pathogens

HEPA Respirator (HEPA stands for
High-Efficiency Particulate Air.)
N-95 Respirator
12

Infectious Disease Prevention

• Written exposure control plan
• Preventive vaccines
• Immune status verification (titer)
• Testing (tuberculin PPD)

13

EmotionandStress
14

3 Stages of Stress

• 1st Stage Alarm Stage
• Fight or Flight
• 2nd Stage Resistance
• Adaptation Coping
• 3rd Stage Exhaustion
• Serious illnesses may occur

15

3 Types of Stress Reactions

• Acute Stress Reaction
• Quick onset
• Overwhelmed feeling
• Delayed Stress Reaction
• May occur days, weeks, or months later

Continued
16

3 Types of Stress Reactions

• Cumulative Stress Reaction
• Buildup of low stress over long period

17
EMS Stressful SituationsMass-Casualty Incidents

18
EMS Stressful SituationsMass-Casualty Incidents

19
EMS Stressful SituationsAmputations

20

Other Stressful Situations

• Death or injury of a coworker
• Infant/elder/spouse abuse

21

Stress Warning Signs

• Irritability toward coworker, family, friends
• Inability to concentrate
• Insomnia and/or nightmares

22

Stress Warning Signs

• Anxiety
• Indecisiveness
• Guilt
• Loss of appetite

23

Stress Warning Signs

• Loss of interest in sex
• Isolation
• Loss of interest in work

24

Stress Management

• Lifestyle Changes
• Change diet. Reduce sugar, caffeine, and alcohol.
• Avoid fatty foods.
• Increase carbohydrates.

25

Stress Management

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

26

Stress Management

• Environmental Changes
• Request assignments that allow more time with
  family and friends.
• Request duty assignment to a less busy area.

27

Stress Management

• Seek professional help if needed.

28
Stress Reactions of Family and Friends

• Lack of understanding
• Fear (of separation, being ignored)
• Stress (caused by on-call situations)
• Frustration (wanting to share)

29
Critical Incident StressDebriefing (CISD)

30

Critical Incident Stress Debriefing

• Within 2472 hours post-incident
• Open discussion (feelings, fears, reactions)
• All information confidential

31

Critical Incident Stress Debriefing

• Not an investigation or interrogation
• CISD team offers suggestions on overcoming stress

32

Death and Dying

• Denial
• Anger
• Bargaining
• Depression
• Acceptance

Stages
33

Death and Dying
Patient and Family Needs

• Dignity and respect
• Sharing
• Communication
• Privacy
• Control

34

Death and Dying

• Rage
• Anger
• Despair

Reaction of Family
35

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.

36

Scene Safety
37

Scene Safety Golden Rule
Plan
Observe
React
38

Hazardous Materials Incidents

• Recognize when a problem exists.
• Initial actions aimed at protecting yourself,
  patients, and bystanders.
• Specialized teams control scene.
• Treat patients AFTER decontamination.

39

Identify situations from a distance.
40

Placards help identify hazardous materials.
41

DOT EmergencyResponseGuidebook (Hazardous
Materials Reference)
42

Specialized Threats

• Electrical
• Fire
• Explosion
• Hazardous materials

43

Violence

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

44

Violence

• Patients
• Perpetrators of crimes
• Bystanders
• Family members
• Animals

Scene Dangers From
45

Planning for Safety

• Wear protective clothing.
• Preparing equipment
• Not cumbersome/bulky
• Flashlight
• Carry a radio.
• Assign safety roles.

46

Protective Clothing

• Turnout gear
• Puncture-proof gloves
• Helmet
• Eyewear
• Non-slip footwear

47

Wear protectiveequipment at rescue scenes.
48
Body armor mayoffer additionalprotection.

49

Safety Observations

• Crime scenes/known violence
• Alcohol or drug use
• Prior calls or violence in area
• Weapons

50

Safety Observations

• Hostile crowds
• Broken glass, blood stains
• Pets
• Disputes/fighting

51

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

52

CONCEALMENT hides your body.
53

COVER hides and protects your body.
54

Review Questions
1. Describe the stages of death and dying. 2.
List some possible reactions of the patient and
family. 3. Describe some methods for dealing
with a dying patient and his/her family.
55

Review Questions
4. List situations that may cause EMS stress. 5.
Describe methods of dealing with EMS stress.
56

Review Questions

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

57

Review Questions

• 8. Describe ways to protect yourself in the
  following situations
• Hazmat
• Rescue
• Violence

58
STREET SCENES

• Why wear protective gloves on this type of call?
• What is the impact of an occupation exposure on
  you, your family, and your fellow EMS workers?
• What can you expect after exposure?

59
STREET SCENES

• How will stress be a factor in your life for the
  next few months?
• How important is hand washing?
• What types of BSI precautions should EMTs always
  be ready to use on all EMS calls?