Well Being of the EMT-B

Terminal Illness and Death The Stages of Dying…

• Denial• “Not me”• Defense mechanism• Buffer

• Shock of dying• Dealing with Injury

Terminal Illness and Death The Stages of Dying…

• Anger• “Why me!”

• EMT may be a target• Not personal• Be empathetic• Listen/Communicate

Terminal Illness and Death The Stages of Dying…

• Bargaining • “Okay, but first let me…”

• Postpones death in pt mind.

Terminal Illness and Death The Stages of Dying…

• Depression• “Okay, but I haven’t…”

• Sadness/Despair• Family support

Terminal Illness and Death The Stages of Dying…

• Acceptance• “Okay, I’m not afraid”

• Family support

Dealing With The Dying Pt and Family

• Pt needs• Dignity, Respect,

Privacy, Communication

• Angry family members• Comfort them

• Be empathetic• NO false reassurances• Everything is being

done that can be

Stressful Situations

• Ex.• MCI• Infant/Child Trauma• Infant/Elder/Spouse Abuse• Death/Injury of a co-worker

Stress Management

• Find and outlet!• Recognize warning signs

• Irritability • Inability to concentrate• Difficulty sleeping• Anxiety• Indecisiveness• Guilt• Loss of appetite• Loss of interest in sex• Isolation

Stress Management

• Lifestyle changes• Exercise • Relaxation techniques • Change diet

• Reduce• sugars, caffeine, and

alcohol

• Avoid fatty foods• Increase carbs

Family and Friend Responses to EMS

• Lack of understanding• Fear of separation• On-call=STRESS• Inability to plan • Frustration of wanting

to share

Critical Incident Stress Debriefing- CISD

• “A team of peer counselors and mental health professionals who help emergency workers deal with critical incident stress”

• Within 24-72 hours• Open Discussion• Not investigation/interrogation • Confidential• Evaluate info and give

suggestions• Accelerates recovery process

Elements of Critical Incident Stress Management

• Pre-Incident Stress Education• Familiarizes EMT with nature of the service

• On-Scene Support• ID and support distressed workers on scene

• One-on-One Support• Disaster Support Services• Defusing

• On scene/shortly after• Stop stress response to incident• 30 minutes or less

Elements of Critical Incident Stress Management

• CISD• Follow Up Services

• Days after• Keep eye on providers• Refer to mental health provider

• Spouse/Family Support• Community outreach• Wellness programs

Switching Gears…

Scene Safety

• FIRST concern on scene • Communicable diseases

• “Capable of being spread from person to person”• Often a microorganism • 3 Elements of Transmission

• Source Host Mode of transport• Factors affecting transmission

• Tx mode, type/degree of exposure, host susceptibility, precautions taken

Scene Safety

• Body Substance Isolation-BSI• Blood, ALL body fluids, secretions, excretions (except

sweat)• Regardless of blood content• BSI includes:

• Hand washing• Eye protection• Gloves• Gowns• Masks

Scene Safety

• BSI continued..• Hand washing

• Immediately after touching fluid• After removing gloves• 10-15 second scrub

• Eye protection• Protects eyes from droplets• Removable shields for glasses

• Gloves• Wear them with EVERY pt.

Scene Safety

• BSI continued…• Gowns

• For those intimate splashy moments

• i.e. Childbirth or trauma

• Masks• Airborne pathogens

• mask on pt• Trauma/blood

• mask on EMT• HEPA mask if TB

The Full Body Condom

The Cardinal Rule of BSI

If its wet, sticky, and not yours… DON’T touch it!!

Personal Protection

• Identify potential threats• Electricity• Fire• Explosion• Hazardous materials

Personal Protection

• Protective Clothing• Turnout gear• Puncture proof gloves• Helmets• Eye wear• Haz Mat suits• SCBA

Hazardous Materials

• Staging• Upwind and uphill

• ID possible materials• Placards

• Color/Symbol/Category/ Names/#’s

• Mark off area• Call for help• “Hazardous Materials, The

Emergency Response Guidebook”

Hazardous Materials

• Scene Control• Specialized professionals

• They get paid to glow in the dark so we don’t have to….

Violent Scenes

• ALWAYS controlled by police

• Perpetrator/Family • Mindful of evidence

• Maintain Chain of evidence

• Document… Document… Document…

And that ends chapter 2…