Define key terms introduced in this chapter. Define key terms introduced in this chapter


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Define key terms introduced in this chapter.

  • Define key terms introduced in this chapter.

  • Given a description of a patient or family member’s behavior, identify the stage of grief it most likely represents (slides 13-15).

  • Explain the principles for interacting with patients and family members in situations involving death and dying (slides 16-17).

  • Give examples of situations that EMS providers may find stressful (slide 18).

  • Compare and contrast the characteristics of acute, delayed, and cumulative stress reactions

  • (slides 20-21).



Recognize signs and symptoms of stress reactions (slides 22-23).

  • Recognize signs and symptoms of stress reactions (slides 22-23).

  • Describe lifestyle changes you can make to help you deal with stress (slides 24-27).

  • Describe responses your friends and family may have to your work in EMS (slides 28-29).

  • Describe changes in the work environment that can help you manage job-related stress (slides 30-31).

  • Discuss the components of a comprehensive system of critical incident stress management (slides 32-36).

  • Describe measures you can take to protect yourself from exposure to diseases caused by pathogens and accidental and work-related injury (slides 37-46).



Give examples of diseases caused by each of the different types of pathogens (bacteria, viruses, fungi, protozoa, and helminths) (slides 38-39).

  • Give examples of diseases caused by each of the different types of pathogens (bacteria, viruses, fungi, protozoa, and helminths) (slides 38-39).

  • Describe the Standard Precautions that must be taken to protect health care workers from exposure to infectious diseases (slides 40-44).

  • Describe the personal protective equipment that may be used by EMS personnel (slides 42-43).

  • Explain the role of immunizations and tuberculosis testing in maintaining good health (slide 45).



Discuss the risks and preventive measures for specific infectious diseases of concern to EMTs, including (slides 47-61):

  • Discuss the risks and preventive measures for specific infectious diseases of concern to EMTs, including (slides 47-61):

    • Hepatitis B
    • Hepatitis C
    • Tuberculosis
    • Acquired immune deficiency syndrome
    • Severe acute respiratory syndrome
    • West Nile virus
    • Infections due to multidrug-resistant organisms


Explain the risks and measures that can be taken to protect yourself against the following hazards

  • Explain the risks and measures that can be taken to protect yourself against the following hazards

  • (slides 62-68):

    • Hazardous materials
    • Hazardous rescue situations
    • Traffic-related injuries
    • Violence and crime
  • Describe the components of physical and mental wellness (slides 69-80).



Slide 36 Grief and a Child’s Death Video

  • Slide 36 Grief and a Child’s Death Video

  • Slide 42 Putting on Clean Gloves Video

  • Slide 54 Epidemiology of AIDS Video



Emotional Aspects of Emergency Care

  • Emotional Aspects of Emergency Care

  • Scene Safety

  • Wellness Principles





Both units respond to 327 Manchester Avenue — possible domestic dispute with reported gunfire — called in by the police department.

  • Both units respond to 327 Manchester Avenue — possible domestic dispute with reported gunfire — called in by the police department.











Denial

  • Denial

  • Anger

  • Bargaining

  • Depression

  • Acceptance





Maintain patient’s dignity

  • Maintain patient’s dignity

  • Show respect

  • Communicate

  • Don’t give false assurances

  • Listen empathetically

  • Use a gentle tone of voice





Multiple-casualty incidents (MCIs)

  • Multiple-casualty incidents (MCIs)

  • Emergencies involving children

  • Injury or death of a coworker

  • Responding to friends or family members

  • Abuse





Acute

  • Acute

  • Delayed

  • Cumulative









Diet

  • Diet

  • Exercise

  • Relax

  • Avoid self-medication





Assess your priorities

  • Assess your priorities

  • Talk to someone you trust

  • Understand mistakes happen





Lack of understanding

  • Lack of understanding

  • Fear of separation or of being ignored

  • Worry about on-call situations

  • Inability to plan

  • Frustrated desire to share





Use a “buddy” system

  • Use a “buddy” system

  • Encourage and support coworkers

  • Exercise

  • Request a rotation of duty assignment





Don’t be afraid to seek mental health advice.

  • Don’t be afraid to seek mental health advice.





Critical incident

  • Critical incident

  • Critical incident stress debriefing (CISD)

  • Defusing









Bacteria

  • Bacteria

  • Viruses

  • Fungi

  • Protozoa

  • Helminths





Wash hands even if you wore gloves

  • Wash hands even if you wore gloves

  • Ten to 15 seconds of scrubbing

  • Foaming hand sanitizer if no access to water





Eye protection

  • Eye protection

  • Protective gloves

  • Gowns

  • Masks



Cleaning

  • Cleaning

  • Disinfecting

  • Sterilization



PPD

  • PPD

  • Tetanus

  • Hep B

  • Influenza

  • Polio

  • MMR

  • Varicella



Date

  • Date

  • Time

  • Amount of fluid

  • Details of exposure





Can be symptom free and still spread disease

  • Can be symptom free and still spread disease

  • Affects the liver









Spread by droplets

  • Spread by droplets

  • Protective procedures

    • Gloves
    • N95
    • Wash hands
    • Disinfect nondisposable equipment






Spread through

  • Spread through

    • Sexual contact
    • Infected needles
    • Infected blood
    • Mother-child transmission
  • Standard Precautions





Respiratory virus

  • Respiratory virus

  • Transmitted by droplets in close proximity

  • Protective procedure





Spread by mosquitoes

  • Spread by mosquitoes

  • Symptoms can be mild to severe

  • Especially dangerous in young and elderly

  • Use Standard Precautions





Pathogens include

  • Pathogens include

    • MRSA
    • VRE
    • PRSP
    • DRSP
  • Spread through direct contact

  • Follow Standard Precautions





Use binoculars

  • Use binoculars

  • Identify placards

  • Allow trained personnel to rescue injured

  • Treat after decontamination, if possible





Call for assistance

  • Call for assistance

  • Control scene

  • Wear protective clothing

  • Watch scene hazards



American National Standards Institute (ANSI)

  • American National Standards Institute (ANSI)

  • Class one

  • Class two

  • Class three





Consider police for situations such as

  • Consider police for situations such as

  • Domestic disputes

  • Patients under the influence

  • Fights

  • Suicides

  • Angry family or bystanders

  • Behavioral emergencies

  • Crime scenes







Target heart rate

  • Target heart rate

  • Measure resting heart rate (HR)

  • Subtract your age from 220; this is your max HR

  • Subtract resting HR from max HR; multiply by 0.70

  • Add the final number to your resting HR







Select a cool and dark environment

  • Select a cool and dark environment

  • Choose an uninterrupted block of time when sleep can be achieved

  • Avoid heavy meals, caffeine, or exercise immediately prior to sleep

  • Turn off phone ringers and pagers to reduce interruptions





Increases risk of

  • Increases risk of

    • Cardiovascular and pulmonary disease
    • Cancer
  • Quitting improves public image of EMS





Does not get rid of stress





Exercise, relaxation, and engaging in activities you enjoy

  • Exercise, relaxation, and engaging in activities you enjoy

  • Don’t be afraid to ask for professional help





Husband holding wife and daughters hostage

  • Husband holding wife and daughters hostage

  • Two hours later still not permitted in

  • Husband then releases two children

  • Single gunshot then heard



Husband then begins to shoot randomly







Three-year-old female patient who was shot in the chest

  • Three-year-old female patient who was shot in the chest

  • Upon arrival, you find blood covering the front porch and sidewalk



What would you do to ensure scene safety?

  • What would you do to ensure scene safety?

  • What other resources should be requested?

  • Why is this a potential high-stress situation?

  • What can be done to reduce your stress associated with the call?






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