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
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
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
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 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 - Surgical mask, eye protection, gloves
Spread by mosquitoes Symptoms can be mild to severe Especially dangerous in young and elderly Use Standard Precautions
Pathogens include Pathogens include 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 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
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 Seek professional assistance Many places have assistance programs
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 Fire then returned by special tactics team
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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