Chapter 2: The Well-Being of the First Responder

Cognitive Objectives

1-2.1 List possible emotional reactions that the First Responder may experience when faced with trauma, illness, death, and dying.

1-2.2 Discuss the possible reactions that a family member may exhibit when confronted with death and dying.

1-2.3 State the steps in the First Responder’s approach to the family confronted with death and dying.

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Cognitive Objectives

1-2.4 State the possible reactions that the family of the First Responder may exhibit.

1-2.5 Recognize the signs and symptoms of critical incident stress.

1-2.6 State possible steps that the First Responder may take to help reduce/alleviate stress.

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Cognitive Objectives

1-2.7 Explain the need to determine scene safety.

1-2.8 Discuss the importance of body substance isolation (BSI).

1-2.9 Describe the steps the First Responder should take for personal protection from airborne and bloodborne pathogens.

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Cognitive Objectives

• Hazardous materials

• Rescue operations

• Violent scenes

• Crime scenes

• Electricity

• Water and ice

• Exposure to bloodborne pathogens

• Exposure to airborne pathogens

1-2.10 List the personal protective equipment necessary for each of the following situations:

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Affective Objectives

1-2.11 Explain the importance for serving as an advocate for the use of appropriate protective equipment.

1-2.12 Explain the importance of understanding the response to death and dying and communicating effectively with the patient's family.

1-2.13 Demonstrate a caring attitude toward any patient with illness or injury who requests emergency medical services.

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Affective Objectives

1-2.14 Show compassion when caring for the physical and mental needs of patients.

1-2.15 Participate willingly in the care of all patients.

1-2.16 Communicate with empathy to patients being cared for, as well as with family members, and friends of the patient.

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Psychomotor Objectives

1-2.17 Given a scenario with potential infectious exposure, the First Responder will use appropriate personal protective equipment. At the completion of the scenario, the First Responder will properly remove and discard the protective garments.

1-2.18 Given the above scenario, the First Responder will complete disinfection/cleaning and all reporting documentation.

Knowledge and Attitude Objectives

1. Define the emotional aspects of emergency care encountered by patients, patients’ families, and first responders.

2. Define the five stages in the normal reaction to death and dying.

3. Explain at least six signs and symptoms of stress.

4. Explain the type of actions a first responder can take to reduce or alleviate stress.

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Knowledge and Attitude Objectives

5. Describe the following three phases in critical incident stress reduction:

• Preincident stress education

• On-scene peer support

• Critical incident stress debriefing (CISD)

6. Discuss the importance of body substance isolation (BSI).

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Knowledge and Attitude Objectives

7. Describe the universal precautions for preventing infectious diseases from bloodborne and airborne pathogens.

8. Describe three phases of scene safety.

9. Describe 10 types of hazards to look for when assessing the scene for unsafe conditions.

10. Describe the safety equipment that first responders should have available for their protection.

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Skill Objectives

1. Put on and remove medical gloves safely.

2. Assess the scene of a real or simulated rescue event for safety hazards.

3. Properly use the safety equipment needed for first responders.

The Well-Being of the First Responder

• To maintain well-being:

– Prevent and reduce stress.

– Protect yourself from infectious diseases.

– Ensure scene safety.

Emotional Aspects of Emergency Care

• You may have to deal with situations that produce a high level of stress:

– Injury or illness to infants and children

– Elderly patients

– Death and violence

– Mass-casualty incidents

Five Stages of Dealing with Death and Dying

• Denial: Refusing to believe that situation is happening

• Anger: Becoming upset at grief-causing event

• Bargaining: Trying to make a deal to postpone death and dying

• Depression: Expressing despair

• Acceptance: Recognizing that death and dying cannot be changed

Stress Management

• Includes:

– Recognition of stress

– Prevention of stress

– Reduction of stress

Recognizing Stress

• Irritability

• Inability to focus

• Abnormal disposition

• Difficulty sleeping

• Anxiety

• Indecisiveness

• Guilt

• Loss of appetite

• Loss of sex drive

• Loss of interest in work

• Isolation

Preventing Stress

• Eat a healthy, well-balanced diet.• Drink adequate amounts of liquids.

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Preventing Stress

• Avoid consuming excessive caffeine and alcohol.

• Be cheerful; spend time with family and friends.

• Create a stress-reducing lifestyle.

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Reducing Stress

• Preincident stress education

• On-scene peer support

• Critical incident stress debriefing (CISD)

• Seek help from professional mental health providers.

CISD

A CISD is a tool that may relieve stress.

Scene Safety

• Infectious diseases

• BSI

• Universal precautions

• Immunizations

• Hazards of the scene

Key Terms

• Pathogen: Disease-causing microorganism

• Body substance isolation (BSI): Concept that treats all bodily fluids as potentially infectious

• Universal precautions: Procedures for infection control that assume blood is potentially infectious

Common Infectious Diseases

• Human immunodeficiency virus (HIV)

• Hepatitis B virus

• Tuberculosis

Transmission of Pathogens

• Respirators can reduce the transmission of airborne diseases.

Universal Precautions

• Always wear gloves. • Always wear protective

eye wear.• Wash your hands; wash

your hands!

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Universal Precautions

• Do not recap, cut, or bend used needles.• Dispose of sharps in a sharps container.• Use a face shield, pocket mask, or other

airway adjunct for resuscitation.

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Removal of Gloves

Proper removal of gloves is important to minimize the spread of pathogens.

Immunizations

• Tetanus prophylaxis

• Hepatitis B vaccine

• Tuberculin testing

Responding to the Scene

• Dispatch: Use dispatch information to anticipate hazards.

• Response: Remember safety when responding.

• Parking your vehicle: Park the vehicle so that it protects scene from traffic hazards.

Assessing the Scene

• Traffic

• Crime or violence

• Crowds

• Electrical hazards

• Fire

• Hazardous materials

• Unstable objects

• Sharp objects

• Animals

• Environmental conditions

• Special rescues

• Airborne and bloodborne pathogens

Hazardous Materials Placards

• Federal regulations require vehicles carrying hazardous materials to be marked with specific placards.

• If you see a HazMat placard at an emergency scene, call for assistance.

Special Rescue Situations

• Include water, ice, and confined space or below-grade rescues, terrorism, and mass-casualty incidents