The Well-being The Well-being of the EMT-of the EMT-BasicBasic

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Emotional Aspects of Emotional Aspects of Emergency CareEmergency CareEmotional Aspects of Emotional Aspects of Emergency CareEmergency Care

Death and DyingDeath and Dying

How People Face Death How People Face Death DenialDenial AngerAnger BargainingBargaining DepressionDepression AcceptanceAcceptance

Dr. Elisabeth Kubler-RossDr. Elisabeth Kubler-Ross

KINDNESS, KINDNESS,

COMPASSION & COMPASSION &

UNDERSTANDING.UNDERSTANDING.

....

KINDNESS, KINDNESS,

COMPASSION & COMPASSION &

UNDERSTANDING.UNDERSTANDING.

....

……may help may help

the patient the patient

and family and family

members members

cope with cope with

their their

emotions.emotions.

……may help may help

the patient the patient

and family and family

members members

cope with cope with

their their

emotions.emotions.

Stressful SituationsStressful SituationsStressful SituationsStressful Situations

EMS IS A

STRESSFUL

PROFESSION!

Multiple-patient incidents can be particularly stressful.

Stressful Situations Stressful Situations Mass-casualty incidentMass-casualty incident

Infant and child traumaInfant and child trauma

Traumatic amputationTraumatic amputation

Death or injury of co-worker or other public safety personnelDeath or injury of co-worker or other public safety personnel

Emergency response to illness or injury of friend or family memberEmergency response to illness or injury of friend or family member

Stress ManagementStress ManagementStress ManagementStress Management

Stress:Stress:

A bodily or mental tension A bodily or mental tension caused by physical, chemical, caused by physical, chemical, or emotional factors.or emotional factors.

Also involves a person’s response to events that are threatening or challenging.

Stress Warning Signs Stress Warning Signs Irritability with co-workers, family, friends Irritability with co-workers, family, friends

or patientsor patients

Inability to concentrateInability to concentrate

Physical exhaustionPhysical exhaustion

Difficulty sleepinDifficulty sleepingg or nightmares or nightmares

AnxietyAnxiety

IndecisivenessIndecisiveness

GuiltGuilt

Stress Warning Signs continued Stress Warning Signs continued

Loss of appetiteLoss of appetite

Loss of interest in sexLoss of interest in sex

IsolationIsolation

Loss of interest in workLoss of interest in work

Increased substance use or abuse Increased substance use or abuse (alcohol, medications, illegal drugs)(alcohol, medications, illegal drugs)

DepressionDepression

Not Not allall stress is stress is negative...negative...Not Not allall stress is stress is negative...negative...

...but ...but too muchtoo much can affect your health!can affect your health!

...but ...but too muchtoo much can affect your health!can affect your health!

STRESSREDUCTIONTECHNIQUES

Get ProfessionalGet ProfessionalCounselingCounseling

Get ProfessionalGet ProfessionalCounselingCounseling

EatEatHealthyHealthy

EatEatHealthyHealthy

StopStopSmokingSmoking

StopStopSmokingSmoking

ExerciseExerciseRegularlyRegularlyExerciseExerciseRegularlyRegularly

Rest &Rest &RelaxRelax

Rest &Rest &RelaxRelax

BalanceBalanceActivitiesActivitiesBalanceBalanceActivitiesActivities

Change WorkChange WorkScheduleSchedule

Change WorkChange WorkScheduleSchedule

Critical IncidentCritical IncidentStress DebriefingStress Debriefing

(CISD)(CISD)

Critical IncidentCritical IncidentStress DebriefingStress Debriefing

(CISD)(CISD)

Critical incident:Critical incident:

A situation causing unusually A situation causing unusually

strong emotional reactions strong emotional reactions

which interfere with one’s which interfere with one’s

ability to function ability to function

immediately or in the future.immediately or in the future.

Posttraumatic Stress Disorder (PTSD):Posttraumatic Stress Disorder (PTSD):

A serious condition involving A serious condition involving

illness, personality changes, illness, personality changes,

and self-destructive behavior.and self-destructive behavior.

Occurs after being exposed to a critical incident or disturbing event.

Criteria for Holding a CISD Criteria for Holding a CISD

Many individuals within a group appear to be distressed after a callMany individuals within a group appear to be distressed after a call

Signals of distress appear to be severeSignals of distress appear to be severe

Personnel demonstrate numerous behavioral changesPersonnel demonstrate numerous behavioral changes

Personnel make significant errors on calls occurring after the critical incidentPersonnel make significant errors on calls occurring after the critical incident

Criteria for Holding a CISD continued Criteria for Holding a CISD continued

Personnel request helpPersonnel request help

The event is extraordinaryThe event is extraordinary

Various agencies are showing the same reactionsVarious agencies are showing the same reactions

Signals of distress continue beyond Signals of distress continue beyond three weeksthree weeks

CISD helps people work

through their emotional

responses more quickly

than they could on their

own.

CISD Process CISD Process Team approachTeam approach

Peer support personnelPeer support personnel Mental health professionalsMental health professionals ClergyClergy

Confidential processConfidential process

NOTNOT an investigation or interrogation an investigation or interrogation

CISD Process continued CISD Process continued Designed to open discussions about feelings, fears and Designed to open discussions about feelings, fears and

reactions to the incidentreactions to the incident

Team evaluates comments and provides feedback and Team evaluates comments and provides feedback and suggestionssuggestions

ComprehensiveComprehensiveCritical IncidentCritical Incident

Stress ManagementStress Management

ComprehensiveComprehensiveCritical IncidentCritical Incident

Stress ManagementStress Management

System for Managing PTSD System for Managing PTSD

Preincident stress educationPreincident stress education

On-scene peer supportOn-scene peer support

One-on-one supportOne-on-one support

Disaster support servicesDisaster support services

DefusingDefusing

System for Managing PTSD continued System for Managing PTSD continued

Critical incident stress debriefingsCritical incident stress debriefings

Follow-up servicesFollow-up services

Spouse and family supportSpouse and family support

Outreach programsOutreach programs

Other health and wellness programsOther health and wellness programs

Scene SafetyScene SafetyScene SafetyScene Safety

Common Scene Safety Issues Common Scene Safety Issues

TrafficTraffic

Crime sceneCrime scene

Hostile crowdsHostile crowds

Hazardous materialsHazardous materials

DogsDogs

Scene Safety

EMTs who become EMTs who become injured cannot help injured cannot help anyone else!anyone else!

EMTs who become EMTs who become injured cannot help injured cannot help anyone else!anyone else!

Body Substance Body Substance Isolation Isolation

PrecautionsPrecautions

Body Substance Body Substance Isolation Isolation

PrecautionsPrecautions

Body Substance Isolation

(BSI) precautions are

designed to prevent

contact with potentially

harmful body substances.

Hand Washing

Gloves

Eye Protection, Gowns and Masks

HEPA Respirator

Use when you suspect Use when you suspect thethepatient has patient has tuberculosis.tuberculosis.

Use when you suspect Use when you suspect thethepatient has patient has tuberculosis.tuberculosis.

It is important that EMS

personnel understand

their rights,

responsibilities and

procedures for

reporting exposures.

Advance Safety Advance Safety PrecautionsPrecautions

Advance Safety Advance Safety PrecautionsPrecautions

Recommended Immunizations Recommended Immunizations

Tetanus prophylaxis Tetanus prophylaxis (every 10 years)(every 10 years)

Hepatitis B vaccineHepatitis B vaccine

Influenza vaccine Influenza vaccine (annually)(annually)

Polio immunizationPolio immunization

Rubella, mumps & measles vaccineRubella, mumps & measles vaccine

Tuberculin testing Tuberculin testing (annually)(annually)

Personal ProtectionPersonal ProtectionPersonal ProtectionPersonal Protection

Hazardous material:Hazardous material:

A substance that poses a threat A substance that poses a threat

or unreasonable risk to life, or unreasonable risk to life,

health or property if not health or property if not

properly controlled.properly controlled.

Crews not trained or equipped to handle a situation should let the experts do it!

Placards are displayed on hazardous materials containers.

Protective Clothing for HazMat

Protective Clothing for Rescue Protective Clothing for Rescue

Puncture-proof or resistant Puncture-proof or resistant turnout gearturnout gear

Puncture-proof glovesPuncture-proof gloves

HelmetHelmet Ear protection and chin strapEar protection and chin strap

Eye protectionEye protection

Boots with steel toes & insolesBoots with steel toes & insoles

Protective Clothing for Rescue Situations

EMS personnel should NOT

ENTER a VIOLENT SCENE

until on-scene police officers

have determined it to be

safe!

EMS personnel should not intervene in violent situations.

SU

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Emergency CareEmergency Care

Scene SafetyScene SafetyPersonal ProtectionPersonal Protection