EMT COMPLETE

A Comprehensive Worktext
SECOND EDITION

CHAPTER 2
Workforce Safety
and Wellness

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 Learning Readiness

• EMS Education Standards, text p. 23

• Objectives, text p. 23
• Key terms, text p. 23

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 Setting the Stage

• Overview of Lesson Topics

 Emotional Aspects of Emergency Care
 Learning to Manage the Effects of Stress
 Reactions to Death and Dying
 Personal Safety
 Protection for Specific Emergencies

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 EMERGENCY DISPATCH

• Chapter 2 Emergency Dispatch, text p. 24

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 EMERGENCY DISPATCH

• Discussion Questions
 What do you think are the riskiest
aspects of work in EMS?
 How do you think the level of risk
compares to that of other jobs?
 What can you do to keep your risks at a
minimum?

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 Introduction

• People in EMS face certain risks and

stressors that can impact safety and
wellness
• Keys to reducing stress and risk
 Knowing risks and anticipating stressors
 Proactive approach to managing risks
and stress

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Emotional Aspects of Emergency
Care
• Everyone has a variety of emotions
every day
• Stress
 Extraordinary demands on a person's
emotional or mental resources
 EMS work can be stressful
 Anticipate stressors and manage stress

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Emotional Aspects of Emergency
Care
• Potential EMS stressors
 Death of human beings
 Multiple casualties
 Injured or ill children
 Major traumatic injury
 Abuse/neglect
 Death or injury of co-worker

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Emotional Aspects of Emergency
Care

A range of stressful reactions can result from working at emergency scenes such as a
multiple-vehicle collision.

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Emotional Aspects of Emergency
Care
• EMS work can • EMS providers
cause stress for often dedicate a lot
worker's family and of time to work
loved ones • Work hours and
schedules
• Being on call

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Emotional Aspects of Emergency
Care
• 12 signs and 1. Irritability
symptoms of stress 2. Inability to
concentrate
3. Anxiety
4. Difficulty sleeping
5. Nightmares
6. Indecisiveness

continued on next slide

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Emotional Aspects of Emergency
Care
• 12 signs and 7. Decreased
symptoms of stress appetite
8. Feelings of guilt
9. Decreased sex
drive

continued on next slide

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Emotional Aspects of Emergency
Care
• 12 signs and 10.Wanting to be
symptoms of stress alone
11.Lack of interest in
work
12.Negative attitude

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Emotional Aspects of Emergency Care

• Three stress 1. Acute stress

reactions response
2. Delayed stress
response
3. Cumulative stress
response

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Stop, Review, Remember

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Learning to Manage the Effects of
Stress
• Be proactive, not reactive

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Learning to Manage the Effects of
Stress

A healthy diet helps one cope with the stress of being an EMT.

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Learning to Manage the Effects of
Stress
• Diet
 Make incremental changes
 Reduce caffeine, sugar, alcohol,
saturated fats
 Stay hydrated

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Learning to Manage the Effects of
Stress

A daily exercise program is an important part of a well-balanced life.

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Learning to Manage the Effects of
Stress
• Daily exercise
 Minimum 20 to 30 minutes
• Relaxation
• Balance in life
• Seek assistance if needed

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Learning to Manage the Effects of
Stress
• 7 core components 1. Pre-crisis
of critical incident preparation
stress 2. Support programs
management 3. Defusing
4. Debriefing

continued on next slide

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Learning to Manage the Effects of
Stress
• 7 core components 5. One-on-one
of critical incident counseling
stress 6. Family crisis
management intervention
7. Follow-up

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Learning to Manage the Effects of
Stress
• Critical incident • Only one of the
stress debriefing CISM components
• Skilled facilitators
and ground rules
• Allows a safe
atmosphere to
discuss feelings
and fears

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Learning to Manage the Effects of
Stress
• Group debriefings may not be as
effective as once thought
• Resiliency model focuses on proactive
strategies to increase resilience to
stress

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 Reactions to Death and Dying

• EMTs may • Predictable

frequently be progression of
exposed to death reactions
and dying patients  Denial
 Anger
 Bargaining
 Depression
 Acceptance

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 Reactions to Death and Dying

• Keys to compassionate response

 Assess who needs support
 Be tolerant of person's reactions
 Listen carefully; respond
compassionately and confidently
 Be honest, offer assistance

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Reactions to Death and Dying

Family members should be treated with compassion.

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Stop, Review, Remember

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 Personal Safety

• Remaining safe is an EMS provider's

first priority
• A common hazard is risk of exposure to
blood and body fluids

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 Personal Safety

• Pathogens • Hepatitis B and C

• Tuberculosis
• Human
immunodeficiency
virus
• Multidrug-resistant
organisms

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 Personal Safety

• Standard Precautions
 Body substance isolation is used to
prevent contact with patient's blood and
body fluids
 Personal protective equipment is used
when there is a reasonable expectation
of exposure

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 Personal Safety

Protective gloves are the foundation of good body substance isolation (BSI)
precautions.

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 Personal Safety

• Gloves
 Non-sterile; latex or non-latex
 Change between patients
 Use heavier utility gloves for cleaning
and disinfecting equipment
 Wash hands after removing

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 Personal Safety

• Proper glove removal

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 Personal Safety

Begin by grasping the outer cuff of the opposite glove.

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 Personal Safety

Carefully slip the glove over the hand, pulling it inside out.

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 Personal Safety

Next, slip a finger of the ungloved hand under the cuff.

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 Personal Safety

Carefully slip it off, turning it inside out.

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 Personal Safety

Once removed, both gloves will end up inside out with one inside the other. Dispose
of them properly, and then wash your hands.

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 Personal Safety

• Eye protection
 Eyes and mucous membranes provide
less protection than skin against
pathogens
 Must protect from front and sides

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 Personal Safety

Proper eyewear should be comfortable and include protection at the sides of the
eyes.

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 Personal Safety

• Face protection
 Mucous membranes provide less
protection than skin does against
pathogens
 A surgical mask is appropriate in most
cases

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 Personal Safety

The eyes, mouth, and nose should be shielded from the splatter of body fluids.
Pictured: Surgical mask with attached eye shield.

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 Personal Safety

• Face protection
 A HEPA or N-95 respirator is used for
patients with known or suspected
tuberculosis

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 Personal Safety

An OSHA approved N-95 mask provides a higher level of protection against airborne
pathogens.

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 Personal Safety

• Disposable clothing or gowns

 Field obstetrical delivery
 Major traumas; uncontrolled bleeding

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 Personal Safety

A gown should be worn in cases of major trauma or childbirth.

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 Personal Safety

• Hand washing
 Most important infection control
measure
 Wash frequently
• After removing gloves
• Between patients
• Anytime hands are soiled

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 Personal Safety

• Hand washing
 Soap and warm water
 Scrub 15 to 30 seconds
 Remove jewelry
 Attention to cuticles, creases, under
nails, between fingers

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 Personal Safety

Alcohol-based hand sanitizers should be used when running water is not immediately
available.

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 Personal Safety

• Hand washing
 Use alcohol-based waterless hand
sanitizer if no soap and water available
 Alcohol-based sanitizers not effective if
hands are visibly soiled

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 Personal Safety

• Occupational Safety and Health

Administration has guidelines for
protecting worker safety
• States may have additional regulations

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 Personal Safety

OSHA provides clear guidelines on how contaminated materials should be disposed of.

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 Personal Safety

Immunizations are an important component of a good risk management plan.

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 Personal Safety

• Immunizations
 Tetanus
 Hepatitis B
 Measles
 Mumps
 Rubella
 Others as recommended

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 Protection for Specific
Emergencies
• Hazardous materials incidents
 Maintain a safe distance
 Protect the public
 Emergency Response Guidebook
 Must be handled by specially trained
and equipped personnel
 Patients must be decontaminated

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 Protection for Specific
Emergencies

Class A protective suits offer the greatest protection at a hazmat scene.

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 Protection for Specific
Emergencies
• Rescue operations
 Vehicle extrication and other situations
 Specialized training and equipment
needed
 Work cooperatively with rescue
personnel to provide patient care

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 Protection for Specific
Emergencies

The “Jaws of Life” is a tool used for the extrication of patients from wrecked
automobiles.

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 Protection for Specific
Emergencies
• Crime scenes and violence
 Stage at a distance
 Retreat if threatened; notify law
enforcement
 Preserve crime scene evidence

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Stop, Review, Remember

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 Lesson Summary

• EMS work can involve unique risks and

stressors
• Stress response can be acute, delayed,
cumulative
• Be proactive in creating resilience to
stress

EMT Complete: A Comprehensive Worktext, 2nd Ed.

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 Lesson Summary

• One source of stress is exposure to

death and dying
• Work-related hazards can be
anticipated and minimized
 Standard precautions
 Immunizations
 Specific PPE and precautions for specific
situations

EMT Complete: A Comprehensive Worktext, 2nd Ed.

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