Chapter 2 notes Workplace safety and EMT wellbeing PDF

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Gina Alaniz EMS 111 Mike Smith Chapter 2:Work force Safety and Wellness of the EMT notes 5 stages of Grief: 

Denial

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Anger

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Bargaining

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Depression

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Acceptance

The best steps to take in this situation are: 

Maintaining the patient’s dignity.

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Show the greatest respect for the patient.

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Communicate.

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Allow family members to express themselves.

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Listen with empathy.

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Don’t give false hope.

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Use a gentle voice.

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Take precautionary steps if the family want to touch/see the deceased.

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Do what you can to comfort them.

Stress inducing calls can include multiple casualty, abuse and neglect of infants, children, adults and elderly. Emergencies involving infants/children. Injury/death of a coworker, Response to relative/bystander and severe trauma/amputations. There are also 3 levels of stress: Acute: Spotted by immediate discomfort and bodily mishaps. PTSD: Which is delayed and may need professional help. Cumulative: The mental issue spills out into physical appearance. The signs and symptoms are: Irritability with those close to you, inability to concentrate, difficulty to sleeping accompanied with nightmares, Anxiety, Indecisiveness, Guilt, Loss of appetite, Loss of sex drive, Isolation and loss of work interest. Warning signs include: Confusion, Indecisiveness, no motivation, very forgetful, and loss of objective, Depression, very angry, negative, hostile, very defensive, mood swings, worthlessness, over exhaustion, headaches, GI distress, dizzy and pounding heart. Overeat, abuse of in toxifications, teeth grinding, hyperactive and lack of energy. Increased inner conflicts and less able to relate to others. Stress management life changes: 

Examine Diet: Cut down sugar, caffeine, and alcohol. Increase intake of lean protein, limit carbs, and decrease saturated fat intake.

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Exercise! It’ll benefit you overall!

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Relax, meditate or find good low-level outlets.

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Don’t self- medicate! Keep balance in your life and respect family and friends.

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Avoid lack of understanding.

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Fear of separation or being ignored is expected.

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Explain on call situations when you can.

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Inability to plan, they’ll learn and understand.

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Share but don’t over-share, and make changes in work environment.

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Develop buddy system with a co-worker, keep each other in check.

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Encourage and support co-workers with no negativity.

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Take breaks for exercise.

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Request reasonable time shifts for work.

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Request rotation duty if it gets overbearing.

Critical Incident stress management is usually held within 24-72 hours of that incident occurring, and is run by a team of peer counselors and mental health professionals helping you rehabilitate so you can keep working and are able to deal with the trauma from that said accident. This process involves anyone involved in the incident, close or distant. It’s usually for held for 30-45 minutes. For the purpose of defusing, CISM program includes: pre-incident stress education, on scene peer support, one on one support, disaster support devices, defuse, CISD, follow up, spouse and family support, community outreach programs and other health and welfare programs. Scene safety: Take appropriate measures and be an advocate for it as well, don’t act beyond your capacity. Diseases are caused by pathogens. Be prepared. 

Bacteria, are treated by antibiotics.

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Viruses require a host, most are mild; luckily since they can’t be treated by antibiotics for ex. SARS, Aids, HIV, and RSV-EID.

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Fungi, can cause disease in a compromised immune system patient such as pneumonia, or HIV.

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Protozoa, are like microscopic amoeba and can move. They typically enter the body through fecal/oral route. Mosquitos also carry protozoa, like malaria and can cause GI/Vaginal infections in uncompromised immune systems.

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Helminthes and parasitic worms; cause infection and are caused by worm eggs either ingested, in water or through the skin.

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HIV, is transferable through bodily fluids/needles and can gestate for months, recommended PPE for HIV are: goggles, gloves and hygienic hand washing.

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Hepatitis B and C; are transferable through bodily fluids, sex and bites. They can gestate from a week up to a few months; the recommended PPE are: gloves, goggles and hygienic hand washing.

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Tuberculosis, is transferable through respiratory secretion, AB or direct. The gestation time can be from 2 weeks up to 6 months, the recommended PPE are: gloves, goggles, M-95 and hygienic hand washing.

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Influenza; is transferable AB, droplet, direct contact and bodily fluids. The gestion period is from 1-3 days. The recommended PPE are: gloves, surgical mask, and hygienic hand washing.

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Chicken Pox; is transferable AB, droplet, and open sores. The gestational period can range from 11-21 days, the recommended PPE are: Gloves, surgical mask, and hygienic hand washing.

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Meningitis, is contractable through nasal and oral secretions; and the gestational period can be from 2-10 days. The recommended PPE are; gloves, surgical mask, and hygienic hand washing.

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Pneumonia; is contractable through the respiratory tract and droplet, and the gestational period can be from 1-3 days. The recommended PPE are: Gloves, surgical mask, and Hygienic hand washing.

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Rubella; is contractable through AB and droplet transmission, and the gestational stage is from 10-12 days. The recommended PPE are: gloves, surgical mask, and hygienic hand washing.

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Pertussis; is contractable through respiratory secretion, AB and droplet, and the gestational period is from 6-20 days. The recommended PPE are: Gloves, surgical mask, and hygienic hand washing.

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Staph, is contractable through direct contact contamination, and the gestational period is from 1-3 days. The recommended PPE are: Gloves and Hygienic hand washing.

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SARS, is contractable through respiratory secretion, AB and direct contact. The gestational period is 10 days and the recommended PPE are: Gloves, surgical mask, goggles and hygienic hand washing.

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Ebola; is contractable through direct contact and bodily fluids, the gestational period is from 2-21 days. The recommended PPE are: All that are available.

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Zika, is contractable through mosquitos and via pregnancy top the fetus, the gestational period is 3-12 days. The recommended PPE are: avoiding mosquitos and sexual activity.

If it’s suspected that you made contact with an infected patient, seek immediate medical attention and document the incident for worker’s compensation. Ask your designated officer if you’ve been exposed. They will gather information and the consult the medical facility where the patient’s been transported. The medical facility must gather information and report their findings to your designated officer within 48 hours. Your designated officer notifies you of the findings. Your employer arranges for you to be evaluated and seen by a doctor or equivalent. So make sure you’re taking hand washing seriously, and always wear your PPE whatever is recommended for the situation. Tips for Infection spread prevention: 

Use disposable equipment and don’t reuse it.

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Bag your uniform if it gets soiled and label it, then shower. Wash in hot soapy water for 25 minutes.

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After transferring get disposables (soiled bag) and seal, than label.

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Document in LB any contact with blood or bodily fluids and cleaning procedures/measurements done. Sponge wipe everything clean or not.

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Dispose due guidelines of equipment in patient care.

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Dispose sharps in puncture proof container.

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Clean blood/bodily fluids ASAP using hospital grade cleaner.

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Clean any visible spoiled spots.

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Wash hands thoroughly once finished.

Sterilization and disinfection is a hazardous and hot process usually requiring extensive training and equipment. Make sure all your immunizations are up to date. Lastly in the case of suspected

exposure, while giving your report provide every detail you’ve got; such as who ,what ,when, where and why. Than follow local protocol and your company’s exposure policies. Infectious Disease: Hepatitis B signs and symptoms: Fatigue, nausea, loss of appetite, abdominal pain, headache, fever, jaundice, and dark urine. Hepatitis C signs and symptoms: Jaundice, fatigue, abdominal pain may vary, nausea, loss of appetite and dark urine. Tuberculosis signs and symptoms: Fever, cough, night sweats, weight loss. HIV contraction: Sex, infected needles, infected blood products, mother to child transmission, open skin, mucous membrane, persistent mild fever, Night sweats, Swollen lymph glands, Loss of appetite, nausea, persistent diarrhea, headache, sore throat, fatigue, weight loss, short of breath, mental changes, muscle/joint aches, rash, and various infections. SARS signs and symptoms: Fever usually higher than 100 degrees Fahrenheit, discomfort, head/body ache, Diarrhea, and dry cough. West Nile signs and Symptoms: High fever, headache, stiff neck, confusion to coma, seizures, muscle weakness, numbness, paralysis, vision loss mild symptoms. Ebola signs and symptoms: High fever, severe headaches, muscle pain/weakness, severe vomiting/diarrhea, and unexplained hemorrhaging. Zika signs and symptoms: Fever, rash, joint/muscle pain, headache, conjunctivitis. Multidrug resistant organisms: MRSA, VRE, PRSP, DRSP, MDRTB, XDRTB and E. coli. these are organisms resistant to standard antibiotic therapy.

Rescue situations: Posing threats to both parties such as; 

Downed powerlines

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Fire or threat of fire

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Explosion or threat of explosion

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Hazardous waste

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Possible structural collapse

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Low oxygen levels in small spaces

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Trenches that aren’t secure

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Bio nuclear/chemical weapons

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Motor vehicle accidents

PSV is necessary for highway rescue, wellness of the EMT must be preserved. Physical Wellbeing: Take care of yourself. 

Physical fitness such as aerobics, cardio, some weights, and don’t strain yourself. Continue 35 minute cardio sessions 3 times a week.

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Measure resting heart rate.

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Subtract age from 220, Max heart rate, subtract heart rate from maximum and multiply by (0.70). Add final number to resting heart rate.

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Try yoga and sleep for 8-10 hours. Quit smoking and vaping, don’t self-medicate; get professional help. For your mental wellbeing, exercise, relax, and have a hobby....