Chapter 2- The well-being of an EMT PDF

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Chapter 2- Well Being of an EMT 

Well Being o Maintain solid personal relationships

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Exercise Sleep Eat right Limit alcohol and caffeine intake

Seeing your physician regularly and keeping up to date on vaccines Personal Protection o Standard Precautions/ BSI (body substance isolations)- strict form of infection control that is based on the assumption that all blood and other body fluide are infectious  Diseases are caused by pathogens- organisms that cause infection, such as viruses or bacteria  Spread through air or by contact with blood or other body fluids  Blood borne pathogens- contracted by patient blood and sometimes other body fluids especially when they come in contact with an open wound or sore on EMTs hands, face, or other exposed parts including mucous membranes such as nose, mouth, or eyes  Air borne pathogens- spread by tiny droplets sprayed during breathing, coughing, or sneezing and can be absorbed into eyes or during inhalation  Must wear PPE (personal protective equipment)- equipment that protects the EMS worked from infection and/or exposure to the dangers of rescue operations  Requirement for employers to have written exposure plan and provide emergency care with training, immunizations, and proper PPE  Requirement for employers is to have written policy in place in event of an exposure to infectious substances o PPE  Protect yourself from all routes of contamination- introduction of dangerous chemicals, disease, or infectious materials  Wear gloves  Change gloves between patients  Hand cleaning  Hand washing- when soap and water available  Alcohol based hand cleaners- when soap and water not available  Eye and Face protection  Masks  Gowns Diseases of Concern o Hepatitius (A, B, C)- infection that causes inflammation of the liver  A- contact with food,water, or feces  B & C- contact with blood and other bodily fluids  B- can be deadly but has a vaccine  C- has no vaccine o Tuberculosis (TB)- infection that sometimes settles in lungs and that can be fatal

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Spread through air- highly contagious

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AIDS (acquired immune deficiency syndrome)- set of conditions that results when immune system has been attacked by HIV (human immunodeficiency virus) and rendered unable to combat certain infections  No cure- but virus does not survive well in human body  Contact with open wounds and bodily fluids Emerging Diseases and Conditions o Ebola- comeback in 2014 Initial symptoms- fever, chills, and weaknesses  Later symptoms- diarrhea, vomiting, and abdominal pain, external and internal bleeding o Avian Flu- disease found poultry that can also affect humans

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EMS services now work at preventing many of these dieases Infection Control and the Law o Occupational Exposure to Bloodborne pathogens-

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OSHA- creates standard for blood borne pathogens  Infection control is joint responsibility of employer and employee o Infection exposure control plan o Adequate education and training

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Hepatitis B vaccination PPE Methods of control Housekeeping Labeling Post exposure evaluation and follow up

Ryan White Care Act/ Ryan White comprehensive AIDS resource emergency act  Enacted by US congress- 1990  Mandates a procedure by which emergency response personnel can seek to find out if they have been exposed to potentially life threatening diseases while providing patient care  Designated officer- responsible for gathering facts surrounding possible emergency responder airborn or bloodborne infection disease exposures o Airborne disease exposure- notified by designated officer when you have been exposed to airborne illness o Blood borne or other infectious exposure- submit a request for a determination as to whether or not you were exposed to a blood borne or other infectious diseases o Tuberculosis Compliance Mandate  Potential rish for exposure to exhaled air of a person with suspected or confirmed- required to wear a N-95 or HEPA respiarator when:  Caring for patients suspected of TB  Transporting an individual from such a setting in a closed vehicle  Performing high risk procedures such an endotracheal suctioning and intubation o Immunizations Many services require immunizations for communicable diseases Emotion and Stress o Physiologic Aspects of Stress  Stress- state of physical and/or psychological arousal to a stimulus

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EMT is exposed to many stress producing agents or situations  Environment, dealings with other people, own self-image, performance expectations Bodys response to stress  First stage: alarm reaction- Sympathetic NS increases its activity to fight or flight o Pupils dilate, heart rate increases, bronchial passages dilate, blood sugar increases, digestive system flows, blood pressure rises, blood flow to skeletal muscle increases  Second stage: stage of resistance- body system returns to normal functioning o Adapted to stimulus and no longer produces stress- coping  Third stage: exhaustion- stressor is severe o Enlargement of adrenal glands (hypertrophy)- produce adrenaline

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Wasting of lymph nodes (atrophy) Bleeding gastric ulcers

Types of Stress Reactions  Acute Stress- often linked to catastrophes  Ordinary reactions to extraordinary conditions  Reflect process of adapting to challenge  Delayed stress- PTSD which are triggered by specific incident  Cumulative stress- results from recurring low level stressors o Causes of stress  Multiple casualty incidents  Calls involving infants and children  Severe injuries  Abuse and neglect  Death of coworker Signs and Symptoms of Stress o Two types of stress:  Eustress- positive form of stress that helps people work under pressure and respond effectively  Distress- negative form of stress when it becomes overwhelming  Can cause long term problems with your health and well being Dealing with Stress o Lifestyle Changes  Offer a benefit in both preventing stress and dealing with it when stress occurs  Develop more healthful and positive dietary habits  Exercise  Devote time to relaxing o Critical Incident Stress Management (CISM)- comprehensive system that includes education and resources to both prevent stress and to do with stress appropriately when it occurs  Seek help from a professional o Understanding Reactions to Death and Dying  When patient finds out they are dying- go through stages  Denial  Anger  Bargaining  Depression

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 Acceptance What to do in order to accommodate the patient:  Recognize patients’ needs  Be tolerant of angry reactions from the patient or family members  Listen empathetically  Do not falsely reassure  Offer as much comfort as you realistically can

Scene Safety o Hazardous Material Incidents  Release of a harmful substance into the environment  Maintain safe distance from source – make sure ambulance or other emergency vehicle is equipped with binoculars  Recognizing potential problems, taking initial actions for protecting safety and safety of others, and notify an appropriate trained hazardous response team  Cannot treat patients until they have undergone decontamination- removal or cleaning of dangerous chemicals and other dangerous or infectious materials o Terrorist incidents  Likely made aware of specific threats or targets in area in addition to protocols relating to potential chemical, biological, nuclear, or explosive incidents o Rescue Operations  Evaluate situation and ensure you call for help early if needed  Wear PPE o Violence  Make sure scene is safe  Plan  Wear safe clothing, prepare equipment so it is not cumbersome, carry portable radio, decided on safety rules  Observe  Violence, crime scenes, alcohol or drug use, weapons, family members, bystanders, perpetrators, pets  React to danger  Flee, get rid of any cumbersome equipment, take cover and conceal yourself  3 R’s o retreat, radio, reevaluate...