9/10/2012 Chapter 1ems.jbpub.com/aehlert/paramedic/docs/PPT_Lectures/Chapter_01.pdf · 9/10/2012 1...

9/10/2012

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Chapter 1

EMS Safety and Well-Being of the Paramedic

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Learning Objectives

List components of wellness, discuss how paramedics can promote wellness

Discuss principles, personal and professional benefits of positive lifestyle choices that promote wellness related to nutrition, rest, exercise, weight control, not smoking

Discuss ways cardiovascular endurance, muscle strength, flexibility contribute to physical fitness

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Learning Objectives (Cont’d)

Define circadian rhythm and discus the impact on those who work shifts and ways to manage that impact

List risk factors and warning signs of cardiovascular disease and cancer and discuss the role of risk assessments

Discuss proper lifting techniques and safety factors related to lifting and moving patients during emergency and nonemergency situations

Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company

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Describe steps, equipment used to protect yourself from airborne, bloodborne pathogens, other adverse conditions and situations

Outline actions that would reduce infectious disease exposure as related to field scenarios

Develop decontamination plan for equipment exposed to body substances

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List & discuss 3 phases of stress response, factors that can trigger response

Identify causes (life & EMS), signs & symptoms of stress, discuss positive/negative coping mechanisms

Discuss importance of dealing with stress, describe critical incident stress management & its uses, need for availability of mental health professionals to EMS system

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When given a scenario involving a stressful situation, develop examples of positive coping responses, how these could be used both on and off duty

List & discuss Kübler-Ross’ 5 stages of the grieving process

Describe & discuss needs that may arise when paramedics deal with stressed patients, families, death, dying


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Introduction

Concepts of EMT well-being Wellness Injury prevention Prevention of disease transmission Stress Management

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Wellness

Physical well-being Nutrition

• Carbohydrates• Fats• Protein• Minerals• Vitamins• Water• Fiber

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Wellness (Cont’d)

Physical well-being Nutrition

• Daily consumption• Weight reduction


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Wellness (Cont’d)

Physical well-being Physical fitness

• Benefits• Physical activity, exercise

Age, fitness level, medications, medical problems have impact amount

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Wellness (Cont’d)


• Physical activity, exercise Isometric

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Wellness (Cont’d)


• Physical activity, exercise Isotonic


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Wellness (Cont’d)

Physical well-being Rest

• Fatigue increases skill response times, affects judgment

• Sleep 7-8 hours/day• Circadian rhythm• Sleep deprivation

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Wellness (Cont’d)

Physical well-being Rest

• Enhance sleep ability

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Wellness (Cont’d)

Mental & emotional well-being Affecting factors

• Physical fitness• Good nutrition• Sufficient rest • Manage stress• Avoid addictive behaviors


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Consequences of Poor Health Habits

Cardiovascular disease Warning signs

• Chest discomfort• Pain that spreads to shoulders, neck, arms, or jaw• Nausea or vomiting• Indigestion• Shortness of breath• Back pain• Dizziness• Unexplained fatigue

Controlling health

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Consequences of Poor Health Habits (Cont’d)

Cancer Warning signs

• Change in bowel or bladder habits• Sore throat that will not heal• Unusual bleeding or discharge• Thickening or lump in breast or elsewhere• Indigestion/difficulty swallowing• Obvious change in wart/mole• Nagging cough or hoarseness

Risk assessment screenings

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Consequences of Poor Health Habits (Cont’d)

Obesity Cardiovascular disease Arthritis Certain cancers Hypertension Diabetes


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Injury Prevention

Proper lifting & moving techniques Move load only if can safely be handled Get assistance when necessary Establish good footing & balance

• Wide base of support

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Injury Prevention (Cont’d)

Proper lifting & moving techniques

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Injury Prevention (Cont’d)

Proper lifting & moving techniques If trauma is present/suspected, move patient in

direction of length (long axis) of body Moving patient down incline/stairs, 2 rescuers

on lower, heavier end of stretcher/board 1 person gives commands Communicate frequently with partner


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Preventing Spread of Disease

Handwashing Use standard precautions Current immunizations, boosters, regular

TB screenings

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Preventing Spread of Disease (Cont’d)

Personal protective equipment (PPE) Gloves Protective eyewear Masks

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Personal protective equipment (PPE) Respirators Gowns Resuscitation equipment


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Personal protective equipment (PPE) Levels

• Level D

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• Level C

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• Level B


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• Level A

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Exposure management Immediately wash affected area(s) with soap &

water Document incident Obtain medical evaluation Get recommended immunization boosters,

immune system boosters, medications Continue follow-up care

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Equipment & unit maintenance PPE properly disposed Unit

• Clean• Disinfect• Sterilize


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Stress

Can help/hurt performance, relationships Mental, emotional, physical

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Stress (Cont’d)

Stressors Stages

• Alarm reaction• Resistance• Exhaustion

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Stress (Cont’d)

Types Eustress

• Good or positive stress Distress

• Negative stress• Accumulation of stress• Lead to anxiety, stress-related health problems,

disorders


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Stress (Cont’d)

Causes & effects Triggers

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Stress (Cont’d)

Causes & effects Anxiety Coping mechanisms

• Negative Do not address, solve or alleviate problem

• Positive Helps address, solve or alleviate problem

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Stress (Cont’d)

Stress in EMS Subjected to stressors most people never deal

with Environmental, psychosocial, personality

stress Positive coping mechanisms


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Death and Dying

Stages of grief Denial Anger Bargaining Depression Acceptance

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Death and Dying (Cont’d)

Dealing with the dying patient May refuse treatment May choose treatment for more time Sharing care & concern can provide comfort Hospice

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Death with family & friends May not be accepting

• Don’t take negative statements personally• Maintain calm, professional manner at scene

Concrete communication EMS can have positive effect on loss


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Age considerations Infancy – 3 years

• Maintain familiar routines if possible with same caregivers

3 – 6 years• Don’t understand death concept• May ask for person or blame themselves• Reassure they are not to blame

6 – 9 years• Understand finality of death• May ask many question & want exact details• Fear of loss of others & denial is common

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Age considerations 9 – 12 years

• May try to act like adult• May ask many questions• May have anger toward deceased, others they

believe responsible for death• May regress

Elderly• May provide comfort to others• Can trigger concern for their own future care• Remaining professional, supportive can provide

structure

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Death and EMS Emotionally, physically challenging Memories of own situation Remain professional, appropriate on scene After call, deal with concerns

• Talk to other EMS professionals• Suppressed emotions lead to burnout• Must have closure after call to remain healthy


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Summary

In EMS, “safety” includes mentally, emotionally, physically preparing and protecting yourself

Physical preparation includes exercise & proper nutrition, ongoing risk assessments

Eating wisely & well is difficult, can be done with preparation and planning

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Summary (Cont’d)

Maintaining healthy weight contributes to lifelong health & decreases disease, also makes lifting easier

Being physically fit decreases injury & disease, increases life span & individual’s ability to deal well with physical, mental, emotional demands found in EMS

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Summary (Cont’d)

Cardiovascular fitness, muscle strength, flexibility should all be maintained, enhancing health & preventing disease

Regular medical check-ups & risk assessments increase longevity

Rest, sleep are physical requirements


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Summary (Cont’d)

Identify & seek assistance/treatment for addictive behaviors

Stress management is important; deal with emotions or they will deal with you; develop & practice positive coping mechanisms

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Summary (Cont’d)

PPE important in self-protection; proper use saves lives

Paramedics work to save lives, but have to deal with death & dying; assess personal stress levels, develop healthy coping strategies

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Summary (Cont’d)

Remain professional & appropriate with stressed, pained or grieving individuals

Difficult calls/critical incidents cause stress; be aware, deal positively with stress, seek professional help if needed


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Summary (Cont’d)

Death affects individuals of varying ages, ethnicities, & cultural backgrounds differently; be supportive and nonjudgmental

Questions?

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9/10/2012 Chapter 1ems.jbpub.com/aehlert/paramedic/docs/PPT_Lectures/Chapter_01.pdf · 9/10/2012 1...

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