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Transcript of Injury Prevention and Control Osama A Samarkandi, PhD, RN BSc, GMD, BSN, MSN, NIAC EMS 313; Public...
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Injury Prevention and Control
Osama A Samarkandi, PhD, RN
BSc, GMD, BSN, MSN, NIAC
EMS 313; Public Health for EMS Professionals
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Public HealthApplies fundamental knowledge of principles of public health and epidemiology including public health emergencies, health promotion, and illness and injury prevention.
National EMS Education Standard Competencies
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Introduction• EMS providers have an important role to
play in injury and illness prevention.• Injury and illness prevention are an important
part of public health.
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Role of Public Health• Public health
• Practice of preventing disease and promoting good health within groups of people
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Injuries as Public Health Threats• Injuries
• Intentional or unintentional damage to the person resulting from exposure to energy or absence of essentials
• Injuries historically reported under distinct umbrellas
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Injuries as Public Health Threats
• May be intentional or unintentional• EMS usually has a greater impact on preventing
unintentional injuries.
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Injuries as Public Health Threats• Years of potential life
lost• Assume a productive
work life until age 65.• Deduct the year of
death from that age.
• It is easier to measure death rates than morbidity rates.
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Injuries as Public Health Threats• Many health experts
consider injury the largest problem facing the World today.
• It is important to understand how injury affects different age groups.
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Illness and Disease as Public Health Threats• Each year, 7 out of 10
Americans die from a chronic disease.
• Causes include:• Poor nutrition• Excessive alcohol
intake• Tobacco use• Sedentary lifestyle
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Public Health Efforts• The APHA
recommends three reforms:• Policies/funding• Strengthen public
health system• All-access system
• Public health efforts can impact many levels of society.
© Capifrutta/ShutterStock, Inc.
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Public Health Efforts• Preventing adverse outcomes is a major
goal of public health programs.• Education campaigns have promoted:
• Disease screening• Injury prevention• Prenatal care
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Public Health Laws, Regulations, and Guidelines• Public health laws or regulations include:
• Law from Government and Ministry of Health• Sharia laws• Saudi Drug Regulation• WHO
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EMS Interface With Public Health• Joint agreement on medical and public
health response to Mass Gathering Event: • Ministry of Health• Saudi Red Crescent Authority
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EMS Interface With Public Health• September: National
Preparedness Month• Get Ready Day
• H1N1 safety• Floods• Heat waves• Power outages• Winter storms• Earthquakes Courtesy of the American Public Heath Assocation.
Photographed by David Fouse.
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Injury and Illness Prevention and EMS
• EMS providers can lead or support interventions.• EMS is an advocate
and practitioner.
• Illness and injury prevention have similar techniques.© Dewitt/ShutterStock, Inc.
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Common Roots• “Accidental Death
and Disability: The Neglected Disease in Modern Society”
• Injury prevention always included EMS.• Primary• Secondary
• There is a role for every provider.
© Steven Townsend/Code 3 Images
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Why EMS Should Be Involved• There are a number of reasons EMS is
especially suited to be involved. Providers:• Reflect community composition• Are medically sophisticated• Are high-profile role models• Have access to community
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Principles of Injury and Illness Prevention• Risk
• A potentially hazardous situation in which the well-being of people can be harmed
• Four E s of Prevention
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The 4 Es of Prevention• Education
• Inform people about potential dangers, persuade them to change behaviors
• Effective messages are: • Tailored to specific
groups• Reinforced with
meaningful rewards
• Enforcement• Legislation and
regulation• Formulates rules that
require people, manufacturers, and governments to comply with safety practices
• Litigation can also lead to enforcement.
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The 4 Es of Prevention• Engineering/environment
• Passive interventions• Can be social, legal, political, or cultural
• Economic incentives• Economic self-interest provides monetary
incentives to reinforce safe behavior.
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The Value of Automatic Protections• Passive interventions are often the most
successful.• Provide constant protection without conscious
action from user• A combination of approaches is still the
most effective strategy.
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Models for Injury and Illness Prevention• Visual models
describe a health problem and how to approach it. • Focuses on:
host, agent, environment
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The Haddon Matrix• Added factor of time to previous models to
address causes of injury• The host, agent, and environment interact
over time to cause injury and correspond to:• Pre-event• Event• Post-event
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The Haddon Matrix• Matrix uses nine components to analyze
the injury• Encourages creative thinking
• Injury prevention requires broad and innovative thinking to be most successful.
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ExamplePhase Human Factors
Vehicles and Equipment
Factors
Environmental Factors
Pre-event
•Information•Attitudes•Impairment•Police Enforcement
•Roadworthiness•Lighting•Breaking•Speed Management
•Road design and road layout•Speed limits•Pedestrian facilities
Event•Use of restraints•Impairments
•Occupant restraints•Other safety devices•Crash-protective design
•Crash-protective roadside objects
Post-Event•First-aid skills•Access to medics
•Ease of access•Fire risk
•Rescue facilities•Congestion
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Injury and Illness Surveillance • Data are collected,
disseminated to people/ organizations that can effect change• Applied to
interventions
• Strong surveillance is fundamental to effective programs.
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Getting Started in Your Community• To be effective, you need to understand:
• Injury and illness patterns• Characteristics of the population, environment• The types of risks present
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Getting Started in Your Community• Intentional injuries
• There are risk factors connected with intentional violence.
• EMS providers:• Reporting data• Note risk factors
© Mikael Karlsson/On Scene Photography
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Getting Started in Your Community• Unintentional Injuries
• “Accidents”
• In Children:• 20 million annually• Children are:
• At higher risk• More likely to be
seriously affected
• “Pass-along effect”
© SuperStock/age fotostock
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Getting Started in Your Community• Risk factors for children
• Lower socioeconomic status• Injuries are more likely to occur where there
is:• Water• Heat• Toxic agents• High potential “energy”
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Getting Started in Your Community• Risk factors for
children (cont’d)• Unintentional injuries
are greatest threat• School injuries are not
uncommon.• 45% of cases are
severe injuries.
• Priority prevention efforts are injuries with highest: • Mortality rate• Hospitalization rate• Long-term disability
rate• Effective
countermeasures
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Getting Started in Your Community• Illness Prevention
• Illness prevention is gaining attention.
• Example: poor health in adolescents• Tobacco/alcohol/other
drugs• STDs• Unhealthy diet• Sedentary lifestyle
• Community Organizing• Implementation plan,
should include: • Identify a leader.• Build support base.• Create a timeline.• Gather data, facts.• Choose goals.• Establish funding.• Be positive, persist.
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Getting Started in Your Community• Five steps of a
prevention program• Conduct community
assessment.• Bring people and
groups together.• Represent the
community at large.• Include survivors, their
families.• Identify partners.
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Getting Started in Your Community• Five steps of a prevention program
(cont’d)• Define problem.
• In specific, quantifiable terms
• Set goals and objectives.• Goals: broad, general, long-term• Objectives: specific, time-limited, quantifiable
• Process or outcome
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Getting Started in Your Community• Five steps of a prevention program
(cont’d)• Plan and test interventions.
• Actions to accomplish your goals, objectives
• Implement and evaluate interventions.• Must be able to measure results quantitatively
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Getting Started in Your Community• Funding a prevention program
• Consider innovative ways to fund programs.• Partner with the media.• Look for grants and sponsorships.• Network with other prevention programs.
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How Every Provider Can Be Involved• Paramedics can, and should, be involved
in prevention to some extent.• Be a role model.
• Responding to the call• Very few calls require the use of lights and
sirens.• Dispatchers can be a resource.
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How Every Provider Can Be Involved
• Education for EMS providers• Understand the
fundamentals of prevention
• “Teachable moment”• Articulate and reinforce
safety messages.• Use good judgment.• Be sensitive.
© Craig Jackson/IntheDarkPhotography.com
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How Every Provider Can Be Involved• Collection/analysis of data and research
• Vital for:• Measuring trends• Validating interventions• Assessing resources• Persuading others to act
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How Every Provider Can Be Involved• Collection/analysis of data and research
(cont’d)• Starts with prehospital care reports• Be a leader by:
• Being a role model• Reaching out in your community
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• Public health encompasses health promotion and disease prevention for groups of people.
• Kingdom rules, regulations, guidelines, and laws govern public health.
Summary
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• Many paramedics have been motivated by their field experience to work actively on prevention.
• The 1966 National Academy of Sciences/National Research Council study, “Accidental Death and Disability: The Neglected Disease of Modern Society,” noted that EMS could help with trauma after an event, and injury prevention could help prevent an accident before it happens.
Summary
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• The 1996 Consensus Statement on the EMS Role in Primary Injury Prevention emphasized that primary injury prevention is an essential activity of EMS.
• EMS can play a supporting role in preventing intentional injuries and can have an even larger impact in preventing unintentional injuries.
Summary
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• The years of potential life lost concept is another way to measure the cost of unintentional injury to society.
• The 4 Es of prevention are education, enforcement, engineering/environment, and economic incentives.
• Automatic protections do not require a conscious decision to act; an example is including air bags in automobiles
Summary
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• The Haddon matrix uses nine separate components to analyze injury.
• Surveillance is the ongoing systematic collection, analysis, and interpretation of data essential to the planning, implementation, and evaluation of public health practice.
• Paramedics need to triage their focus on prevention—do not let the headlines be your guide.
Summary
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• The five steps to developing a prevention program are: conduct a community assessment, define the problem, set goals and objectives, plan and test interventions, and implement and evaluate interventions.
• Primary prevention begins at home by taking care of yourself and presenting a role model for others in your service and in the community.
Summary
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• The best teachable moments are those that convey positive reinforcement.
• The importance of collecting data in measuring trends, validating interventions, assessing resources, and ultimately persuading others to act cannot be overestimated.
Summary