The Well-Being of the EMT-B

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The Well-Being of the EMT-B

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• Accidental Death & Disability: The Neglected Disease of Modern Society

• Department of Transportation (DOT)– Highway Safety Act of 1966

• Department of Health and Human Services (DHHS)– Emergency Medical Act of 1973

Origins of EMS

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National Standard Curriculum

• Developed by DOT– First developed in early 1970’s– Current - 1994

• Purpose– Standardization of Training Programs– Standardization of Levels of

Certification– Standardization of Patient Care

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What is the Star of Life??

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The complete human and physical resources that provides patient care in cases of sudden illness or injury

EMS System

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Levels of EMS Training

• First Responder

• EMT – Basic

• EMT – Intermediate

• EMT – Critical Care

• EMT – Paramedic

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Components of an EMS System• Advisory Council

• Medical Direction (Scope of Practice)– The process used by the Medical community to

assure quality and accountability in the delivery of pre-hospital care

– On-line– Off-line

• Protocols

• Quality Improvement

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Components of an EMS System

Specialty Facilities

• Trauma Center

• Burn Center

• Pediatric Center

• Stroke Centers

• Other specialty centers

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• EMT Training– Initial – 180 hours– Continuing Education

• Instructor Training

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• Communications Systems– System Communication

• Radio

• Cellular

– System Access• 911

• Other easily remembered numbers

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• Dispatch Center– Well Designed– Well Equipped– Well Staffed & Trained– Policies & Procedures

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• Ambulance Service– Well Designed– Well Equipped– Well Maintained– Well Trained Staff

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• Rapport with other healthcare professionals

• Reports & Records

• System Evaluation– Quality Improvement – CQI

• Protocol Review/Update

• Run Review

• Remedial or Continuing Education

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• Disaster Plans– Major Incident Response

• Designed by EMS

• Designed to Integrate with Other Agencies

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A professional provider of emergency care

EMT

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Scope of Practice• Defined by NYS Public Health Law

• Established by Medical Director– Medical Practice Act

• Allows Physicians to delegate procedures to EMS personnel

– Off-Line Medical Direction (Protocols)• Standing orders issued by the Medical Director that allow

EMT’s to give certain medications and perform certain procedures without speaking to a physician

– On-Line Medical Direction• Orders from an on-duty physician given directly to the

EMT in the field by radio or telephone

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Roles & Responsibilities• Safety

– Priorities• Yourself

• Partner

• By-standers

• Patient

• Survey Scene– Look for Hazards

– Listen to Others

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Safety– Stay aware of danger

A. PLANA. Support personnel

B. Proper clothing

C. Radio

B. OBSERVEA. Violence

B. Pets

C. Crime Scene

D. Weapons

C. REACTA. Retreat B. Radio C. Reevaluate

E. Hazards-power linesF. Alcohol/DrugsG. Bystanders

Scene Safety• Body Substance Isolation

– Hand washing– Eye protection

• Prescription eye glasses with side shields OR goggles

– Gloves• Needed for contact with bodily fluids• Change between contact with different patients

– Gowns• Needed for large splash situations

– Masks• Surgical for blood splatter• High Efficency Particulate Air (HEPA) respirator with

suspected tuberculosis (TB)

Scene Safety• Hazardous Materials

– Identify possible hazards– Protective clothing– Haz-Mat scenes are controlled by Haz-Mat teams– EMT patient care starts when the scene is safe and the

patient has been decontaminated

Scene Safety• Rescue

– Identify and reduce potential life threats• Electricity

• Fire

• Explosion

• Hazardous materials

– Protective clothing• Turnout gear

• Puncture-proof gloves

• Helmet

• Eyewear

Scene Safety• Violence

– Scene should always be controlled by law enforcement before providing care

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Roles & Responsibilities

• Patient Care– Patient Assessment– Basic Life Support– Mechanical Aids to Breathing– Pulse-Oximetry– Semi-Automatic External Defibrillator– Pneumatic Anti-Shock Garment (PASG or

MAST)

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• Patient Care (cont.)– Hand-held Metered Dose Nebulizers– Epinephrine Auto-injectors (Epi pens)– Nitroglycerin– Aspirin– Charcoal

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Roles & Responsibilities• Patient Care (cont.)

– Oral Glucose– Bandaging & Splinting / Traction Splinting– Emergency Childbirth – Spinal Immobilization

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• Extrication & Rescue

• Transport

• Transfer of Care

• Communications

• Records & Reports

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• Patient Advocacy

• Maintenance– Vehicle Maintenance– Equipment Maintenance– Self

Temple College EMS Professions 28

1. Physical Traits– Hygiene– Good physical health– Eyesight

2. Attitude

3. Resourceful

4. Sincerity/Compassion/Empathy

EMT Traits


5. A leader/self-starter6. Emotional stability7. Good moral character8. Adaptability9. Effective communicator

- Verbal- Written

10. Ongoing Education

EMT Traits

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The Well-Being of the EMT

• Personal health, safety, and well-being are vital to an EMS operation.

• You must learn to recognize and protect yourself from hazards.

• You must cope with mental and physical stress.

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Medical Examiner Cases

• DOA – no Primary MD

• Unknown cause of death

• Suicide

• Violent death

• Poisoning

• Accidents

• Criminal act

Keep notes of any care provided.

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Death and Dying

• Death is something you will have to face.

• Coming to grips with death is part of delivering care.

Stages of Grieving1. Denial – refusal to accept

2. Anger – blaming others• Be tolerant• Do not become defensive

3. Bargaining – promise to change• “Ok, but first let me”

4. Depression – open expression of grief, sadness/despair

5. Acceptance• “Ok, I’m not afraid”

What you arefeeling isnormal

Dealing with the dying patient and family members

• Patient needs include dignity, respect and communication

• Act in a calm manner

• Listen empathetically

• Family members may express rage, anger and despair

• Show concern about privacy

• Do not create false hope or falsely reassure

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Stress Warning Signs and the Work Environment

Definition of Stress• Any response, physical, emotional or

behavioral, we have to the things that happen in our lives, on and off the job

• Causes:1. Boss

2. Deadlines

3. Job

4. Finances

5. Home life

6. Social life

Examples of Stressful Situations• Mass casualty situations

• Infant and child trauma

• Amputations

• Infant/child/elder/spouse abuse

• Death/injury of a family member, co-worker or other public safety personnel

What can you do to help deal with stress?• Change your diet

– Reduce sugar, caffeine, and alcohol intake– Avoid fatty foods– Increase carbohydrates

• Exercise

• Practice relaxation techniques– Deep breathing – inhale through your nose deeply,

hold breath for 3 seconds and then forcefully exhale through your mouth

• Talk about your worries, fears, concerns

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• CISD – Critical Incident Stress Debriefing

– A team of peer counselors and mental health professionals who help emergency care workers deal with critical incident stress

• Meeting is held 24 to 72 hours after a major incident

– Open discussion of feelings, fears and reactions

– Not an investigation or interrogation

– All information is confidential

Components of CISM System

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What can you do to help deal with stress?

The Well-Being of the EMT-B

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