WellBeing of the First Responder

1
Well-Being of the First Responder
Unit 1 Preparatory

• CHAPTER 3

2
Well-Being of the First Responder

• Emotional Aspects of Emergency Care
• First Responders and Stress
• Critical Incident Stress Management
• Body Substance Isolation (BSI)
• Scene Safety
• Hazardous Materials Incidents
• Rescue Operations
• Violence and Crime Scenes

3
Emotional Aspects of Emergency Medical Care

• First Responders and Stress
• Stress contributes to
• Cardiovascular disease
• Stroke
• Diabetes
• Cancer
• Arthritis
• Gastrointestinal conditions
• Neurological disorders
• Emotional disorders

4
Emotional Aspects of Emergency Medical Care

• First Responders and Stress
• Physical demands
• Psychological demands
• must respond quickly to emergencies.
• must react instantly to situations.
• must make right decisions

5
Emotional Aspects of Emergency Medical Care

• Emergencies can be stressful.

6
Stressful Situations

• The First Responder will experience personal
  stress as well as encounter patients and
  bystanders in severe stress.

7
Common Causes of Stress

• Multiple-casualty incidents
• Pediatric patients
• Death
• Violence
• Abuse and neglect
• Death or injury of a coworker

8
Multiple-Casualty Incident
9
Burnout

• A reaction to cumulative stress or exposure to
  multiple critical incidents
• The signs of burnout include
• Loss of enthusiasm and energy
• Feelings of frustration
• Hopelessness
• Low self-esteem
• Isolation
• Mistrust

10
Death and Dying

• As a First Responder, you will at some time have
  to deal with a patient who has a terminal illness
  or injury.
• Patients, their families, and the providers will
  have many different reactions to the illness or
  injury.

11
The Grieving Process

• The five stages include the following
• Denial, or not me
• Anger, or why me?
• Bargaining, or OK, but first let me . . .
• Depression
• Acceptance

12
The Grieving Process

• The First Responder should
• Recognize the patients needs.
• Be tolerant of angry reactions.
• Listen empathetically.
• Do not give false hope or reassurance.
• Offer comfort.

13
Signs and Symptoms of Stress
14
Stress Management

• Recognize warning signs
• Make Lifestyle changes
• Diet, Exercise, Time to Relax, Change work
  Env/Shifts, Seek Help
• CISM / CISD

15
Critical Incident Stress

• The normal stress response to abnormal
  circumstances.

16
Critical Incident Stress Management
17
Critical Incident Stress Management

• When to access CISD
• Line of duty death
• Serious injury of a co-worker
• Death or serious injury of a child
• Any event that has an unusual impact on personnel

18
Body Substance Isolation (BSI)(now called
Universal Precautions)

• A form of infection control based on the
  presumption that all blood and body fluids are
  infectious.

19
Dealing with Risk

• An estimated 250 health-care workers die each
  year from hepatitis B or its complications, more
  than from any other infectious disease.
• EMS personnel must follow the rules for their own
  safety and the safety of others.

20
Dealing with Risk

• Infections are caused by organisms
• viruses (which cause illnesses such as colds,
  flu, HIV, and hepatitis)
• bacteria (which cause sore throats, food
  poisoning, rheumatic fever, gonorrhea,
  Legionnaires disease, and tuberculosis, to name
  a few)
• There are both viral and bacterial forms of
  pneumonia and meningitis.

21
Dealing with Risk

• Organisms are also called pathogens
• The term pathogen means to generate suffering
• patho-, suffering
• -gen, create or form
• Spread by exposure to body fluids
• Spread by exposure to airborne droplets

22
Personal Protective Equipment (PPE)

• Gloveslatex, vinyl, or other synthetic
• Face shields or maskssurgical-type masks
• For fine particles of airborne droplets
  (coughing), wear a high-efficiency particulate
  air (HEPA) or N-95 respirator.
• Eye protectionUse eyewear that protects them
  from both the front and sides.
• GownsUse when there is spurting blood,
  childbirth, injuries with heavy bleeding.

23
Dealing with Risk

• Handwashing
• Wash hands and change gloves between patients.
• OSHA has stated that handwashing is one of the
  most important steps to take for infection
  control.

24
Dealing with Risk
25
Bloodborne and Airborne Pathogens

• HIV (human immunodeficiency virus)
• HIV is the pathogen that causes AIDS.
• HIV does not survive well outside the body.
• Routes of exposure to HIV
• Direct contact with non-intact (open) skin or
  mucous membranes
• Blood, semen, or other body fluids

26
Bloodborne and Airborne Pathogens

• Hepatitis
• Hepatitis B virus (HBV) is a very tough virus
• It can survive on clothing, newspaper, or other
  objects for days after infected blood has dried.
• HBV causes permanent liver damage in many cases.
• Can be fatal
• Hepatitis C
• Non-A and Non-B hepatitis
• Less common than HBV

27
Bloodborne and Airborne Pathogens

• Tuberculosis (TB)
• Most often affecting the lungs, can also be
  fatal.
• Thought to have been nearly eradicated as
  recently as 1985.
• Has had a recent resurgence.
• New strains of the disease are resistant to
  treatment with traditional medication.

28
Bloodborne and Airborne Pathogens

• Tuberculosis (TB)
• Spread by aerosolized droplets in the air,
  usually the result of coughing and sneezing.
• TB can be contracted even without direct physical
  contact with a carrier.
• Use face masks with one-way valves for rescue
  breathing and (HEPA) respirator or N-95
  respirator.

29
Bloodborne and Airborne Pathogens

• Meningitis
• An inflammation of the lining of the brain and
  spinal cord
• The most infectious varieties of meningitis are
  caused by bacteria.
• Meningitis is transmitted by respiratory
  droplets.
• First Responders should make sure that EMS and
  hospital staffs inform them if they have been in
  contact with a patient infected with meningitis
  or a scene that may be contaminated with it.

30
Protecting First Responders

• In 1992, OSHA issued guidelines for employers
  whose workers run a risk of occupational exposure
  to bloodborne diseases.
• All such agencies are required to implement plans
  to meet the OSHA standards.
• Provide a free hepatitis B vaccination.
• Educate employees about bloodborne diseases.
• Establish safe workplace procedures.
• Supply personal protective equipment.
• Set up engineering controls.
• Provide an equipment-cleaning site.
• Ensure proper waste disposal according to local
  regulations.
• Implement post-exposure follow-up
• Determine the significance of exposure.
• Document the event.
• Test the employee.

31
Employee Responsibilities

• An infection-control program will only work if
  First Responders learn and follow correct
  procedures.
• As a First Responder, you have an obligation to
  adhere to safe work practices
• Washing hands regularly
• Using gloves and other personal protective
  equipment

32
Employee Responsibilities

• You may not withhold emergency care from a
  patient who you think may have an infectious
  disease.
• To date, there are no known cases of emergency
  workers contracting HIV or HBV during routine
  patient care using gloves and appropriate
  personal protective equipment.

33
Scene Safety

• Starts before First Responders actually arrive at
  the scene
• En route to the scene, get information from
  dispatch.
• Approaching an emergency scene
• look around for hazards
• listen for noises

34
Scene Safety

• Position the vehicle.
• You must ensure the safety for
• Yourself
• Your Partner
• The Patient
• Bystanders

35
Scene Safety

• Look for
• Environmental conditions
• Violent situations
• Weapons
• Crowds
• Other situations

36
Scene Safety

• Ensure the scene is safe.

37
Hazardous Materials Incidents

• Some chemicals can cause serious illness or even
  death, even if your exposure is brief.
• First Responders should maintain a safe distance
  from the source of any materials and treat it as
  a hazardous materials incident.

38
Hazardous Materials Incidents

• Transport and Storage
• Truck
• Train
• Boat
• Various storage containers and facilities

39
Hazardous Materials Incidents

• Placards may help with identifying materials in
  vehicle collisions.
• Coded colors and identification numbers

40
Hazardous Materials Incidents

• Listed in the Emergency Response Guidebook
• Published by the U.S. Department of
  Transportation (DOT)
• It can provide important information
• About a hazardous substance
• Safe distances
• Emergency care
• Suggested procedures in the event of spills or
  fire

41
Hazardous Materials Incidents

• Procedures
• Identify hazardous materials placards from a safe
  distance, thus ensuring your own safety.
• Recognize potential problems and take action to
  preserve your own safety and that of others.
• Notify hazardous materials response teams.

42
Rescue Operations

• Rescue scenes may include dangers from
  electricity, fire, explosion, hazardous
  materials, traffic, or water and ice.
• Evaluate each situation and request the
  appropriately trained teams to assist in handling
  these incidents
• Police
• Fire department
• Utility companies
• Other specialized personnel

43
Rescue Operations

• Never perform acts that you are not properly
  trained to do.
• Use personal protective equipment
• Turnout gear
• Protective eyewear
• Helmet
• Gloves

44
Violence and Crime Scenes

• Your first priorityeven before patient careis
  to be certain the scene is safe before you enter
  it.
• Recognize the situation.
• Request the necessary help.

45
Summary

• Emotional Aspects of Emergency Care
• First Responders and Stress
• Critical Incident Stress Management
• Body Substance Isolation (BSI)
• Scene Safety
• Hazardous Materials Incidents
• Rescue Operations
• Violence and Crime Scenes