The Well-Being of the EMT-B

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• The Well-Being of the EMT-B

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Objectives 1 of 3

• List possible emotional reactions that an EMT-B
  may experience.
• Discuss reactions that family members may
  experience when confronted with death and dying.
• State the steps in approaching a family that is
  confronting death and dying.

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Objectives 2 of 3

• State the possible reactions the family of an
  EMT-B may exhibit.
• Recognize signs and symptoms of critical incident
  stress.
• State steps to help alleviate stress.
• Explain the need to determine scene safety.

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Objectives 3 of 3

• Discuss the importance of BSI.
• Describe the steps of personal protection from
  airborne and bloodborne pathogens.
• List personal protective equipment necessary for
  various situations.

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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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Self-control is achieved by

• Proper training
• Ongoing experience
• Dedication to serving others

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Death and Dying 1 of 2

• Changes in society have changed peoples
  attitudes toward death.
• Life expectancy has increased.
• Family mobility may mean less support for
  grieving people.
• Death no longer commonly occurs at home, but
  occurs in a hospital or at an accident site such
  as the highway instead.
• Dead loved ones are now kept at a funeral home
  instead of at home, so people are less used to
  dead bodies.

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Death and Dying 2 of 2

• Death is something you will have to face.
• Coming to grips with death is part of delivering
  care.

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Physical Signs of Death

• Absence of circulatory and respiratory function
• If the body is still warm, initiate care.
• If hypothermia is present, initiate care.

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Presumptive Signs of Death 1 of 2

• Unresponsive to painful stimuli
• Lack of pulse
• Absence of breath sounds
• Absence of eye movement
• No blood pressure

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Presumptive Signs of Death 2 of 2

• Dependant lividity
• Profound cyanosis
• Decreased body temperature

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Definitive Signs of Death

• Obvious mortal injury
• Rigor mortis
• Putrefaction (decomposition of body)

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Medical Examiner Cases

• DOA
• Unknown cause of death
• Suicide
• Violent death

• Poisoning
• Accidents
• Criminal act

Keep notes of any care provided.
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Grieving Process

• 1. Denial Refusal to accept
• 2. Anger Blaming others
• 3. Bargaining Promise to change
• 4. Depression Open expression of grief
• 5. Acceptance The simple yes

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What can an EMT-B do?

• Do helpful things.
• Make simple suggestions.
• Be yourself and sincere.

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Dealing with Family Members

• Act in a calm manner.
• Show concern about privacy.
• Respect familys wishes.
• Be honest.
• Dont create false hope.

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Concerns of the Critically Injured or Dying
Patient

• Anxiety
• Pain and fear
• Anger and hostility
• Depression

• Dependency
• Guilt
• Mental health problems
• Receiving unrelated bad news

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Caring for the Critically Ill and Injured
Patients 1of 2

• Avoid sad and grim comments.
• Orient the patient.
• Be honest.

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Caring for the Critically Ill and Injured
Patients 2 of 2

• Acknowledge the seriousness of the condition.
• Allow for hope.
• Locate and notify family members.

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Factors Affecting Patient Reactions

• Socioeconomic background
• Fear of medical personnel
• Alcohol/substance abuse
• Chronic diseases

• Mental disorders
• Medication reactions
• Age
• Nutritional status
• Guilt feelings

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Stress Warning Signs and the Work Environment
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Physiological Manifestations of Stress 1 of 2

• Rise in respirations and pulse
• Increase in blood pressure
• Cool, clammy skin
• Dilated pupils

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Physiological Manifestations of Stress 2 of 2

• Tensed muscles
• Increase blood sugar levels
• Perspiration
• Decreased circulation to GI tract

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Critical Incidents

• Mass Casualty Incidents
• Traumatic injury or death of child
• MVA caused by EMS personnel
• Serious injury or death of coworker

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Critical Incident Stress Management

• Developed in the 1980s
• Process designed to help EMS personnel deal with
  responses to critical incidents
• Composed of trained peers and mental health
  professionals

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Components of CISM System 1 of 2

• Pre-incident stress education
• On-scene peer support
• One-on-one support
• Disaster support services
• Defusings

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Components of CISM System 2 of 2

• CISD
• Follow-up services
• Spouse and family support
• Community outreach programs
• Other wellness programs

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Stress and Nutrition 1 of 3

• Prolonged stress drains the bodys reserves.
• Under stress, bodys fuel sources are consumed in
  large quantities.
• Physical stress will deplete energy sources
  quicker.

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Stress and Nutrition 2 of 3

• Glucose
• Quickest source of energy
• Taken from glycogen stored in liver
• Proteins
• Drawn from muscles
• Long-term source of glucose

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Stress and Nutrition 3 of 3

• Fats
• Used by tissues for energy
• Water
• Conserved by exchanging sodium potassium from
  kidneys
• Vitamins and minerals
• Vitamins B, C, and most minerals are depleted.

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Benefits of Exercise and Proper Nutrition

• Muscles will grow and retain protein.
• Bones store calcium and become stronger.
• Well-balanced meals provide necessary nutrients
  to body.