The Well-Being of the EMT-B

1. The Well-Being of the EMT-B

2. Origins of EMS • 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

3. 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

4. What is the Star of Life??

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

6. Levels of EMS Training • First Responder • EMT – Basic • EMT – Intermediate • EMT – Critical Care • EMT – Paramedic

7. 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

8. Components of an EMS System Specialty Facilities • Trauma Center • Burn Center • Pediatric Center • Stroke Centers • Other specialty centers

9. Components of an EMS System • EMT Training • Initial – 180 hours • Continuing Education • Instructor Training

10. Components of an EMS System • Communications Systems • System Communication • Radio • Cellular • System Access • 911 • Other easily remembered numbers

11. Components of an EMS System • Dispatch Center • Well Designed • Well Equipped • Well Staffed & Trained • Policies & Procedures

12. Components of an EMS System • Ambulance Service • Well Designed • Well Equipped • Well Maintained • Well Trained Staff

13. Components of an EMS System • Rapport with other healthcare professionals • Reports & Records • System Evaluation • Quality Improvement – CQI • Protocol Review/Update • Run Review • Remedial or Continuing Education

14. Components of an EMS System • Disaster Plans • Major Incident Response • Designed by EMS • Designed to Integrate with Other Agencies

15. EMT A professional provider of emergency care

16. 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

17. Roles & Responsibilities • Safety • Priorities • Yourself • Partner • By-standers • Patient • Survey Scene • Look for Hazards • Listen to Others

18. Safety • Stay aware of danger • PLAN • Support personnel • Proper clothing • Radio • OBSERVE • Violence • Pets • Crime Scene • Weapons • REACT • Retreat B. Radio C. Reevaluate • E. Hazards-power lines • F. Alcohol/Drugs • G. Bystanders

19. 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)

20. 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

21. Scene Safety • Rescue • Identify and reduce potential life threats • Electricity • Fire • Explosion • Hazardous materials • Protective clothing • Turnout gear • Puncture-proof gloves • Helmet • Eyewear

22. Scene Safety • Violence • Scene should always be controlled by law enforcement before providing care

23. 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)

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

25. Roles & Responsibilities • Patient Care (cont.) • Oral Glucose • Bandaging & Splinting / Traction Splinting • Emergency Childbirth • Spinal Immobilization

26. Roles & Responsibilities • Extrication & Rescue • Transport • Transfer of Care • Communications • Records & Reports

27. Roles & Responsibilities • Patient Advocacy • Maintenance • Vehicle Maintenance • Equipment Maintenance • Self

28. EMT Traits • Physical Traits • Hygiene • Good physical health • Eyesight • Attitude • Resourceful • Sincerity/Compassion/Empathy Temple College EMS Professions

29. EMT Traits • A leader/self-starter • Emotional stability • Good moral character • Adaptability • Effective communicator • Verbal • Written • Ongoing Education Temple College EMS Professions

30. 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.

31. Medical Examiner Cases • DOA – no Primary MD • Unknown cause of death • Suicide • Violent death • Poisoning • Accidents • Criminal act Keep notes of any care provided.

32. Temple College EMS Professions

33. Temple College EMS Professions

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

35. Stages of Grieving • Denial – refusal to accept • Anger – blaming others • Be tolerant • Do not become defensive • Bargaining – promise to change • “Ok, but first let me” • Depression – open expression of grief, sadness/despair • Acceptance • “Ok, I’m not afraid” What you are feeling is normal

36. 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

37. Stress Warning Signs and the Work Environment

38. 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: Boss Deadlines Job Finances Home life Social life

39. 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

40. 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

41. 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 41

42. What can you do to help deal with stress?

43. Temple College EMS Professions