Emotional Aspects of Emergency Care

1. Emotional Aspects of Emergency Care

2. Lesson 3: The Well-Being of the Emergency Medical Responder You Are the Emergency Medical Responder Your police unit responds to a call for a medical emergency involving a man who has collapsed in front of a school building. When you and your partner arrive, you see that the man is bleeding from the mouth and face. Vomit and blood are on the ground around him. “His face hit the ground when he fell,” a bystander says. The victim does not appear to be breathing.

3. Stressful Situations • Dangerous situations • Physical and psychological demands • Critically injured or ill people • Death and dying patients • Overpowering sights, smells and sounds • Multiple-patient situations • Angry or upset patients, family and bystanders

4. Emotional Crises • Steps that will help the EMR to deal with a dying victim and his or her family members • Recognizing that the victims needs include sharing, communication, privacy, and control • Allowing family members to express emotions, know that its usually not personal • Listening empathetically • Not offering false reassurance • Using a gentle tone of voice • Letting the victim know that everything that can be done to help will be done • Comforting the patient and family

5. Exceptions to Resuscitation • Valid Do Not Resuscitate (DNR) order present at the scene • Patient with obvious signs of death • Tissue decay • Rigor mortis • Obvious mortal wounds • Dependent lividity – pooling of blood • Situation endangering to EMR’s life

6. Stages of Grief • Denial – denies seriousness of situation • Anger – toward other people • Bargaining – negotiate with a spiritual being • Depression – sadness and grief • Acceptance – accepts the situation

7. Warning Signs of Stress • Difficulty sleeping and nightmares • Irritability • Sadness, anxiety or guilt • Indecisiveness or lack of concentration • Loss of appetite or interest in sexual activity or work • Isolation or hopelessness • Alcohol or drug misuse/abuse

8. Critical Incident Stress Reactions • A critical incident is a specific situation that causes an EMR to have an unusually strong emotional reaction that interferes with his or her ability to function immediately after the event and later on. This reaction can produce stress called Critical Incident Stress • Confusion, shortened attention span or poor concentration • Denial, guilt, depression or anger • Change in interactions with others • Increased or decreased eating • Uncharacteristic or excessive humor or silence • Any other unusual behavior

9. Critical Incident Stress • Strong emotional reaction that interferes with ability to function • Can build-up over days, weeks, months, or years • May require professional counseling • A critical incident stress debriefing (CISD) is a type of meeting held within 24 to 72 hours of an incident. • During a CISD, participants are encouraged to have an open discussion of feelings, fears, and reactions triggered by the incident. • Defusing • Less formal and less structured

10. Activity You are the first to arrive on the scene of a multi-vehicle collision involving a tractor trailer and several cars. The driver of the tractor trailer is severely injured with a portion of his hand partially severed. A person in one of the cars, a young teenager, has been thrown through the windshield and is lying in a contorted position on the side of the road. Another person is trapped in the car and unable to move her leg.

11. Steps to Relieve Stress After an Incident • Quick relaxation techniques • Healthy meal • No caffeinated beverages • Avoidance of alcohol and drugs • Event review • Rest • Involvement in physical activity • Debriefing/defusing

12. Enrichment: Health of the Emergency Medical Responder • Physical well-being • Physical fitness, nutrition and sleep • Prevention of disease transmission • Safety, including protection from the sun • Mental well-being • Stress management techniques • Balance of work and life demands • Avoid alcohol or drug use or misuse • Read Enrichment pages 38-40