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Workforce Safety of the ECA

Workforce Safety of the ECA. Objectives. List possible emotional reactions that an ECA 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. Objectives.

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Workforce Safety of the ECA

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  1. Workforce Safety of the ECA

  2. Objectives • List possible emotional reactions that an ECA 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.

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

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

  5. The Well-Being of the ECA • 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.

  6. Death and Dying • Changes in society have changed people’s 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.

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

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

  9. Presumptive Signs of Death • Unresponsive to painful stimuli • Lack of pulse • Absence of breath sounds • Absence of eye movement • No blood pressure

  10. Presumptive Signs of Death • Dependant lividity • Profound cyanosis • Decreased body temperature

  11. Definitive Signs of Death • Obvious mortal injury • Rigor mortis • Putrefaction (decomposition of body)

  12. Medical Examiner Cases • DOA • Unknown cause of death • Suicide • Violent death • Poisoning • Accidents • Criminal act Keep notes of any care provided.

  13. Stages of Grieving 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”

  14. What can an ECA do? • Do helpful things. • Make simple suggestions. • Be yourself and sincere.

  15. Dealing with Family Members • Act in a calm manner. • Show concern about privacy. • Respect family’s wishes. • Be honest. • Don’t create false hope.

  16. Anxiety Pain and fear Anger and hostility Depression Dependency Guilt Mental health problems Receiving unrelated bad news Concerns of the Critically Injured or Dying Patient

  17. Caring for the Critically Ill and Injured Patients • Avoid sad and grim comments. • Orient the patient. • Be honest.

  18. Caring for the Critically Ill and Injured Patients • Acknowledge the seriousness of the condition. • Allow for hope. • Locate and notify family members.

  19. Factors Affecting Patient Reactions • Mental disorders • Medication reactions • Age • Nutritional status • Guilt feelings • Socioeconomic background • Fear of medical personnel • Alcohol/substance abuse • Chronic diseases

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

  21. 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

  22. Components of CISM System • Pre-incident stress education • On-scene peer support • One-on-one support • Disaster support services • Defusings

  23. Components of CISM System • CISD • Follow-up services • Spouse and family support • Community outreach programs • Other wellness programs

  24. Stress Warning Signs and the Work Environment

  25. Physiological Manifestations of Stress • Rise in respirations and pulse • Increase in blood pressure • Cool, clammy skin • Dilated pupils

  26. Physiological Manifestations of Stress • Tensed muscles • Increase blood sugar levels • Perspiration • Decreased circulation to GI tract All caused by release of epinephrine

  27. Stress Warning Signs • Irritability toward family, friends, coworkers • Inability to concentrate • Insomnia or nightmares • Anxiety • Indecisiveness • Guilt • Loss of appetite • Isolation • Loss of interest in work

  28. Stress Management • Lifestyle changes • Eat healthy • Exercise • Relaxation • Meditation, visual imagery • Balance work, family, recreation and health

  29. Stress Management • Environmental Changes • Request assignments that allow more time with family and friends • Request duty assignment to less busy area • Seek professional help if needed

  30. Stress and Nutrition • Prolonged stress drains the body’s reserves. • Under stress, body’s fuel sources are consumed in large quantities. • Physical stress will deplete energy sources quicker.

  31. Stress and Nutrition • Glucose • Quickest source of energy • Taken from glycogen stored in liver • Proteins • Drawn from muscles • Long-term source of glucose

  32. Stress and Nutrition • 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.

  33. 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.

  34. Body Substance Isolation • EMT and patients protection • Assumes all body substances are infectious

  35. Basic Protection • Hand washing • Your best protection! • Before and after patient contact • Even if gloves were worn • Soap and Water preferred • Gel if soap and water not available

  36. Basic Protection • Gloves • Vinyl, Latex or synthetic • Used with contact of body fluids • Should be changed between patient contacts

  37. Basic Protection • Eye protection • Goggles or glasses • Prescription glasses need side shields • Worn with • Splashing • Spiting • Vomiting • Spurting

  38. Basic Protection • Masks • Blood Splatter • Surgical type • Airborne disease or particles • HEPA (High Efficiency Particulate Air) • N95 Respirator

  39. Basic Protection • Gowns • Used with large volumes of blood or other body fluids • Trauma • Child birth

  40. Scene Protection • Turnout gear • Gloves • Helmet • Eyewear • Footwear

  41. Scene Protection • Body Armor

  42. Scene Protection Concealment - hides your body Cover – hides and protects

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