Chapter 2 Emergency Medical Responder Safety and Wellness
OBJECTIVES DIRECTORY 1. Define key terms introduced in this chapter. 55-56 2. List indications of the potential for danger to yourself or others at the scene of an EMS call. 11-13 3. Given a scenario of an emergency call, describe how you could use each of the following principles to protect yourself: 14-15 a. Cover b. Concealment c. Distraction d. Retreat
OBJECTIVES DIRECTORY 4. Explain the importance of assessing an emergency scene from a distance. 16 5. Describe the role of each of the following measures in protecting yourself from disease and injury in your work as an EMR: 17-28 a. Regular physical examination b. Vaccinations c. Personal protective equipment (gloves, eye and face protection, respiratory protection, gown) d. Hand washing e. Reporting exposure to communicable disease
OBJECTIVES DIRECTORY 6. Give examples of common stressors for EMS personnel. 29-31 7. Recognize behaviors in yourself or others that are signs of stress. 32 8. Describe actions that you can take, and things you should avoid, to prevent and reduce stress. 33 9. Describe signs that a patient is dead and cannot be resuscitated. 34-36
OBJECTIVES DIRECTORY 10. Explain each of the following reactions to grief: 37-38 a. Denial b. Anger c. Bargaining d. Depression e. Acceptance 11.Give examples of instances when you mayneed to use an emergent or urgent move to relocate or reposition a patient before additional help arrives. 45-46, 49
OBJECTIVES DIRECTORY 12.Demonstrate the use of good body mechanics when lifting. 39-42, 44 13.Given a scenario in which a patient must be moved or repositioned, explain the principles you will follow to move the patient with regard to both your safety and well-being and the patient s. 47-48, 50 14. Explain the basic principles of patient restraint. 51-53
MULTIMEDIA DIRECTORY Slide 27 Slide 28 Slide 38 Putting on Gloves Video Epidemiology of AIDS Video Grief and the Death of a Child Video
TOPICS Scene Safety Protection from Disease Stress Death and Dying Lifting and Moving Patients Patient Restraint
INTRODUCTION Scene safety Taking care of yourself
CASE STUDY: THE CALL Environment Residence Dispatch Man down call Caller is still on the line Husband fell in the bathroom Caller cannot wake him up
Scene Safety Back to Topics
Photo: Craig Jackson/ In the Dark Photography
Protecting Yourself from Violence Observation Signs of violence Weapons Crowds Drugs or alcohol Back to Objectives
Cover and Concealment Take cover Concealment Take cover Concealment
Distraction and Retreat Distraction Retreat Back to Objectives
Other Scene Hazards Hazardous materials Placards Downed power lines Unstable vehicles Confined spaces Back to Objectives
Protection from Disease Back to Topics
Photo: Mark C. Ide
Protection from Disease Standard Precautions Body fluids Airborne droplets
Before the Response Vaccinations Tetanus Hepatitis A Hepatitis B Measles, mumps, and rubella (MMR) Chicken pox Influenza
During the Response Personal Protective Equipment Protect yourself from disease Don appropriate equipment
During During the the Response Personal Response Personal Protective Protective Equipment Equipment Eye and face protection Safety glasses Eye and face protection Surgical mask Face shield Safety glasses Surgical mask Face shield
During the Response Personal Protective Equipment Respiratory protection Respiratory protection
During the Response Personal Protective Equipment Gown Protects clothes from being contaminated For major trauma For childbirth
Exposure to an Infectious Substance Exposure Infectious disease exposure procedure What to do if you re exposed
Hand Washing Hand Washing Use warm water Use warm water Scrub Scrub Use a brush Use if a brush if necessary necessary Rinse Rinse Dry Dry Turn off water Turn off water with a barrier with a barrier
Putting on Gloves Click on the screenshot to view a video on putting on gloves. Back to to Directory
Epidemiology of AIDS Click on the screenshot to view a video on the epidemiology of AIDS. Back to Directory Back Directory Back Objectives
Stress Back to Topics
Photo: Charles H. Porter IV/SYGMA
Stressors Stressors Life-threatening situations Seeing the stress of patient, family, or bystander Seriously ill or injured patients Death of patient or coworker Multiple patients Pediatric patients Photo: BlackStar Back to Objectives
Signs of Stress Difficulty sleeping or nightmares Irritability Sadness, anxiety, or guilt Indecisiveness Loss of appetite Loss of interest in sexual activity Isolation Loss of interest in work Inability to concentrate Feelings of hopelessness Misuse of drugs or alcohol Signs of physical illness Back to Objectives
Dealing Dealing with with Stress Stress Everyone experiences it Everyone experiences it Lifestyle Lifestyle changes changes Professional Professional help help Back to Objectives
Death and Dying Back to Topics
Death and Dying Experiencing death is inevitable Signs of death Tissue decay Rigor mortis Obvious signs incompatible with life Back to Objectives
Dealing with Grieving Denial Anger Bargaining Depression Acceptance
Grief and a Child s Death Click on the screenshot to view a video on grief over a child s death. Back to Directory Back Directory Back Objectives
Lifting and Moving Patients Back to Topics
Lifting and Moving Patients Body mechanics The lift Positioning patients for comfort and safety
Body Mechanics Keep your back in line Keep your back in line Use a firm and secure Use grip a firm and secure grip Ensure solid footing Ensure solid footing Do not twist Do not twist Communicate Communicate Back to Objectives
CASE STUDY: THE RESPONSE The patient s wife is waving you into the house Patient was on the toilet and collapsed You don gloves and eye protection Police arrive on scene Patient is pulseless Patient is located in a small bathroom You successfully move the patient to another room
The Lift Foot placement Grip Foot placement Bend at your knees Communicate Grip Communicate Weight close to you Bend at your Weight kneesclose to you Back to Objectives
Positioning Patients for Safety and Comfort Emergency moves Urgent moves
Positioning Patients for Safety and Comfort Emergency moves Fire or risk of explosion Unstable vehicles or surfaces Cardiac arrest The need to access other patients Back to Objectives
Positioning Patients Positioning for Patients Safety for and Safety and Comfort Comfort Drag Drag
Positioning Positioning Patients for Patients for Safety and Safety and Comfort Comfort Cradle carry Cradle carry Back to Objectives
Positioning Patients for Safety and Comfort Urgent moves Urgent Inadequate moves breathing Inadequate breathing Altered mental status Altered mental status Shock Hypothermia Back to Objectives
Positioning Patients for for Safety and and Comfort Position of comfort Recovery position Supine position Position of comfort Recovery position Supine position Back to Objectives
Patient Restraint Back to Topics
Photo: Craig Jackson/ In the Dark Photography
Patient Restraint Protect the patient and others Practice safety first Coordinate effort Move swiftly and decisively Position the patient face up Back to Objectives
CASE STUDY: TRANSITION EMS arrives as you are performing CPR You provide information to the EMS crew You offer to continue helping
REVIEW Define the following terms Cover Concealment Distraction Retreat Hazardous materials Placards Standard Precautions Airborne droplets Personal protective equipment (PPE) CONTINUED
REVIEW Define the following terms HEPA mask Rigor mortis Emergency moves Urgent moves Recovery position Supine Back to Objectives
STOP, REVIEW, REMEMBER The best method to protect yourself from danger is to a) know defensive tactics. b) practice concealment. c) know how far you can go before encountering danger. d) be observant and avoid danger altogether. CONTINUED
STOP, REVIEW, REMEMBER The difference between concealment and cover is a) concealment hides your body, and cover protects it. b) concealment protects your body, and cover hides it. c) concealment would stop a bullet, and cover won t. d) cover is rarely found at emergency scenes, and concealment is common. CONTINUED
STOP, REVIEW, REMEMBER Standard precautions are best defined as a) taking all possible protection against disease whether or not there is a risk of transmission. b) practices to prevent exposure to disease. c) wearing gloves on any call. d) wearing gloves and eyewear on any call.
REVIEW Discussion 1. List three things to consider before lifting a patient. 2. List the five stages of death and dying. 3. Describe the steps of proper hand washing. 4. List some signs of stress. 5. Explain types of PPE and when they are indicated.
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