EMT Chapter 2

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Workforce Safety and Wellness

Cover

Concealment for protection

PPE

Personal protective equipment

- e.g. gloves, gowns, and face shields

OSHA

Occupational Safety and Health Administration

- The federal regulatory compliance agency
- develops, publishes, and enforces guidelines concerning safety in the workplace

PTSD

Posttraumatic stress disorder

- A delayed stress reaction to a prior incident
- This delayed reaction is often the result of one or more unresolved issues concerning the incident.

General adaptation syndrome

-The body's response to stress
-begins with an alarm response, followed by a stage of reaction and resistance, and then recovery or, if the stress is prolonged, exhaustion.

Pathogen

- A microorganism
- is capable of causing disease in a susceptible host.

Transmission

- the way in which an infectious disease is spread: contact, airborne, by vehicles, or by vectors.

Postexposure Management

- encompasses reporting, documentation, and treatment

Emergency Response Guidebook

- A preliminary action guide for first responders
-operating at a hazardous materials incident in coordination with the US Department of Transportation's labels and placards marking system.
-The ERG was jointly developed by the DOT, the Secretariat of Communications and Transportation of Mexico, and Transport Canada.

Hepatitis

-Inflammation of the liver
-usually caused by a viral infection, that causes fever, loss of appetite, jaundice, fatigue, and altered liver function.

Infection control

-Procedures to reduce transmission of infection among patients and health care personnel

Exposure

-A situation
-a person has had contact with blood, body fluids, tissues, or airborne particles in a manner that suggests disease transmission may occur.

Two type of Sexual harassment

- Unwelcome sexual advance
1. Quid pro quo
- the harasser requests sexual favors in exchange for sth else

2. Hostile work environment
- jokes, touching, leering, requests for a date, talking about body parts

-> report to your supervisor immediately and keep notes

Contamination

-The presence of infectious organisms or foreign bodies on or in objects
- e.g. dressings, water, food, needles, wounds, or a patient's body.

Trauma

- Leading cause of death (fr age 1 to 40)

Cardiac arrest

- the heart fails to generate effective and detectable blood flow
- pulses are not palpable in cardiac arrest, even if muscular and electrical activity continues in the heart.

The grieving process

1. Denial - Refusal to accept diagnosis or care, unrealistic demands for miracles, or persistent failure to understand why there is no improvement
2. Anger, hostility - Projection of bad news onto the environment and commonly in all directions.
3. Bargaining - An attempt to secure a prize for good behavior or promise to change lifestyle.
4. Depression - Internalized anger, hopelessness, and the desire to die.
5. Acceptance - Acceptance of impending death by the patient, or the acceptance of the death of a loved one.

Concerns of the Dying, Critically Ill, or Injured Patient

- Anxiety
- Pain and fear
- Anger and Hostility
- Depression
- Dependency
- Guilt
- Mental health problems
- Receiving unrelated bad news

Stressors include:

Emotional, physical and environmental situations or conditions that may cause physiologic,physical, and psychological responses

The body's response to stress

Begins with an alarm response, followed by a stage of reaction and resistance, and the recovery or, if the stress is prolonged, exhaustion

Events that can trigger critical incident stress include:

- Mass-casualty incidents
- Serious injury or traumatic death of a child
- Crash with injuries, caused byan emergency services provider while responding to or from a call
- Death or serious injury of a coworker in the line of duty

Prolonged or excessive exposure to stress is known as:

Cumulative stress

CISM

Critical incident stress management

- A process that confronts the responses to critical incidents and defuses them, directing the emergency services personnel toward physical and emotional equilibrium.

Vital to an EMS operation

The personal health, safety, and well-being of all EMTs

The number one cause of all deaths today is:

Hearth disease

Cover and concealment

The tactical use of an impenetrable barrier for protection.

Infectious disease

The growth and spread of small, harmful organisms within the body

Direct contact

Transmission of a communicable disease from one person to another by physical contact

Standard precautions

Protective measures that have traditionally been developed by the Centers for Disease Control and Prevention for use in dealing with objects, blood, body fluids, and other potential exposure risks of communicable disease.

Infection

The abnormal invasion of a host or host tissues by organisms such as bacteria, viruses, or parasites, with or without signs or symptoms of disease.

Immune

The body's ability to protect itself from acquiring a disease.

Indirect contact

Exposure or transmission of disease from one person to another by contact with a contaminated object.

CDC

The primary federal agency that conducts and supports public health activities in the United States. The CDC is part of the US Department of Health and Human Services.

Bloodborne pathogens

Pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus and human immunodeficiency virus (HIV).

Infection control

Procedures to reduce transmission of infection among patients and health care personnel.

Transmission

The way in which an infectious disease is spread: contact, airborne, by vehicles, or by vectors.

HIV

human immunodeficiency virus

Acquired immunodeficiency syndrome (AIDS) is caused by HIV, which damages the cells in the body's immune system so that the body is unable to fight infection or certain cancers.

Designated officer

The individual in the department who is charged with the responsibility of managing exposures and infection control issues.

Host

The organism or individual that is attacked by the infecting agent.

Basic concept of stand and precautions

Assumption that every person is potentially infected or can spread an organism that transmitted in the health care setting. Therefore, you must apply infection-control procedures to reduce infection in patients and health care personnel.

Describe the process for proper handwashing

1. Use soap and water.
2. Rub your hands together for at least 20 seconds to work up a lather
3. Rinse your hands using warm water.
4. Dry your hands with a paper towel and use the paper to turn off the faucet.

List the three layers of clothing recommended for cold weather

1. Thin inner layer
2. Thermal middle layer
3. Outer layer

List the four principal determinants of violence

1. past history
2. Posture
3. Vocal activity
4. Physical activity

Proper glove removal technique

1. Partially remove the first glove by pinching at the wrist. Be careful to touch only the outside of the glove.
2. Remove the second glove by pinching the exterior with your partially gloved hand.
3. Pull the second glove inside-out toward the fingertips.
4. Grasp both gloves with your free hand, touching only the clean, interior surfaces.

Airborne transmission

The spread of an organism in aerosol form.

Foodborne transmission

The contamination of food or water with an organism than can cause disease.

Vector-borne transmission

The use of an animal to spread an organism from one person or place to another.

The simplest and most effective way to control disease transmission

Proper handwashing

2 Mask, 1 respirator, 2 barrier devices

Standard surgical mask

Nonrebreathing mask

HEPA respirator

Pocket mask or bag-mask device

Surgical mask

- If blood or body fluid spatter is a possibility
- place on patient if suspect has an airborne disease
- reduce the risk of transmission of germs from the patient into the air

If supect patient has tuberculosis

Surgical mask (patient) + HEPA high-efficiency particulate air respirator (self)

Nonrebreathing mask

If patient needs oxygen (set oxygen flow rate at 10 to 15/Lmin)

HEPA respirator

- High-efficiency particulate air respirator
- If suspect patient has tuberculosis
- should comply with OSHA standards, which state the facial hair (such as long sideburns or a mustache), will prevent a proper fit.

Pocket mask or bag-mask device

- mouth-to-mouth resuscitation

General Postexposure Management

If you are exposed to a patient's blood or bodily fluids:
- Turn over patient care to another EMS provider.
- Clean the exposed area.
- Rinse eyes if necessary.
- Activate your department's infection control plan.

Stress Management on the Job

-EMS is a high-stress job.
-Important to know causes and how to deal with stress

Physiologic signs of stress

-Increased respirations and heart rate
-Increased blood pressure
-Cool, clammy skin
-Dilated pupils
-Tensed muscles
-Increased blood glucose level
-Perspiration
-Decreased blood flow to gastrointestinal tract

General adaptation syndrome:

Alarm response to stress
Reaction and resistance
Recovery—or exhaustion

Prolonged or excessive stress has been proved:

To be a strong contributor to heart disease, hypertension, cancer, alcoholism, and depression

Warning Signs of Stress

-Irritability toward coworkers, family, friends
-Inability to concentrate
-Sleep difficulties
-Sadness, anxiety, or guilt
-Indecisiveness
-Loss of appetite
-Loss of interest in sexual activities
-Isolation
-Loss of interest in work
-Increased use of alcohol
-Recreational drug use
-Physical symptoms such as chronic pain
Headache
Backache
-Feelings of hopelessness

Strategies to Manage Stress

- Minimize or eliminate stressors.
- Change partners to avoid a negative or hostile personality.
- Change work hours.
- Change the work environment.
- Cut back on overtime.
- Change your attitude about the stressor.
- Talk about your feelings.
- Seek professional counseling if needed.
- Do not obsess over frustrations.
- Try to adopt relaxed, philosophical outlook.
- Expand social support system.
- Sustain friends and interests outside emergency services.
- Minimize physical response to stress
- Deep breathing
- Periodic stretching
- Regular exercise

Three sources of body's fuel

- Carbohydrate
- Fat
- Protein

Glucose

-Take from stored glycogen in the liver
- supply will last less than a day

Protein

-Drawn primarily from muscle, is a long-term source of fule

Fat

- Used by fat for energy

Death occurs

-Quite suddenly
-After a prolonged, terminal illness

The EMT's role in Death and Dying:

- Ask how you can help.
- Reinforce reality.
- Be honest.
- Allow the patient/family to grieve.

Caring for Critically Ill and Injured Patients

Avoid sad and grim comments.
- Orient the patient.
- Be honest.
- Deal with possible initial refusal of care.
- Allow for hope.
- Locate and notify family members.

Scene Safety

- Begin protecting yourself as soon as you are dispatched.
- before leave scene, begin preparing yourself mentally and physically.
- make sure wear seatbelts and shoulder harnesses at all times during transport.

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