Chapter 02
Chapter 02
Chapter 02
Cognitive Objectives (1 of 3)
12.8 Discuss the importance of body substance
isolation (BSI).
12.9 Describe the steps the EMTBasic should take for
personal protection from airborne and
bloodborne pathogens.
12.10 List the personal protective equipment necessary
for each of the following situations:
• Hazardous materials • Exposure to bloodborne
• Rescue operations pathogens
• Violent scenes • Exposure to airborne
pathogens.
• Crime scenes
Affective Objective
1-2.11 Explain the rationale for serving as an advocate for
the use of appropriate protective equipment.
Psychomotor Objectives
1-2.12 Given a scenario with potential infectious exposure,
the EMT-Basic will use appropriate personal
protective equipment. At the completion of the
scenario, the EMT-Basic will properly remove and
discard the protective garments.
1-2.13 Given the above scenario, the EMT-Basic will
complete disinfection/cleaning and all reporting
documentation.
Additional Objectives (1 of 3)
Cognitive
1. Describe the various ways by which
communicable diseases can be transmitted from
one person to another.
2. Define the term “universal precautions” and
describe when it is appropriate to use such
measures.
3. Identify appropriate task-specific personal
protective equipment.
Additional Objectives (2 of 3)
Cognitive
• Dependency
Caring for Critically Ill and Injured
Patients (1 of 2)
• Avoid sad and grim
comments.
• Orient the patient.
• Be honest.
Caring for Critically Ill and Injured
Patients (2 of 2)
• Acknowledge the seriousness of the
condition.
• Allow for hope.
• Locate and notify family members.
Injured and Critically Ill Children
• Basic treatments remain the same.
• Consider variations between children and
adults.
• Being accompanied by a relative may relieve
the child’s anxiety.
Dealing With the Death of a Child
• A child’s death is a tragic event for
both EMT-Bs and the family.
• How the family deals with the death
will affect its stability.
• EMT-B is responsible for helping the
family.
Helping the Family
• Acknowledge the fact of the child’s death in a
private place.
• Tell the parents that they may see their child.
• Do not overload the parents with information.
• Parents should be encouraged to talk about their
feelings.
Stressful Situations
• Mass-casualty situations
• Infant and child trauma
• Amputations
• Abuse
• Death or injury of a coworker
Factors Affecting Patient Reactions
to Stressful Situations
• Fear of medical • Medication reactions
personnel
• Age
• Alcohol/substance
• Nutritional status
abuse
• Guilt feelings
• Chronic diseases
• Past experience
• Mental disorders
Uncertain Situations
• When uncertain if the patient’s condition is an
emergency, contact medical control.
• Minor symptoms may be early signs of severe
illness or injury.
• When in doubt, err on the side of caution.
Stress Warning Signs and the
Work Environment
• EMS is a high-stress job.
– Understand the causes of stress.
– Prevent stress from negatively affecting
you.
Physiological Manifestations of the
Fight-or-Flight Response (1 of 2)
• Rise in respirations and pulse
• Increase in blood pressure
• Cool, clammy skin
• Dilated pupils
Physiological Manifestations of the
Fight-or-Flight Response (2 of 2)
• Tensed muscles
• Increase blood glucose levels
• Perspiration
• Decreased circulation to GI tract
Physical Symptoms of Stress
• Fatigue
• Changes in appetite
• Headaches
• Insomnia/hypersomnia
• Irritability
Psychological Reactions
to Stress
• Fear
• Depression
• Anger
• Frustration
Critical Incidents
• Mass-casualty incidents
• Traumatic injury or death
of child
• Automobile crash caused
by EMS personnel
• Serious injury or death of
coworker
Signs and Symptoms of
Posttraumatic Stress Disorder
• Depression
• Startle reactions
• Flashback phenomena
• Amnesia of event
Critical Incident Stress
Management
• Confronts responses to critical incidents and
defuses them
• Process designed to help EMS personnel deal with
responses to critical incidents
• Composed of trained peers and mental health
professionals
Stress and Nutrition (1 of 3)
• Prolonged stress
drains the body’s
reserves.
• Under stress, body’s
fuel sources are
consumed in large
quantities.
Stress and Nutrition (2 of 3)
• Glucose
– Quickest source of energy
– Taken from glycogen stored in liver
• Proteins
– Drawn from muscles
– Long-term source of glucose
Stress and Nutrition (3 of 3)
• Fats
– Used by tissues for energy
• Water
– Conserved by retaining sodium
• Vitamins and minerals
– Depletes vitamins B, C, and most minerals that are
not stored in large amounts by the body
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.
Critical Incident Stress
Debriefing (CISD)
• Held within 24 to 72 hours of a major incident
• All information is confidential.
• CISD leaders and mental health personnel offer
suggestions for overcoming the stress.
Components of CISM System (1 of 2)
• Preincident stress
education
• On-scene peer
support
• Disaster support
services
• Defusings
Components of CISM System (2 of 2)
• CISD
• Follow-up services
• Spouse and family support
• Community outreach programs
• Other wellness programs
Stress Management
• There are positive and negative ways of
handling stress.
• Stress is unavoidable.
• Understand the effects of stress.
• Find balance in life.
Strategies to Manage Stress (1 of 2)
• Change or eliminate stressors.
• Change partners to avoid negative or hostile
personality.
• Stop complaining or worrying about things you
cannot change.
• Expand your social support system.
Strategies to Manage Stress (2 or 2)
• Minimize the physical response by:
– Stretching
• Domestic disputes
• Crime scenes
• Large gatherings
Safety
• If personal safety is in
doubt, do not place
yourself at risk.
Behavioral Emergencies
• Determinants of violence
– Past history
– Posture
– Vocal activity
– Physical activity