Paramedic

1. Copyright © 2023 by Jones & Bartlett Learning, LLC, an Ascend Learning Company and the American Academy of Orthopaedic Surgeons.
Workforce Safety
and Wellness
CHAPTER 2

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Introduction (1 of 2)
 A paramedic’s job is very gratifying but also very demanding.
 The most important factor is your personal wellness and safety.
 Scene safety issues
 Do not compromise your safety.
 Maintain your health from the beginning.

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Introduction (2 of 2)
 Data from NHTSA show an annual estimate of 1,500 ambulance crashes in the
United States.
 New paramedics should be aware of their:
 Own health and well-being
 Limitations
 The scene is never safe, and EMS providers should never let their guard down!

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Components of Well-Being
 Wellness is the quality or state of being in good health.
 Components of wellness:
 Physical
 Mental
 Emotional

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Physical Well-Being (1 of 2)
 Providers who are physically in shape:
 Are less likely to become injured or ill
 May heal more quickly if injured
 Have a better quality of life

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Physical Well-Being (2 of 2)
 The AHA’s Life’s Simple 7 are factors that improve heart health.
 Get active, control cholesterol, eat better, manage blood pressure, lose weight,
reduce blood sugar, stop smoking
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Nutrition (1 of 5)
 Nutritional information changes regularly, but current nutritional guidelines are
readily available.
 Consequences of poor nutrition
 Eat foods in suggested portions from six main categories.
 Each person’s requirements are different.

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Nutrition (2 of 5)
 Vegetables
 Fruits
 Grains
 Dairy
 Protein foods
 Oils
Courtesy of USDA.

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Nutrition (3 of 5)
 Read nutrition labels of prepared or processed foods.
 Review:
 Sodium levels
 Amount and type of fat
 Composition of carbohydrates

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Nutrition (4 of 5)
 Beware of:
 Fat-free products
 Look for:
 High-fiber content foods
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Nutrition (5 of 5)
 Plan for your shift as if you will get minimal time to rest or to eat a meal.
 What to bring
 What to avoid

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Weight Control
 The USDA’s dietary guidelines recommendations.
 Make healthy food choices and avoid dieting.
 Gradual weight reduction is key.

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Exercise (1 of 3)
 Benefits of exercise
 The exercise program for you depends on personal preferences and fitness
goals.

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Exercise (2 of 3)
 Your exercise program should be targeted at maintaining or improving:
 Cardiovascular endurance
 Flexibility
 Overall physical strength
 Consult your primary care physician before beginning an exercise program.

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Exercise (3 of 3)
 Adults should engage in 30 minutes
of moderate to vigorous physical
activity every day.
 Attempt to reach your target heart
rate.
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Smoking and Tobacco
 If you don’t smoke, don’t start!
 Everyone responds differently to smoke.
 Options for smoking cessation
 Electronic cigarettes

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Alcohol Use
 Alcohol is a drug that can modify how the brain perceives stress.
 Alcohol cannot alleviate stress.
 The stress persists beyond the duration of the alcohol’s effects.
 Using alcohol to cope can lead to dependence.

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Circadian Rhythms and Shift Work
 Your job as a paramedic will often conflict with your body’s circadian rhythms.
 Ignoring your circadian rhythms can lead to several problems.
 Determine your natural rhythms.
 Tips for dealing with shift work
 Do not overlook the need for sleep.

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Periodic Health Risk Assessments
 Hereditary factors may affect your overall health.
 Consider researching your family history.
 Build health assessments into your routine physical checkups.

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Body Mechanics (1 of 3)
 A paramedic is required to lift and move a variety of patients.
 Develop the following habits:
 Minimize the number of total body lifts you have to perform.
 Coordinate every lift prior to performing the lift.
 Minimize the total amount of weight you have to lift.

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Body Mechanics (2 of 3)
 Habits (cont’d)
 Never lift with your back.
 Always lift with your legs!
 Breathe
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Body Mechanics (3 of 3)
 Habits (cont’d)
 Do not carry what you can put on
wheels.
 Ask for help.
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Mental Well-Being
 When you are subjected to stress, the fight-or-flight response is activated.
 A paramedic needs to be in control of his or her emotions.

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Emotional Well-Being
 Make a deliberate effort to create a healthy balance between your work and
home life.
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Spiritual Well-Being
 Human spirituality is an unseen dimension of human experience.
 Medical care supports the dignity and value of life and the sacredness of all
people.

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Disease Transmission (1 of 2)
 Paramedics are called on to treat and transport patients with a variety of
communicable and infectious diseases.
 Inform other health care providers who may come in contact with the patient.

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Disease Transmission (2 of 2)
 Infectious diseases can be transmitted in various ways:
 Contact (direct or indirect)
 Airborne
 Foodborne
 Vector-borne (insects or parasitic worms)

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Management of an Exposure
 Follow your department’s infection control plan, such as:
 Turn over care to another EMS provider.
 Wash affected area with soap and water.
 If eyes were exposed, rinse them with water for at least 20 minutes as soon as
possible.
 Comply with all reporting requirements.
 Get a medical evaluation.
 Obtain proper immunization boosters.
 Document the incident.

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Protecting Yourself
 Due to the COVID-19 pandemic, EMS practices are changing rapidly.
 Recommendations for protection updated as research and best practices shared
 EMS follows standard precautions.
 Prevention begins with personal health.
 Annual examinations
 Immunizations

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Personal Protective Equipment and Practices (1 of 4)
 At a minimum, each ambulance
should have:
 Gloves
 Facial protection
 Gowns
 N95 or N100 respirators
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Personal Protective Equipment and Practices (2 of 4)
 Important infection control
practices:
 Wear gloves.
 Wash your hands.
 Use hand lotion.
 Use eye protection.
 Wear a mask.
 Protect your body.
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Personal Protective Equipment and Practices (3 of 4)
 Infection control practices (cont’d):
 N95 or N100 respirators
 Clean your ambulance and
equipment.
 Properly dispose of sharps.
 Wear appropriate turnout gear. © science photo/Shutterstock
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Personal Protective Equipment and Practices (4 of 4)
 Infection control practices (cont’d):
 Wear gloves, helmets, and boots
 Protect your eyes, ears, and skin
 Consider body armor

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Hostile Situations (1 of 2)
 EMS should not arrive on scene first.
 Scrutinize all information.
 Ask for law enforcement response to any suspicious call.

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Hostile Situations (2 of 2)
 Once in contact with a hostile patient:
 Listen more and talk less.
 Do not argue or ridicule.
 Concentrate on de-escalating emotions.
 Show empathy.
 Be aware of the environment.

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Traffic Incidents (1 of 2)
 Primary concern is safety for
yourself and those around you.
 It is important to stay aware of your
surroundings, even the familiar
ones.
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Traffic Incidents (2 of 2)
 Make physical observations a mile before you approach the scene.
 Approach should include:
 Visual assessment of entire surroundings
 Looking for hazards
 Becoming familiar with response area to determine safest route
 Alerting those available to help

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Power Lines and Lightning Hazards
 Dealing with power lines is beyond the scope of paramedic training.
 Mark off a danger zone around such lines.
 Use utility poles as landmarks.
 Do not approach downed wires or touch anything wires have contacted, including
patients.
 Get inside your vehicle or unit!

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Stress (1 of 3)
 EMS is a high-stress job.
 Understanding the causes of stress and how to deal with them is critical to your:
 Job performance
 Health
 Interpersonal relationships

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Stress (2 of 3)
 You need to understand:
 What stress is
 Its physiologic effects
 What you can do to minimize these effects
 How to deal with stress on an emotional level

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Stress (3 of 3)
 Any event that causes us to react
physically, emotionally, or mentally
is considered stress.
 Stress is neither good nor bad.
 Eustress
 Distress
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What Triggers Stress?
 A stress response often begins with events that are perceived as threatening or
demanding.

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Physiology of Acute Stress (1 of 2)
 When a person perceives an event as threatening, a standard series of
physiologic reactions are triggered.
 Prepares us for fight-or-flight response

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Physiology of Acute Stress (2 of 2)
 Reactions to stress can be:
 Acute
 Delayed
 Cumulative
 Stress can result in many physical and psychological symptoms.
 Prolonged or excessive stress is a strong contributor to:
 Heart disease
 Hypertension
 Cancer
 Depression
 Job burnout

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Responses of Patients to Illness and Injury (1 of 2)
 Responses to emergencies are
determined by personal methods of
adapting to stress.
 Common reactions include:
 Fear
 Depression
 Anxiety
 Anger
 Confusion
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Responses of Patients to Illness and Injury (2 of 2)
 Psychological defense mechanisms
include:
 Denial
 Regression
 Projection
 Displacement
 Reactions to illness or injury are
often rooted in the patient’s culture.
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Responses of Family, Friends, and Bystanders (1 of 2)
 Bystanders and family members may exhibit responses similar to the patient’s.
 Paramedics should remember:
 Do not take it personally.
 Remain calm.
 Reassure.

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Responses of Family, Friends, and Bystanders (2 of 2)
 Situations where people should be removed from the scene, but not left alone:
 Anxiety
 Blind panic
 Depression
 Overreaction
 Conversion hysteria

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Paramedic Responses
 Paramedics are not immune to stress.
 Avoid becoming irritated with a patient who does not seem ill or injured.
 Recognize the signs of compassion fatigue so that it does not interfere with
your work or family life.

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Coping With Your Own Stress (1 of 2)
 Early warning signs of stress
 Identify your body’s reaction to the fight-or-flight response.

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Coping With Your Own Stress (2 of 2)
 Management techniques include:
 Controlled deep breathing
 Progressive relaxation
 Professional assistance
 Focus on the immediate situation
 Attempt to get enough rest
 Exercise
 Befriend a coworker
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Burnout (1 of 2)
 The exhaustion of physical or emotional strength
 May be a consequence of chronic, unrelieved stress
 The timeline for burnout will vary among people.
 Avoid false beliefs that can lead to burnout.
 Signs and symptoms

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Burnout (2 of 2)
 The paramedics who do not
experience burnout have learned to
respect and value themselves.
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Coping With Death and Dying
 Encounters with life and death are an honor.
 Births and deaths are a holy time in some cultures.
 You will help many people.

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Stages of the Grieving Process
 The stages of grieving include:
 Denial
 Anger
 Bargaining
 Depression
 Acceptance
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Dealing With a Dying Patient
 People who are dying generally know their situation is serious.
 Dying patients need to feel they still have some control over their lives.
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Dealing With a Grieving Family
 Even if there is nothing you can do
for the patient, the call is not over.
 Do not try to hide the body from
the family.
 Do not use euphemisms.
 Do not hurry to clear away
resuscitation equipment.
 Give the family time with their
loved one.
 Try to arrange for further support. © Glen E. Ellman.

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and
the
American
Academy
of
Orthopaedic
Surgeons.
Dealing With a Grieving Child
 Be particularly sensitive to the emotional needs of children.
 Children up to 3 years of age will not be aware.
 3- to 6-year-olds believe death is temporary.
 6- to 9-year-olds may mask their feelings.
 9- to 12-year-olds may want to know details.

59. Copyright
©
2023
by
Jones
&
Bartlett
Learning,
LLC,
an
Ascend
Learning
Company
and
the
American
Academy
of
Orthopaedic
Surgeons.
After the Call Is Over (1 of 3)
 Everyone involved in shocking calls is likely to experience some intense
feelings.
 Do not keep feelings inside.
 Every service should have debriefing procedures.
 Watch for PTSD after critical incidents.

60. Copyright
©
2023
by
Jones
&
Bartlett
Learning,
LLC,
an
Ascend
Learning
Company
and
the
American
Academy
of
Orthopaedic
Surgeons.
After the Call Is Over (2 of 3)
 Critical incident stress management (CISM) is a resource for emergency
personnel involved in particularly traumatic calls.
 Reactions are impossible to predict.
 Give opportunities to debrief.
 Never force someone to share their feelings or make debriefings mandatory.

61. Copyright
©
2023
by
Jones
&
Bartlett
Learning,
LLC,
an
Ascend
Learning
Company
and
the
American
Academy
of
Orthopaedic
Surgeons.
After the Call Is Over (3 of 3)
 Employee assistance programs (EAPs)
 Provided by trained, professional counselor who works outside of the service and is
available off duty
 EAPs are successful only if those who attend do so voluntarily and are willing to
share issues that bother them.

62. Copyright
©
2023
by
Jones
&
Bartlett
Learning,
LLC,
an
Ascend
Learning
Company
and
the
American
Academy
of
Orthopaedic
Surgeons.
Peer Support and Suicide Prevention
 EMS providers are not immune to thoughts of suicide or suicide attempts.
 Prevention starts with recognizing that you or a colleague are becoming
overwhelmed.