Well Being of First Responder9/9/08

As a first responder may encounter someone dealing with an emotional crisis (highly emotional state resulting from stress)

Victim will depend on you and your directions

You as the first responder will also feel emotions and the stress from an incident

Death and Dying

Stressful for family and you, especially sudden death

Always attempt to resuscitate a body that feels warm or a victim of extreme cold until otherwise directed

DNR (Do not resuscitate)- legal orders written saying that they do not wish to be resuscitated of kept alive by mechanical means

Families and Grieving Approach a family with care and comfort with

positive statements such as, “We are doing everything we can”.

Avoid discussing the victim’s condition Steps in the grieving process

Anxiety Denial/disbelief Anger Bargaining Guilt/depression acceptance

Stress

Body’s normal response to any situation that changes a person’s existing mental, physical, or emotional balance

Signs and symptoms Irritability towards co-workers, family and friends Inability to concentrate Difficulty sleeping or nightmares Anxiety Indecisiveness Guilt Loss or increase in appetite Loss or interest in sexual activites Isolation Loss of interest in work and family

CISD

Critical incident stress debriefingCounseling to help deal with stress for first

responders and medical personnel

Cumulative stress- stress building over a period of days, weeks, months, or even years

Meeting is usually held within 24 to 72 hours of a major incident

Scene Safety

Size up an emergency scene for safety by looking at the following keys:Location of emergencyExtent of the emergencyApparent scene dangersApparent number of ill or injured peopleBehavior of victim(s) and bystanders

If a scene seems unsafe you may need to move the emergency

For example: presence of explosives or hazardous

materials fire or danger of fire inability to make scene safe need to get to other victims requiring

lifesaving care

Hazardous Materials

HAZMATLook for signs-

Signs (placards) on vehicles, storage facilities or railroad cars

Clouds of vaporSpilled liquids or solidsUnusual odorsLeaking containers, bottles, or gas cylindersChemical transport tanks or containers

Motor Vehicle Crashes

Do not attempt to rescue until wreckage has been stabilized

Make sure you have proper training and equipment such as turn-out gear (flame and puncture resistant outwear), safety glasses, gloves, and a helmet

Violence

Do not enter the scene until summoned by law enforcement personnel

Do not touch anything except what you must to give care

Additional Emergency Situations

Traffic: put up reflectors, flares, or lights to direct traffic, leave a path for arriving emergency vehicles

Fire: do not enter a building without proper equipment and training, do not open hot doors or use elevators

Electricity: assume all downed wires are dangerous and contact fire and power company

Cont.

Water and Ice: follow reach-throw-row, never enter a body of water, fast moving water, or ice unless you have been trained

Unsafe structures: do not enter call for trained equipment personnel, gather information about victims

Natural disasters: report to person in charge, follow rescue plan

Multiple victims: care for victim’s with most life-threatening conditions first

Cont.

Hostile situations: if threatened retreat to safety, get law enforcement personnel

Suicide: do not enter until told by law enforcement, do not touch anything unless to give care

Hostage situations: do not enter until told by law personnel, gather as much info about victims as possible

Legal and Ethical issues

Good Samaritan LawServe the physical and emotional needs

with respect for human dignity and with no regard to nationality, race, gender, creed, or status

Before giving care, determine patient’s competence and get either express or implied consent

Competent adult has the right to refuse treatment or withdraw treatment

Cont.

Duty to act, if there is a breach of duty could be charged with abandonment or negligence

Patient’s history, condition, and emergency care are confidential

If called to a potential crime scene, police must be notified

Special reporting: report child, elder, or spouse abuse, injury that is result of crime including sexual assault, and infectious disease exposure

AVPU

Alert

Verbal

Painful

Unresponsive

Able to respond to appropriately to questions

Responds appropriately to verbal stimuli

Only responds to painful stimuli

Does not respond

Role Play

Pair up with someone around youEveryone will be handed a cardAct out the way you think a patient mightSee if your partner can guess level of

consciousness

Homework for Chapter 2

Workbook: pg. 12 case study 2.1 and 2.2, and self assessment questions 1-15.