Chapter 2 Knowledge Objectives: Workforce Safety and Wellness

Define "infectious disease" and "communicable disease" Ch.2 #1 Pg. 33

infectious disease- medical condition caused by growth and spread of small, harmful organisms within the body

Communicable disease- can spread from one person or species to another

-all bloodborne diseases are communicable diseases (ex: HIV) but not all communicable diseases are bloodborne

Describe the routes of disease transmission Ch.2 #2 Pg. 33-35

-transmission- way infectious disease if spread

-ways: contact (direct or indirect); airborne; foodborne; vector borne (transmitted through insects or parasitic worms)

-Direct contact- through touch without intermediary ex: HIV- immunodeficiency virus (sexual transmission) or bloodborne pathogens through blood

-Indirect Contact- transmission from person to inanimate object (called fomite) to another person

-Airborne- spreading disease through airbonrne mechanisms ex: common cold- sneezing direct contact and airborne routes

-Foodborne transmission- contamination of food and water that can cause disease

-Vector-borne transmission- involves spread of infection by animals or insects that carry fromm person to person ex: rabies and lyme disease and plague

Understand the standard precautions that are used in treating patients to prevent infection Ch.2 #3 Pg. 35-40

Occuptational Safety and Health Admin- OSHA- guidelines in workplace

-requires EMTs to be trained in handling bloodborne pathogens

-Centers for Disease Control and Prevention (CDC)- developed set of standard precautions for health care workers to use when treating patients

-CDC says- assume everyone is infected

-handwashing simplest and most effective way to control disease transmission

Describe the steps to take for personal protection from airborne and bloodborne pathogens Ch.2 #4 Pg. 35-40

-wash hands

-gloves- wear double gloves if substantial bleeding; most common type personal protection equipmwnt

-gowns- protects from extensive blood splatter

-eye protection- blood splatter toward eyes

-face shield- toward face and eyes

-Masks, Respirators and Barrier Devices-

-tuberculosis- place mask on patient and high efficiency particulate air (HEPA) respirator on yourself

-if patient needs oxygen- place nonbreathing mask on patient set O2 flow rate to 10-15 L/min

Understand the mode of transmission and the steps to prevent and/or deal with an exposure to hepatitis, tuberculosis, and HIV/AIDS Ch.2 #5 Pg. 33-45

-Handling needles/sharps can cause spread HIV/AIDS

-Sharps- do not recap, bend or break needles- dispose properly

-cleaning ambulance is essential for prevention

-Partial immunity- ex: tuberculosis- when immune system is down signs of tuberculosis and protected from infection from new person

Understand how immunity to infectious diseases is acquired Ch.2 #6 Pg. 43-45

-Full immunity/lifelong- Hep A, Hep B, Rubella, Measles, Mumps, Polio

-partial immunity- chickenpox, Tb

-no immunity- HIV, syphilis, gonorrhea

Explain postexposure management of exposure to patient blood or body fluids, including completing postexposure report Ch.2 #7 Pg. 45

1) turn over patient care to another EMS provider

2) when safe- clean area with soap and water or rinse eyes at least 20 min

3) activate department infection control plan

4) contact supervisor

5)follow up evalutationby physician/ screening- blood drawn maybe

6) exposure report- when happen? What doing when happened? etc

Understand the physiologic, physical, and psychological reponses to stress Ch.2 #8 Pg. 45-47

General Adaptation syndrome

Stress sign- perspiration, increased HR and BP, dilated blood vessels near skin surface (causing cool and clammy skin); dilated pupils; tensed muscles; increased glucose levels; decreased blood flow to GI tract

-Acute stress- stressed in the moment (vs delayed stress- can function then but not later)

-Cumulative Stress reactions- cumulative stress occurs when EMT is exposed to prolonged or excessive stress; each stressful event EMT is finding it harder and harder to recover- symptoms: fatigue; changes in appetite; GI problems, headaches

Describe PTSD and steps that can be taken, including critical incident stress management, to decrease the likelihood that PTSD will develop Ch.2 #9 Pg. 46-47

can be experienced after person experiences psychologically distressing event

-symptoms: depression, flashbacks phenomena, dissociative episodes

-Critical incident stress management (CISM)- developed to address acute stress situations

-defusing sessions

-give guidance within 24-72 hours of major incident

State the steps that contribute to wellness and their importance in managing stress Ch.2 #10 Pg. 48-52

-in stressful situation understand focus- patient care; recognize you are not alone; stay calm;

-Table 2-5

-change work hours; eliminate stressors; cut back overtime, etc

- nutrition

Discuss workplace issues such as cultural diversity, sexual harassment and substance abuse Ch.2 #11 Pg. 52-54

Be respectiful of those from different cultures; get skills from broader range of people; don't patronize;

Sexual Harassment-

1) quid pro quo- harasser requests sexual favors in exchange for something like a promotrion

2) hostile work environment- jokes, touching ,leering, etc

Substance Abuse- have right to confront cowrokers with substance abuse issues

Understand the emotional aspects of emergency care Ch.2 #12 Pg. 54-55

normal to have emotions when asked to recover a body- keep emotions under control though

Describe issues concerning care of the dying patient, death and the grieving process of family members Ch.2 #13 Pg. 55-58

-Grieving-

1. Denial

2. Anger, hostility

3. Bargaining

4. Depression

5. Acceptance

-Ask if there is anything you can do- relative or religious advisor

provide gentle caring support

-grieving person needs to be validated (don't suggest silver lining); do not give false hope; be sincere; "I am so sorry for your loss"

Understand the care of critically ill and injured patients Ch.2 #14 Pg. 58-60

-may feel helpless, disabled, painful, separation

-symptoms anxious: emotional upset, sweaty and cool skin (diaphoretic); rapid breathing (hyperventilating); fast pulse (tachycardic); restlessness; tension; fear; shakiness

-encourage to express pains or fears

-anger- can be the target of displaced aggression

-depression- natural response to illness

guilt- patients who are dying can feel guilt

-mental health problems- loss of contact with reality; distortion of perception; regression to eearlire age; may ac without normal judgment ex: violent or inappropriately affectionate; hallucaintions delusions

-keep patient informed from start

-decide how much information they can understand and accept

-"I don't know if youre going to die but let's fight this one out together"- trust and hope

-death of child- find place where parents can hold child- important for grieving process

Recognize the stress inherent in many situations, such as mass casualty scenes Ch.2 #15 Pg. 61-62

The Following factors affect how people react to stressful systems;

-Socioeconomic Background

-Fear of medical personnel

-Alcohol or substance abuse

-History of Chronic Disease

-Mental Disorders

-Reaction to medication

-Age

-Nutritional Status

-Feelings of Guilt

-Past Experience with Illness or Injury

Describe the steps necessary to determine scene safety and to prevent work related injuries at the scene Ch.2 #16 Pg. 62-67

-prepare mentally and physically

-strap in on way there

-prepare appropriate PPE

-scene must be well marked

-plenty of light

-do not enter area if has hazardous materials

-remain uphill and upwind of scene

Discuss the different types of protective clothing worn to prevent injury Ch.2 #17 Pg. 67-70

cold weather, turnout gear, gloves, helmets, boots, eye protection, ear protection, skin protection, body armor

Recognize the possibility of violent situations and the steps to take to deal with them Ch.2 #18 Pg. 70-71

-Check that the scene is safe

-Request Law enforcement if needed

-Protect your self from projectiles (bullets,bottles, and rocks)

-Cover and Concealment- tactical use of an impenetrable barrier for protection

Remember your personal safety is of the utmost importance

Describe how to handle behavioral emergencies Ch.2 #19 Pg. 71

look at past history, posture, vocal activity, physical activity