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Chapter 2
Workforce Safety
and Wellness
Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
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Objectives
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Wellness
• Wellness is a state of health and happiness
(well-being) that involves lifestyle choices in
pursuit of an optimal state of health.
• Components
– Physical well-being
– Mental well-being
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Physical Well-Being
• Physical fitness
• Maintaining adequate
nutrition and proper body fat
• Obtaining adequate rest
• Preventing disease and injury
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Physical Well-Being
• Regular exercise
• Stress
– A chemical, physical,
or emotional factor that
causes bodily or
mental tension
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Physical Well-Being
• Benefits of physical
fitness:
– Improved personal
appearance and self-image
– Decreased resting heart
rate and blood pressure
– Increased oxygen-carrying
capacity
– Increased muscle mass
and metabolism
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Physical Well-Being
• Good dietary habits include the following:
– Limiting fat, saturated fat, and cholesterol
intake
– Reducing or avoiding the intake of sugar,
caffeine, and alcohol
– Eating a variety of foods each day
– Limiting salt intake
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Physical Well-Being
• Both shift work and long work
hours have been associated with
health and safety risks.
• Obtaining adequate rest is
necessary to
–
–
–
–
Restore energy
Maintain a healthy immune system
Handle stress
Function at your best
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Mental Well-Being
• The ill or injured
patient, family, and
friends expect
excellent medical care
• They will also depend
on you for emotional
support
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Mental Well-Being
• Your emotions:
– Joy
– Pride
– Contentment
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Mental Well-Being
•
•
•
•
•
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Anger
Anxiety
Frustration
Fear
Grief
Feelings of
helplessness
• Unable to relieve
suffering
• Patient dies despite
your best efforts to
resuscitate him or her
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Mental Well-Being
• You will learn to recognize and control
these feelings while caring for patients
• You must:
– Act professionally
– Be able to work quickly
– Think clearly
– Make appropriate decisions regarding
your patient’s care
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Mental Well-Being
• You must learn to:
– Anticipate and recognize
signs and symptoms of
stress in yourself and others
– Manage signs and symptoms
of stress when they occur
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Common Stressors Associated with EMS
Environmental Stressors
• Lights, siren, alarm noise
• Long hours and shifts
• Absence of challenge between calls
• Weather conditions and temperature extremes
• Confined work spaces
• Emergency driving and rapid scene response
• Demanding physical labor
• Multiple role responsibilities
• Dangerous situations
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Common Stressors Associated with EMS
Psychosocial Stressors
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•
•
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Family relationships
Conflicts with supervisors or coworkers
Agitated, combative, or abusive patients
Dealing with critically ill and injured or dying
patients
• Patients under the influence of drugs or
alcohol
• Incompatibility with partner
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Common Stressors Associated with EMS
Personal Stressors
• Life-and-death decision making
• Personal expectations
• Feelings of guilt and anxiety
• Dealing with death and dying
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Stressful Situations
•
•
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•
•
•
•
Mass casualty incident
Infant and child trauma
Death, terminal illness
Amputations
Violence
Death of a child
Infant, child, elder, or
spousal abuse
• Death or injury of a
coworker or other
public safety personnel
• Emergency response to
illness or injury of a
friend or family member
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Stressful Situations
Additional Factors
• Facing dangerous situations
• Working in challenging locations and terrain
• Enduring problematic weather conditions
• Operating under severe time pressures
• Handling media attention
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Fight-or-Flight Response
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Physical Signs of Stress
• Increased heart rate
• Pounding/racing heart
• Elevated blood
pressure
• Sweaty palms
• Tightness of the chest,
neck, jaw, and back
muscles
• Headache
• Diarrhea, constipation
• Trembling, twitching
• Stuttering and other
speech difficulties
• Nausea; vomiting
• Sleep disturbances
• Fatigue
• Dryness of mouth or
throat
• Susceptibility to minor
illness
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Behavioral Signs of Stress
• Excessive humor or
silence
• Violence, aggressive
behavior (such as
when driving)
• Withdrawal
• Hostility
• Accident-proneness
• Impatience
• Crying spells
• Hyperactivity or
underactivity
• Changes in eating habits
• Increased substance use
or abuse
– Smoking
– Alcohol consumption
– Medications
– Illegal substances
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Mental Signs of Stress
• Inability to make
decisions
• Forgetfulness
• Reduced creativity
• Lack of concentration
• Diminished productivity
• Lack of attention to detail
•
•
•
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Attention deficit
Disorganized thoughts
Negative self-esteem
Lack of control/need for
too much control
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Emotional Signs of Stress
•
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Irritability
Angry outbursts
Hostility
Depression
Jealousy
Restlessness
Withdrawal
Anxiousness
Diminished initiative
• Feelings of unreality or
overalertness
• Reduction of personal
involvement with others
• Tendency to cry
• Being critical of others
• Nightmares
• Impatience
• Reduced self-esteem
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Managing Stress
Lifestyle Changes
• Change diet
• Exercise regularly
• Learn relaxation
techniques
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Managing Stress
Balance
• Develop a hobby
• Get away when you can
• Learn to say no
• Get adequate sleep
• Develop supportive friendships/relationships
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Managing Stress
Family and Friends
• Lack of understanding of prehospital care
• Fear of separation or being ignored
• Frustration caused by the “on-call” nature of
the job and the inability to plan activities
• Frustration caused by wanting to share
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Managing Stress
Family and Friends
• Do your best to leave your work at work.
• Family and friends are a base of support
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Managing Stress
Family and Friends
• Make it a point to talk about your day with
your loved ones
• Actively listen to what they have to say when
they tell you about theirs
• Plan time for your family and friends
– Say no when a request would require you
to alter those plans
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Managing Stress
Work Environment
• Request work shifts that allow for more time
for relaxation with family and friends
• If you recognize warning signs of stress:
– Consider asking for a temporary rotation
to a less stressful assignment
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Managing Stress
Professional Help
• Mental health professional
• Social worker
• Member of the clergy
• Employee assistance program
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Traumatic Incident Stress
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Traumatic Incident Stress
• Traumatic incident • Examples:
– A situation that
causes a healthcare
provider to
experience
unusually strong
emotions
– Line-of-duty death or serious
injury
– Mass casualty incident
– Suicide of a coworker
– Serious injury or death of a child
– Dead bodies or body parts
– Events with excessive media
interest or criticism
– When victims are known to you
– Any event that has unusual
impact on personnel
– Any disaster
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Traumatic Incident Stress
• Traumatic incident
– A situation that causes a healthcare
provider to experience unusually strong
emotions
• Traumatic incident stress
– A normal stress response to abnormal
circumstances
– Can affect all levels of healthcare workers
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Traumatic Incident Stress
• Signs and symptoms of traumatic incident
stress:
– Exhaustion, often due to disturbing
images
– Anxiety
– Depression
– Irritability
– Inability to concentrate
– Indecisiveness
– Hyperactivity or underactivity
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Preventing Disease Transmission
• Infection
– Results when the body is invaded
by pathogens
• Pathogens
– Germs capable of producing
disease
• Communicable (contagious) disease
– An infection that can be spread
from one person to another
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Methods of Disease Transmission
• Direct contact
• Indirect contact
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Disease Transmission
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Infection Control
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Exposure
• Exposure
– Contact with infected blood, body fluids,
tissues, or airborne droplets
– Contact may be direct or indirect
• An exposure to a communicable disease
does not automatically result in infection
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Standard Precautions
• Self-protection
• Handwashing
against all body fluids
and substances
• Using personal
– Blood
protective equipment
– Urine
(PPE)
–
–
–
–
–
Semen
Feces
Vaginal secretions
Tears
Saliva
• Cleaning,
disinfecting, and
disposing of soiled
materials and
equipment
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Standard Precautions
Handwashing
• Handwashing
– Single most important method you
can use to prevent the spread of
communicable disease
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Handwashing
– Remove all jewelry from hands and arms
– Use soap and warm water
– Wash for at “least 15 seconds”
– Scrub under and around fingernails with a
brush
– Rinse your wrists, hands, and fingers with
running water
– Use a paper towel to dry them
– Use a paper towel to turn off the faucet
– Avoid touching any part of the sink or door
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handle
Handwashing
• According to the Centers for Disease Control
& Prevention (CDC), “if hands are not visibly
soiled, use an alcohol-based hand rub for
routinely decontaminating hands”.
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Hand Hygiene
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Standard Precautions
PPE
• Personal Protective Equipment (PPE)
– Includes:
•
•
•
•
Eye protection
Protective gloves
Gowns
Masks
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Standard Precautions
Eye Protection
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Standard Precautions
Gloves
• Protective gloves
– Put on before physical contact with every
patient
– Check condition of gloves before putting
them on
– Change gloves between contact with
different patients
– Never reuse gloves
– Discard in clearly labeled biohazard
container
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Removing Gloves
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Removing Gloves
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Removing Gloves
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Key Points
• Always put on disposable gloves before
physical contact with every patient.
• Always change gloves before caring for another
patient.
• Always change your gloves and wash your
hands if your gloves become soiled. Put on
clean gloves.
• Always dispose of gloves properly.
• Always wash your hands after removing your
gloves.
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Standard Precautions
Gowns
• Gowns
– Use in situations in which large splashes
of blood or body fluids could occur
– Examples
• Childbirth
• Vomiting
• Massive bleeding
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Standard Precautions
Masks
• Surgical-type face mask
– Use to protect against
possible blood or other body
fluid splatter
– Use in situations in which an
airborne disease is suspected
– Change the mask if it
becomes moist
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Standard Precautions
Masks
• N-95 or High-Efficiency Particulate Air (HEPA)
mask
– Use if patient has or may have and airborne
disease, such as tuberculosis
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Standard Precautions
PPE
Guidelines for Use
Gloves
Potential for contacting blood
or other body fluids
Gloves, chin-length
plastic face shield
(or mask/eyewear)
Splashing or spattering of
blood or other body fluids is
likely
Gloves, chin-length
plastic face shield
(or mask/eyewear),
gown
Splashing or spattering of
blood or other body fluids is
likely and clothing is likely
to be soiled
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Immunizations
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Immunizations
• Keep your immunizations up to
date:
– Tetanus prevention
• Booster every 10 years
– Hepatitis B vaccine
– Influenza vaccine (yearly)
– Measles, mumps, and
rubella vaccine (if needed)
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Documenting and
Managing an Exposure
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Documenting and Managing an Exposure
• If you are exposed to blood or body fluids:
– Immediately wash affected area with soap
and water
– Notify designated person as soon as
possible
– Get a medical evaluation
– Get proper immunizations if necessary
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Documenting and Managing an Exposure
• Document:
– Date and time of the exposure
– Circumstances surrounding the
exposure
– Type, source, and amount of body
fluid to which you were exposed
– Actions you took to reduce chances
of infection
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Cleaning Equipment
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Cleaning Equipment
• Use disposable equipment whenever
possible
• Reusable equipment used in the care of a
patient with intact skin usually requires only
cleaning or disinfecting
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Cleaning Equipment
• Cleaning
• Disinfecting
– Chemical solutions can be harmful
– Protect yourself by wearing gloves and
goggles
• Sterilizing
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Injury Prevention
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Hazardous Materials Scene
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Hazardous Materials Scene
• Hazardous material
– “A substance (solid, liquid, or gas) that,
when released, is capable of creating harm
to people, the environment, and property”
– “Any biological agent and other diseasecausing agent, or a waste or combination
of wastes”
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Hazardous Materials Scene
• Use binoculars to identify
possible hazards before
approaching the scene
• Look for signs or placards
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Hazardous Materials Scene
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Hazardous Materials Scene
• Do not enter the scene
• Contact law enforcement
• Contact local hazardous material response
team
• Stay upwind and on higher ground than the
incident site
• Keep unnecessary people away from area
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Hazardous Materials Scene
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Motor Vehicle Crashes/
Rescue Scenes
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Motor Vehicle Crashes / Rescue Scenes
• Study the scene before entering
– Determine if it is safe to approach the
patient
– Determine the number and type of vehicles
– Determine extent of damage
– Determine approximate number of persons
injured
– Look for hazards
– Assess the need for additional resources
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Motor Vehicle Crashes / Rescue Scenes
• Potential hazards
– Traffic
– Blood
– Gasoline spills
– Hazardous materials
– Undeployed air bags
– Sharp edges and fragments
– Exposed or downed electrical wires
– Fire or potential for fire
– Explosive materials
– Unstable vehicle or structure
– Environmental conditions
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Motor Vehicle Crashes / Rescue Scenes
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Questions?
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