CHAPTER 2

Workforce Safety
and Wellness

Copyright © 2023 by Jones & Bartlett Learning, LLC, an Ascend Learning Company and the American Academy of Orthopaedic Surgeons.
Introduction (1 of 2)

Copyright © 2023 by Jones & Bartlett Learning, LLC, an Ascend Learning Company and the American Academy of Orthopaedic Surgeons.
 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.
Introduction (2 of 2)

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 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!
Components of Well-Being

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 Wellness is the quality or state of being in good health.
 Components of wellness:
 Physical
 Mental
 Emotional
Physical Well-Being (1 of 2)

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 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
Physical Well-Being (2 of 2)

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 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)

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 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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Courtesy of USDA.
Nutrition (2 of 5)

 Protein foods
 Vegetables

 Grains
 Fruits

 Dairy

 Oils
Nutrition (3 of 5)

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 Read nutrition labels of prepared or processed foods.
 Review:
 Sodium levels
 Amount and type of fat
 Composition of carbohydrates
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© Mira/Alamy Stock Photo.
 High-fiber content foods
 Fat-free products
Nutrition (4 of 5)

 Beware of:

 Look for:
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 Plan for your shift as if you will get minimal time to rest or to eat a meal.
Nutrition (5 of 5)

 What to avoid
 What to bring
Weight Control

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 The USDA’s dietary guidelines recommendations.
 Make healthy food choices and avoid dieting.
 Gradual weight reduction is key.
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 The exercise program for you depends on personal preferences and fitness
 Benefits of exercise
Exercise (1 of 3)

goals.
Exercise (2 of 3)

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 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.

Exercise (3 of 3)

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 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

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 If you don’t smoke, don’t start!
 Everyone responds differently to smoke.
 Options for smoking cessation
 Electronic cigarettes
Alcohol Use

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 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.
Circadian Rhythms and Shift Work

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 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.
Periodic Health Risk Assessments

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 Hereditary factors may affect your overall health.
 Consider researching your family history.
 Build health assessments into your routine physical checkups.
Body Mechanics (1 of 3)

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 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.
Body Mechanics (2 of 3)

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 Habits (cont’d)
 Never lift with your back.
 Always lift with your legs!
 Breathe

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 Do not carry what you can put on
Body Mechanics (3 of 3)

 Ask for help.

 Habits (cont’d)

wheels.
Mental Well-Being

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 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.
Emotional Well-Being

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 Make a deliberate effort to create a healthy balance between your work and
home life.

© Carolyn Cole/Los Angeles Times/Shutterstock.

Spiritual Well-Being

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 Human spirituality is an unseen dimension of human experience.
 Medical care supports the dignity and value of life and the sacredness of all
people.
Disease Transmission (1 of 2)

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 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.
Disease Transmission (2 of 2)

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

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 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.
Protecting Yourself

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 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
Personal Protective Equipment and Practices (1 of 4)

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 At a minimum, each ambulance
should have:
 Gloves
 Facial protection
 Gowns
 N95 or N100 respirators

© Jones & Bartlett Learning. Courtesy of MIEMSS.

Personal Protective Equipment and Practices (2 of 4)

Copyright © 2023 by Jones & Bartlett Learning, LLC, an Ascend Learning Company and the American Academy of Orthopaedic Surgeons.
 Important infection control
practices:
 Wear gloves.
 Wash your hands.
 Use hand lotion.
 Use eye protection.
 Wear a mask.
 Protect your body.

© science photo/Shutterstock
Personal Protective Equipment and Practices (3 of 4)

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 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

© The Venusian One/Shutterstock.

Personal Protective Equipment and Practices (4 of 4)

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 Infection control practices (cont’d):
 Wear gloves, helmets, and boots
 Protect your eyes, ears, and skin
 Consider body armor
Hostile Situations (1 of 2)

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

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 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.
Traffic Incidents (1 of 2)

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 Primary concern is safety for
yourself and those around you.
 It is important to stay aware of your
surroundings, even the familiar
ones.

© Jeff Thrower (Web Thrower)/Shutterstock.

Traffic Incidents (2 of 2)

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 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
Power Lines and Lightning Hazards

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 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!
Stress (1 of 3)

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 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
Stress (2 of 3)

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 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
Stress (3 of 3)

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 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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 Copyright © 2023 by Jones & Bartlett Learning, LLC, an Ascend Learning Company and the American Academy of Orthopaedic Surgeons.
 A stress response often begins with events that are perceived as threatening or
What Triggers Stress?

demanding.
Physiology of Acute Stress (1 of 2)

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

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 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
Responses of Patients to Illness and Injury (1 of 2)

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 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)

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 Psychological defense mechanisms
include:
 Denial
 Regression
 Projection
 Displacement
 Reactions to illness or injury are
often rooted in the patient’s culture.
© Hugh Van der Poorten/Alamy Stock Photo.
Responses of Family, Friends, and Bystanders (1 of 2)

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 Bystanders and family members may exhibit responses similar to the patient’s.
 Paramedics should remember:
 Do not take it personally.
 Remain calm.
 Reassure.
Responses of Family, Friends, and Bystanders (2 of 2)

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 Situations where people should be removed from the scene, but not left alone:
 Anxiety
 Blind panic
 Depression
 Overreaction
 Conversion hysteria
Paramedic Responses

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 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.
Coping With Your Own Stress (1 of 2)

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

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 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)

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 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

Burnout (2 of 2)

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 The paramedics who do not
experience burnout have learned to
respect and value themselves.

© Kevin Dodge/Getty Images.

Coping With Death and Dying

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 Encounters with life and death are an honor.
 Births and deaths are a holy time in some cultures.
 You will help many people.
Stages of the Grieving Process

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 The stages of grieving include:
 Denial
 Anger
 Bargaining
 Depression
 Acceptance

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Dealing With a Dying Patient

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 People who are dying generally know their situation is serious.
 Dying patients need to feel they still have some control over their lives.

© John Moore/Getty Images News/Getty Images.

Dealing With a Grieving Family

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 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.
Dealing With a Grieving Child

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 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.
After the Call Is Over (1 of 3)

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 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.
After the Call Is Over (2 of 3)

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 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.
After the Call Is Over (3 of 3)

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 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.
Peer Support and Suicide Prevention

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 EMS providers are not immune to thoughts of suicide or suicide attempts.
 Prevention starts with recognizing that you or a colleague are becoming
overwhelmed.