CHAPTER 2: WELLBEING OF THE

FIRST RESPONDER

CAMARINES SUR DISASTER RISK REDUCTION AND

MANAGEMENT TRAINING ACADEMY
 INTRODUCTION
Stress
  is your body's way of
responding to any kind of
demand or threat.
 When you sense danger—

whether it's real or imagined—

the body's defenses kick into
high gear in a rapid, automatic
process known as the “fight-
or-flight” reaction, or
the stress response.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Physical hazards
Physical Hazards
- is a type of occupational hazard that involves environmental
hazards that can cause harm with or without contact. 
- include ergonomic hazards, radiation, heat and cold stress,
vibration hazards, and noise hazards.
- Engineering controls are often used to mitigate physical hazards.
 Communicable disease
 Hazardous materials
 Threats of violence
 Lifting, moving

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 The Well-Being of the EMR/EMT-B

 Personal health, safety,

and well-being are vital
to an EMS operation.
 Hazards vary greatly.

 Mental and physical

stresses are part of the

job.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Self-Control

 Is achieved through:
 Proper training
 Experience
 Strategies to cope
with stress
 Dedication to
serving others

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

Emotional Aspects of Emergency Care

 Even the most

experienced
providers have
difficulty overcoming
personal reactions.

 Emotions must be
kept under control at
the scene.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Death and Dying

Changes in society have

altered people’s
attitudes toward death.
Few people have

actually witnessed a
death.
Life expectancy has

increased.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Death and Dying

 Death is
something you
will have to face.
 Coming to grips
with death is part
of delivering care.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 The Grieving Process

1. Denial: Refusal to
accept
2. Anger: Blaming others
3. Bargaining: Promising
to change
4. Depression: Openly
expressing grief
5. Acceptance: The simple
“yes”

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

Dealing With Family Members
 Be calm. Family
members may express
rage, anger, and despair.
 Use a gentle tone of
voice and a reassuring
touch, if appropriate.
 Respect the family’s
wishes and privacy.
 Do not create false hope.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Caring for Critically Ill and Injured Patients

 Avoid sad and grim

comments.
 Orient the patient.
 Be honest.
 Acknowledge the
seriousness of the
condition.
 Allow for hope.
 Locate and notify family
members.
CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING
Injured and Critically ill Children
 Basic treatments
remain the same.
 Consider variations
between children and
adults.
 Being accompanied by
a relative may relieve
the child’s anxiety.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

Dealing With the Death of a Child
 A child’s death is a
tragic event for both
EMS Practitioner and
the family.
 How the family deals
with the death will affect
its stability.
 EMS Practitioner is
responsible for helping
the family.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Helping the Family
 Acknowledge the fact of
the child’s death in a
private place.
 Tell the parents that they
may see their child.
 Do not overload the
parents with information.
 Parents should be
encouraged to talk about
their feelings.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Stressful Situations
 Mass-casualty
situations
 Infant and child
trauma
 Amputations
 Abuse
 Death or injury
of a coworker

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Factors Affecting Patient Reactions to Stressful
Situations

 Fear of medical  Medication reactions

personnel  Age
 Alcohol/substance abuse  Nutritional status
 Chronic diseases  Guilt feelings
 Mental disorders  Past experience

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Uncertain Situations
 When uncertain if the patient’s condition
is an emergency, contact medical control.
 Minor symptoms may be early signs of

severe illness or injury.

 When in doubt, err on the side of caution.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Stress Warning Signs and the
Work Environment

 EMS is a high-
stress job.
 Understand the
causes of stress.
 Prevent stress
from negatively
affecting you.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Physiological Manifestations of the
Fight-or-Flight Response

 Rise in respirations and  Tensed muscles

pulse
 Increase blood
 Increase in blood glucose levels
pressure
 Perspiration
 Cool, clammy skin
 Decreased circulation
 Dilated pupils to GI tract

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 Physical Symptoms of Stress
 Fatigue
 Changes in appetite

 Headaches

 Insomnia/hypersomnia

 Irritability

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Stress and Nutrition
 Prolonged stress
drains the body’s
reserves.
 Under stress, body’s
fuel sources are
consumed in large
quantities.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Psychological Reactions
to Stress

 Fear
 Depression
 Anger
 Frustration

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Signs and Symptoms of Posttraumatic Stress
Disorder

 Depression
 Startle reactions
 Flashback phenomena
 Amnesia of event

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Critical Incident Stress
Management
 Confronts responses
to critical incidents
and defuses them
 Process designed to
help EMS personnel
deal with responses to
critical incidents
 Composed of trained
peers and mental
health professionals
CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING
 Critical Incident Stress
Debriefing (CISD)

 Held within 24 to 72 hours of a major

incident
 All information is confidential.
 CISD leaders and mental health
personnel offer suggestions for
overcoming the stress.

CAMARINES SUR DISSTER RISK REDUCTION AND MANAGEMENT TRAINING

 Components of CISM System
 Pre-incident stress
education
 On-scene peer support
 Disaster support
services
 Defusings

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Components of CISM System
 CISD
 Follow-up services
 Spouse and family
support
 Community outreach
programs
 Other wellness
programs

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Stress Management
 There are positive and negative ways of handling
stress.
 Stress is unavoidable.
 Understand the effects of stress.
 Find balance in life.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Strategies to Manage Stress
 Change or eliminate
stressors.
 Change partners to avoid
negative or hostile
personality.
 Stop complaining or
worrying about things you
cannot change.
 Expand your social support
system.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Strategies to Manage Stress
Minimize the physical response by:
 Taking a deep breath
 Stretching
 Regular physical exercise
 Progressive muscle relaxation

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Workplace Issues
 Cultural diversity
 Your effectiveness as an EMS
Practitioner
 Avoiding sexual harassment
 Substance abuse

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Scene Safety and Personal Protection

 Prepare yourself
when dispatched.
 Wear seat belts and
shoulder harnesses.
 Ensure scene is well
marked.
 Check vehicle
stability.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Scene Safety
 Must be first concern

 Assistance from other

agency & PPE required:
 Hazmat incidents
 Rescue operations
 Violent scenes
 Exposure to contagious
diseases

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Scene Safety
 Ambulance safety
 Most common EMS
Practitioner cause of death
– motor vehicle collision
(MVC)
 Most common injuries
 Sprains
 Strains
 Tears

 Most commonly injured

body part - back

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Communicable Diseases
 A disease transmitted from one person to
another
 An infectious disease transmissible (as from

one person to another) by direct contact with

an affected individual or the individuals
discharges by indirect means.

 Minimize risk of contracting disease with

proper protection
CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING
 Routes of Transmission
 Direct  Vector-borne
 Being sneezed on  Bitten by a tick
 Vehicle (indirect)  Airborne
 Touching contaminated  Inhaling contaminated
linen droplets

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Common Terms
 Exposure
 Contact with blood, bodily fluids, tissues, or
airborne droplets directly or indirectly
 Universal precautions
 Protective measures developed by the CDC to
prevent workers from direct or indirect contact
with germs

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Common Terms
 Body substance isolation (BSI)
 Infection control techniques based on the
assumption that all bodily fluids are
infectious
 Exposure control plan
 Comprehensive plan to reduce the risk of
exposure

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Body Substance Isolation (BSI)
 Handwashing
 Gloves and eye
protection
 Mask and gowns
 Proper disposal of
sharps

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Reducing Risk of Infection
 Follow the exposure control plan.
 Always follow BSI precautions.
 Always use a barrier between you and the patient.
 Be careful when handling needles.
 Always wash your hands.
 Make sure all immunizations are current

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Immunizations
 Recommended:
 Tetanus-diphtheria
boosters (every 10
years)
 Measles, mumps,
rubella (MMR)
 Influenza vaccine
(yearly)
 Hepatitis B vaccine

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Duty to Act
 The EMS Practitioner cannot deny act to a
patient with a suspected communicable
disease, even if the patient poses a risk to
safety.
 To deny care is considered abandonment or
breach of duty; the EMS Practitioner may
also be considered negligent.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 ACQUIRED IMMUNUNODEFICIENCY SYNDROME (AIDS)
 IS A DISORDER CAUSED BY THE Human immunodeficiency virus (HIV)

 It is characterized by generalized dysfunction of the immune system

 Routes of transmission:

• Sexual

• Blood exposure

• Maternal to infant exposure

 Diagnostic test:

o ELISA(Enzyme-linked immunosorbent assay)

o Western Blot

o CD4 +

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 Risk persons:
 Male homosexuals or bisexuals
 IV drug abusers
 Babies born to infected mother
 Frequent exposure to blood and body fluids

 Signs and symptoms:

 Weight loss
 Diarrhea
 Fatigue
 Presence of opportunistic infections
 Fungal infections
 Candidiasis

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 Management:
 Implement standard precaution
 Promote comfort
 Maintain fluid and electrolyte balance
 Promote respiratory function
 Medications: Anti Retro Viral drugs
 Medications:
 Anti Retro-Viral drugs
 Anti-fungul drugs
 Protease inhibitors
 Best Practice:
 Proper hand washing when caring for clients with HIV and AIDS infection.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 HEPATITIS-Is the inflammation of the liver.
 Causes:

• Autoimmune
• Medications
• Drugs
• Toxins
• Alcohol
 Types of Hepatitis and Routes of transmission

 Hepatitis A- caused by Hepatitis a virus, transmitted through consuming food or

water contaminated by feces from a person infected with hepatitis A

 Hepatitis B-transmitted through contact with infectious body fluids such as blood,

vaginal and semen.

 Hepatitis C-transmitted through direct contact or sexual contact or injection drugs

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 Signs and Symptoms:  Diagnostic Test:
• Abdominal pain  Blood test
• Dark Urine  Management:
• Joint pain  Bed rest
• Loss of appetite  Abstaining from alcohol
• Nausea and Vomiting  Diet
• Weakness and Fatigue  Exercise
• Jaundice (yellowing of skin
and whites of the eyes)

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 MENINGITIS- is the inflammation
of the meninges surrounding your
brain and spinal cord
 Causes:
• Bacterial
• Viral
• Fungal
 Routes of transmission:
 Airborne/Droplet
 Signs and symptoms:
 Headache
 Fever
 Stiff neck
 Vomiting

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 Diagnostic Test:
 Blood Culture
 Spinal Tap
 Management:
• Antibiotics
• Steroids
• Bed rest
• Always practice good hygiene
• Proper hand washing

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 TUBERCULOSIS-infectious disease that affects the lungs.
 Causative agent
 Mycobacterium Tubercle
 Routes of transmission:
 Airborne/Droplet
 Signs and symptoms:
• Weight loss
• Loss of appetite
• Night sweats
• Coughing up for more than two weeks
• Coughing up with blood

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES
 Diagnostic Test:
• Chest X-ray
• Blood test
• Sputum test
 Management:
 Anti-TB drugs for 6-9 months (Rifampicin, Isoniazid,
Pyrazinamide, Ethambutol and Streptomycin)
 Rest
 Proper Nutrition
 Practice hand washing

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES

 Rabies-is a deadly virus spread to people from

the saliva of infected animals. The rabies virus
is usually transmitted through a bite.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES

First Symptoms of Rabies in Human?

 The first symptoms of rabies can appear from a

few days to more than a year after the bite happens.

At first, there's a tingling, prickling, or itching
feeling around the bite area. A person also might
have flu-like symptoms such as
a fever,headache, muscle aches, loss
of appetite, nausea, and tiredness.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES

 Incubation Period:
In animals, development of symptoms can be from 2
weeks to many months. In humans, symptoms usually
develop after3 - 8 weeks. In some cases, symptoms
have appeared as early as 9 days and as long as 7
years after exposure.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 COMMUNICABLE DISEASES

 Treatment:
The combination of human rabies
immune globulin (HRIG) and vaccine
is recommended for both bite and
nonbite exposures, regardless of the
interval between exposure and initiation
of treatment. People who have been
previouslyvaccinated or are receiving
preexposure vaccination for rabies
should receive only vaccine.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Other Diseases Causing Concern
 Syphilis
 Can be a bloodborne disease
 May result from needle stick

 Whooping Cough
 Airborne disease caused by

bacteria
 Usually occurs in children
 Wear a mask to avoid

exposure

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Other Diseases Causing Concern

 Newly
recognized
diseases
 Escherichia
coli

 Hantavirus

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

Other Diseases Causing Concern
 Severe acute respiratory syndrome  Ebola Virus
(SARS)

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

General Post-exposure Management

 Ryan White Law requires notification of

exposure.
 You should be screened immediately after any
exposure.
 All exposures need to be reported to
company’s designated officer.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Establishing an Infection
Control Routine
 Make infection control procedures a part
of your daily routine.
 Routinely clean the ambulance after each

run.
 Properly dispose of medical waste.

 Remove contaminated linen.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Scene Hazards
 Hazardous materials
 Never approach an object marked with placards.
 Electricity
 Do not touch downed power lines.
 Recognize the signs before a lightning strike.
 Fire
 Do not approach unless trained and protected.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

Hazardous Materials Safety Placards

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Personal Protective Equipment
 Cold weather clothing
 Should have three
layers
 Turnout gear
 Provides head-to-toe
protection
 Gloves
 Type depends on job
being performed

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Personal Protective Equipment
 Helmets
 Must be worn in any
fall zone
 Boots
 Should protect the feet,
fit well, and be flexible

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Personal Protective Equipment
 Eye and ear protection
 Should be used on rescue
operations
 Skin protection
 Use sun block when
working outdoors.
 Body Armor
 Worn by EMS responders
in some areas for personal
protection

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Violent Situations
 Civil disturbances

 Domestic disputes

 Crime scenes

 Large gatherings

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Safety
 If personal
safety is in
doubt, do not
place yourself
at risk.

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Behavioral Emergencies
 Determinants of violence
 Past history
 Posture
 Vocal activity
 Physical activity

CAMARINES SUR DISASTER RISK REDUCTION AND MANAGEMENT TRAINING

 Thank
You!!!

CAMARINES SUR DISASTER RISK REDUCTION AND

MANAGEMENT TRAINING ACADEMY