hey hey good evening class welcome welcome back to intro to em emergency medical care hope everybody's doing okay we logged in a little bit early let you guys get in and get settled get ready to go hope everybody had a good day hey hey what's going on what's going on welcome welcome welcome J baby what's up what's going on what's going on everyone you on time today that's hey that's what's up thank you thank you guys thank you very much for being good students I very much appreciate it hello Rachel good evening good evening Aaron Mel good evening hello hello hello it's all good man again you guys know if you don't make the lives or you can't stay for the entire lives they are reposted hey bossy paramedic what's up what's going on Erica hello how you doing Briana hey what's going on Deborah hello so remember guys we're on chapter two tonight chapter 2 we will be discussing EMS uh what we still oh no we will be discussing Workforce safety and wellness Workforce safety and wellness this evening so if you got access to the PowerPoint make sure you have a PowerPoint pulled up if you want to follow along with the PowerPoint again guys thank you thank you all thank you very much a couple reminders um if you just joining remember I need you guys to engage with all the previous videos so you can catch up make sure pre engaged with the previous videos so you can catch up if you just join in today also make sure that on my profile page you hit that Bell in the top Corner that way you're notified whenever I put a video out that way you guys don't miss any updates on what's going on in the class and or what you need to prepare for all right NC R that's what's up that's what I like man stay in ahead of the game nothing wrong with that at all I mean that's a good time to make notes that's definitely a good time to make notes um also guys please just keep doing what you're doing man liking the lives the gifts always accepted all that fun stuff man it's very very much appreciated good evening good evening forcefully en rolled you you can drop at any time if you don't want to do it Grace all right I'll check that once the live is over no worries no worries come back when you can come back when you can remember if you remember if you need to um you would never I'm glad to hear it remember if you need to step out for a minute or you can't stay for the whole class remember it's going to be posted onto my YouTube channel so yall just make sure you subscribe there so you can catch up or see whatever you missed hey good morning over there in South Africa 2: in the morning oh you sleep don't stay up get you some rest I promise you can always catch I appreciate you being live but you can get some rest it's going to be posted for you to catch up on YouTube so don't don't don't miss out on no sleep please trust me as somebody who works in my field I know how important sleep is and we actually going to go over that in this lesson tonight yes under my name you can search my name or you can click the link in my bio it's in there I appreciate you thank you guys thank you thank you please always good man make sure you liking the live share the live all that fun stuff we got about four more minutes before the class gets started hey Alita what's going on Miss Aussie tattooed what's going on how you doing present good good that's all right feel better catch the video later you a't know we had class day when now you do you in here now so that's why I tell you you guys make sure you have that Bell you click that Bell on my profile so you notified Iris good evening so you notified cuz every morning I drop a video letting you guys know what's going on okay so make sure y'all when you you going to pop out real quick and pop back into the live but make sure that Bell is is on so you know how you doing vet shout out to you in Brazil thank you I appreciate it man I appreciate it do they' been good man my last the last time I did this on Monday we had about 1,500 students in here bro so I I think I did pretty good for 1500 what's going on what's going on yes go feed you baby hey in Louisiana how you doing candy in eastern North Carolina what's going on hi in St Lucia what's up man that's what's up man I like to see you guys from all over the place taking your education seriously that's what's up Kai good evening how you doing hello in Germany what's going on high in South Korea plenty of practice plenty of practice with patience I've learned how to pronounce a lot of things I never knew I did so Kai in Atlanta shout out to you in Atlanta Maryland South Carolina Minnesota Chicago all right Canada shout out to you up in Canada all right guys we got about two more minutes two more minutes make sure you guys are ready got everything you need to take notes all that fun stuff absolutely share my information haven't reach out to me I don't mind um answering questions hello hello good evening good evening sh what's going on hey good evening guys good evening hi hi hello hello hello good evening guys good evening we're almost ready we're almost about to get started we got one more minute one more minute before class starts Delicia yes you're on time today good I'm glad glad you're on time yes you can join from today just make sure you catch up on everything so you got to go back to all the videos I posted so far and try to catch up good evening good evening guys good evening welcome welcome welcome K thank you thank you for the gift very much appreciated that's fine Again the video will be posted to the YouTube channel so you guys if you need to catch up you can catch up later if you can't stay for the whole class no I've never been to the EMS convention in Orlando I've been invited but I haven't been there I haven't been up there yet I'm still working on that I'm still working on it it's it's a whole process i' I've got um the LLC already done but again it's just raising the money and again with everything going up that mean Builders go up rent goes up so it's a process but I'm still hoping one day to have that um have that gym absolutely haven't haven't given up on that dream all right guys it's 7 o' everybody ready ready to go ready to start everybody ready to start all right all right let's get it so we on chapter two we're on chapter two we are discussing work force safety and wellness so work force safety and wellness and just as last time guys if you see a question that you know the answer to for one to your classmates in the comments please respond I want to get through this lecture as um efficiently as possible so I don't have time to keep stop and answer everybody's question questions Kelly I saw you um about moderating we going to get into that uh the next lecture I'm still trying to figure out how it goes but we we'll get into that the next lecture um so yeah let's get started all right all right so first and foremost uh paramedic EMT any kind of EMS provider is dedicated to providing prehospital emergency care and transport for the sick and injured making the job very gratifying but also very very demanding all right most important thing is do not lose sight of the most important factor which is your personal wellness and safety both on scene and off again like I told you guys back in chapter one the very first thing is BSI scen safety that's the very very very first thing all right and when it comes to your personal wellness and your personal safety that's first and foremost even over that BSI seen safety you got to be mentally well and physically well to perform and and work in these stressful environments all right so some seen safety issues that we uh take into consideration are scene hazards environmental conditions um human-made threats um violence aimed at First Responders and infectious disease infectious diseas is Exclamation point Exclamation exclamation point all right never never never compromise your safety when dealing with an an emergency uh never ever compromise your safety when dealing with a medical emergency all right you want to maintain your health um from the beginning so first and foremost man again you guys maintain your health your health is first and foremost all right so s several recent Studies have assessed injury illness and death among Emergency Medical Services Workers all right it was a 2013 study and in that study it found that EMS has one of the lowest overall fatality rat SC compared with other emergency services such as law enforcement and the fire service so compared to the fire service and law enforcement paramedics and EMTs has have the lowest overall fatality rate all right these fatalities tend to be linked to Transportation crashes with ambulance crashes resulting in a high number of deaths so the one the high the thing that causes the highest number of univance in the EMS Field is actually vehicle accidents vehicle accidents is the number one thing that causes fatalities in the EMS Field all right nonfatal injuries EMS also exceeds all other emergency professions with strain strains being common injuries and the most common injury site being the back so in EMS the most common injury site is the back in EMS the most common injury site for EMS workers is your back all right so data from the national highway traffic safety administration suggest that 1,500 ambulance crashes occur each year in United States 1,500 ambulance crashes occur each year in the United States all right 59% occurred during an emergency response while 34% occurred while non-emergent so again guys when you see these these ambulances you see these rescues and they're flying down the road with the lights and sirens on I need you guys to be even more aware um be listening out man cuz it's it's trust me you don't know who's behind that wheel and a lot of times they're trying to get you don't know the call that they're trying to get to so you if you see um an ambulance you see a rescue and you see lights and Sirens make sure that no matter where you are just pull over to the pull over even if they on the opposite side of the road if they dist distance away it doesn't matter pull over cuz again these the stress and the adrenaline is pumping these guys are trying to get to an emergency all right and whatever you got going on is not more important than what they're trying to get to because if those lights and siren is on I want you to think of worst case scenario somebody's um possibly about to pass away so think of it as one of your um relatives think of how you would want traffic to be if you was wanting 911 to respond to you all right so keep that in mind when you see these lights and sirens on the road all [Music] right so these finders emphasize that new workers in EMS should be aware of their own health and well-being while being aware of their own limitations all right the scene is never safe and EMS providers should never let their go guard down so again always be aware awareness is extremely extremely important when dealing with an emergency situation all right always be aware of your surroundings always be aware of your own personal safety all right components of well-being Wellness was first defined in 1654 as the quality or state of being in good health especially as an actively sought goal so the three components of Wellness physical mental emotional the three components of Wellness are physical mental and emotional all right some believe that spiritual Wellness is also essential but for this this the purposes of this class the three components of Wellness physical mental and emotional all right physical well-being you want to be in the top physical physical condition as possible when you're in this when you're in the top physical condition is possible before injuries heal more quickly and uh injured than other so basically what I'm saying is keep yourself in the best shape possible because again God forbid you do get hurt you will heal quickly you will heal quicker than you would if you weren't in such great shape all right all right so I want you guys on your own to read the next few slides and do your own studying about the nutrition I don't want to get into that tonight cuz it's pretty self-explanatory we're all adults here so I know we all understand what's good for us to eat what's good for us not to eat okay so you guys review the nutrition and things of that on your own I'm not going to test you on that but again just knowing the good things to eat and what not to eat all right all right so we're going to go down and talk about exercise okay so exercise um regular exercise they shown links to overall body weight nutritional status and hydration all right so the benefits of regular exercise again you guys are adults we understand exercise is extremely extremely important to our well-being and our health all right so again I'm not going to Too Much harp on that in this uh in this lecture cuz again we're all adults we know that exercise is key and we want to be in the best physical shape possible so nutrition and exercise I'm going leave that to you guys to check out the slides check out the textbook and look look that up cuz I want to spend too much time be laboring those points again we're all adults you need to eat well and you need to exercise you want to be in the best shape possible all right cuz like I say when you get into an emergency situation you want to be able to perform the best at your best abilities all right a person doesn't want to hear um you know like say for instance I'll show up on scene a person is needing of help they call me that mean they have an emergency they need help they don't want to hear that I'm tired or I hurt myself or my knees hurt my back hurt oh I'm sorry I can't lift you up that ain't how that works all right got to keep yourself to in your best physical mental and uh emotional states possible all right how you guys doing so far you guys all right we all good all right let's get it let's keep it going all right um Jen is in the room my ta is in the room right now so you guys have any questions Jen the ta ta she just logged in so you guys she'll answer any of you guys questions while I'm doing this lecture all right we're going to talk about so we're going to talk about right now let's go down to the mental wellbe all right so we're going to go down to mental well-being I want you guys to find that if you falling along on the PowerPoint um let me know when you find mental well be and I'll continue I want to give you a chance of guys to catch up cuz I skipped over some again the nutrition and the exercise stuff we're all adults I know you guys know eat right and exercise all right we ready we guys there I see if you see everybody's pretty much there we're there all right let's get it going so mental well-being all right so when you are subject when you're subjected to stress in an emergency situation your figh or flight or your fight ORF flight response is activated all right so physiologic responses to fight ORF flight these responses help you deal with the situation immediately all right to maintain your mental well-being for the long term you need to be able to handle these situations by using appropriate coping skills all right as a as an EMS provider you will need to be in control of your emotions at all times regardless of the situation and I cannot stress that enough you need to be in control of your emotions at all times no matter what the situation is okay emotional well-being the key to remaining healthy throughout your career or if you taking a career at EMS is to make a deliberate effort to create a healthy balance between your work and home Life EMS professionals must be able to deal with the stress that they're exposed to on the job a common stressor is how to deal with patient disability and unal living another common stressing is the frequent fly the and and also combative or belligerent patients so again the common stressors you deal with in EMS dis patient disability patient univance frequent flyers and what a frequent flyer is is someone who constantly calls EMS calls 911 I mean virtually every chance they get like you know this person name when they address pop up you already know who it is like you you and these people become family all right that's that's a frequent flyer and again some of your frequent flyers have really serious health conditions that yeah they need to go to the hospital a lot and some of your frequent flowers hypochondriacs you know every little thing they got to go to the hospital so it just it all depends and then combative and belligerent patients so again combative and belligerent patients you have to know and that's where that being in control of your your mental well-being at all times you're going to get people that are combative you're going to get people that um are belligerent and that can be just dealing with an altered state of mind they might not be in their right state of mind and not knowing that they're being combative with you or you know they're just they don't want to go they don't want to go to the hospital even though they need to go to the hospital so those are things you have to look out for as far as stressers in the field so good AMS workers are strong sensitive people these traits are intertwined with normal emotional reactions to stressors of the job all right if a coworker or leader has noticed changes in your behavior take their concerns seriously these could be warning signs that you need to seek assistance okay um in this field man it's it's a lot lot of people that deal with a lot of things that are afraid to talk to people if you're working and you're dealing with a stressful situation even if you're not working as an EMS provider if you see something that's that's mentally you know traumatizing or something that's stressful on your mind talk to people don't be afraid to talk to people cuz at the end of the day that stuff will wear and eat at you and at the end of the day it will they make you not a good worker and it'll make you not be able to perform at the best of your ability so reach out and talk to people man and spiritual well-being so human spirituality is an unseen dimension of The Human Experience all right some people address spirituality with formal religion Medical Care supports the dignity and value of life and the sacredness of all people so again I don't care what you looking at I don't care who you worship I don't care what you believe I don't care none of that stuff man when it comes to a medical emergency how can I help you that's the first and foremost man it's human decency and that's again that's why I got into this field that's why I got into this line of work that's why I got into doing what I'm doing man cuz at the end of the day when when somebody's having an emergency all that stuff go out the window you don't be thinking about none of that stuff the the only thing is on your mind is am I going to get this next breath if am I going to see my next heartbeat and that right there that again that when people have a lot of come to Jesus moments when they start to think about that type of stuff so believe you me um it's extremely extremely important that you have your physical wellbeing your mental wellbeing your emotional wellbeing and your spiritual wellbeing all in sync if you're going to get involved in uh emergency medicine or if you're going to be involved in an emergency um situation you got to have those things lock loaded and ready to go all right so now we're going to talk about disease transmission all right guys we going to talk about disease transmission give me give you guys a second to catch up let me know when you catch up and ready to go we ready we ready all right let's get it all right so paramedics are called on to treat and transport patients with a variety of communicable and infectious diseases all right at times they may have to transport a chronically ill patient without knowing that that individual has an infectious or contagious disease until well after the call an infectious disease a mental a medical condition caused by the growth and spread of small harmful organisms within the body an infectious disease is a medical condition caused by the growth and spread of small harmful organisms within the body a communicable disease a disease that can be spread from one person or species to another all right know the difference between an infectious disease and a communicable disease all right an an infectious disease medical condition caused by the growth and spread of small harmful organisms within the body communicable disease is disease that can be spread from one person to another all right please please please know the difference all right I can't drop no more hints I can't drop no better hints than that know the difference between an infectious disease and the communicable disease okay pay attention to this next thing I'm telling you all right all contagious diseases are infectious all all contagious diseases are infectious only some infectious diseases are contagious all right all contagious diseases are infectious only some infectious diseases are contagious all right for example pneumonia caused by uh bacteria is an infectious process but it's not contagious so someone has pneumonia and you're around them that doesn't necessarily mean you're going to have pneumonia so pneumonia is an example of an infectious disease all right pneumonia is an example of an infectious disease it will not be transmitted from one person to another all right Hepatitis B and Co are contagious because they can be transmitted from one person to another so an example of a communicable communicable disease is Hepatitis B or Co those are diseases that can be transferred from one person to another all right so the following minimize the risk of infection okay immunizations personal protective equipment hand washing and proper cleaning and disinfecting of the ambulance and Equipment after each call following the following dramatically minimizes the risk of infection immunizations personal protective equipment or PPE handwashing proper cleaning and disinfecting of all equipment and ambulances all right inform other health care providers and co-workers who may be in contact with the pation of the potential risk all right use discretion you do not give out sensitive patient info to uh to anyone who is not directly involved with the patient care for example if you are dealing with someone in uh in an emergency situation and you know that that person uh for example has HIV um what we do is especially if that person's in our location in our Zone where we serve we make a note amongst ourselves at the station to the other Crews like hey just a FYI if you're running on this if you run on this person know that this person has this Medical history or disc communicable disease and we'll have that in our patient notes it is okay to put those types of things and patient notes again as long as you're not sharing patient information um names date of births um any of that type of stuff you can let them know that uh hey by the way if you ever run on this person just be aware that way where you properly protecting that person and they can properly prepare to go and treat that person accordingly and make sure that they have the proper personal protective equipment also when you transferring if you are if you are working with a person with a communicable disease you want to make sure when you're passing that person over to the hospital that you communicate that with the hospital so they know what they're treating you don't want to give somebody you know with a communicable disease to someone in the hospital and not let them know cuz then they they are at risk as well so um communication communication is key so different germs use different means of attack known known as the mechanism of transmission all right so different germs use different means of attack known as mechanisms of transmission transmission is the way an infectious agent is spread all right so infectious diseases can be transmitted in various ways all right these are the four ways I want you to know that infectious diseases can be transmitted all right infectious diseases can be transmitted indirect or direct contact airborne foodborn and Vector born meaning transmitted through insects or parasites so four ways infectious diseases can be trans can be transmitted indirect or direct contact airborne foodborn and Vector born meaning from an insect or a parasite contact transmission is the movement of an or organism from one person to another through physical touch contact trans contact transmission is the movement of an organism from one person to another another through physical touch direct and indirect are two types of contact transmission direct contact occurs when an organism is moved from one person to another through touching without an intermediary so blood bloodborne pathogens and you know STDs are examples of direct contact transmission all right indirect contact involves the spread of an infection between a patient with an infection to another patient through a contaminated in adamant object for example a NE stick that's you know you get a lot of people who use um who use um illegal um Pharmaceuticals um trying not to get the live banned illegal Pharmaceuticals you can see that um if they're sharing needles you don't have to have direct contact with that person but if you're sharing needles you have indirect contact and you can still uh spread that infectious disease even though you didn't have direct contact with that person okay Airborne transmission involves spreading an infectious agent through mechanisms such as droplets or dust but the common cold and covid for example are spread by coughing and sneezing again Airborne transmission involves an infectious agent through mechanisms such as droplets of dust both the common cold and Co spread by coughing and sneezing so we going to talk about how to manage these exposures so management of an exposure if you have been exposed to a patient's blood or body fluids follow your Department's infection control plan all right so generally you do the following so if if you're ever working in an emergency scenario if you're ever working with somebody who if you ever exposed to anybody's bodily fluids or blood at any point in time first thing you want to do is wash the affected area immediately with soap and water that is the very very first thing if you ever exposed wash the area with soap and water immediately turn the care over to someone else so when you immediately when you are immediately exposed to anything any kind of again sneezing coughing uh uh droplets um direct or indirect any kind of exposure you have turn the care to someone else let someone else who's properly who has proper PPE let them take over and you go wash your hands wash wherever you were exposed at with soap and water immediately if your eyes were exposed rinse them with water for at least 20 minutes as soon as possible 20 minutes as soon as possible get a medical evaluation so make sure you go get medically evaluated even if you think it's something small if you don't think you were it wasn't that bad go get evaluated go get checked ASAP all right you want to make sure you're properly immunized from all different communicable diseases that are out there um most of you guys like say if you ever had to go to high school or any kind of school you got most of your immunizations but definitely want to make sure you stay up to date on those um you want to include the actions taken to reduce chances of infections all right so always document what happened and then make sure you write down everything you do you did to try to reduce the harm all right all right we're going to go to the protecting yourself so we're going to talk about protecting yourself so make sure you guys catch up let me know when you're there protecting yourself ready ready ready ready to go all right holding on give you a few seconds catch on up we ready all right we ready to go all right so protecting yourself so since the Inception of EMS much much much has changed all right the use of PPE wasn't even common in the early years in BMS people didn't wear anything they just they was in that raw dogging it just ready to just jumping in ready to help all right um being being covered in like you know fluids and dirt used to be like a status symbol I don't know why but it used to be a status symbol um back in those times um in the 1800s surgeons took similar pride in messy operating aprons um not realizing that they were transmitting infectious disease so keep in mind back in the day they didn't use any PPE they was just out here sticking their hands in all different places and just spreading just spreading infectious disease all over the place all right obviously present day EMS practices have changed dramatically and rapidly and it's especially after what happened after the pandemic like things have just been flipped all the way over their head all right um recommendations are always being updated as research and best practices are shared among health professionals the CDC developed a set of precautions for healthcare workers to use in treating patients all right EMS follows all these precautions uh standard precautions approach all body fluids as being infectious I don't care how well you know someone I don't care they could be they could be your husband or your wife whatever I don't care how you will you know that person you approach all bodily fluids as if they were potentially infectious all right like again don't care mama daddy sister brother everybody everybody might everybody might got something cuz at the end of the day protect yourself always protect yourself immunization sorry we're going to talk about immunizations again I'm not we we're not going to get into that into this class I'm just letting you know what the information is is out there you choose what you want to do with the information all right so immunizations using basic protective protective measures can minimize a person's risk for inquiring an infectious or communicable disease all right you want to maintain your personal health you want to receive annual Health exams make sure y'all going to the doctor at least once a year keep yourself keep on top of your health keep on top of your health all right keep a history of all childhood infectious diseases on file so you if you ever had anything I know when I was little I had chickenpox on you don't really hear about chickenpox anymore but when I was growing up chickenpox was a thing so we ever um we um I had chickenpox so again you want to keep a document of everything you've been exposed to um cuz it it'll be important later on in life if you have any long term effects all right so keep a history of all childhood infectious diseases on file including chickenpox Ms measles rebella whooping cough and if you haven't had one of these ever you probably were immunized as a kid and don't realize it or you didn't know it all right so if you had one of the if you never had one you probably been imun immunized from it all right so the CDC and OSHA so the CDC is the Center for Disease Control and OSHA is the the uh the occupational safety and uh workplace hazards organization they have developed requirements for protection from bloodborne pathogens such as the Hepatitis B virus all right and immunization program should be in place in in in in your EMS system so most of you most of your providers anybody who um is providing Medical Care to you we have to be immunized you can't even get into this career field if you're not immunized so again most people that are working with you don't worry like I say you can't even get hired if you don't have these immunizations so um that is a requirement to work in the medical field and the recommended the recommended immunizations include Tech and uh tchis booster which you get every 10 years so uh tchis shot you get every 10 years measles Ms and rubella which is the MMR vaccine uh the influenza vaccine so the flu vaccine every year um that one we can actually opt out of you don't have to get the flu vaccine every year as a EMS provider or any I don't I can't speak for nurses or doctors but I know as EMS providers they don't make us get that every year um hbv hbv vaccine and the hepatitis C screening all right those are those are the recommended immunizations you want to have you want to stay on top of those vericella which is the chickenpox vaccine or haven't had chickenpox so if you had chickenpox you have natural immunization all right if you had the verella vaccine that's probably why you never experienced chickenpox I think I saw somebody said they avoided chickenpox I will check and see check your records and see if you ever had the verella vaccine if you had the ver verella vaccine that's the vaccine that's a that um stops chicken boox it's probably why you never had it um and also a skin test for tuberculosis or TB so it's that's recommended as well you have to get one of those every two years so we get tested for tubercul tuberculosis every two years so again that's just a skin test that they do to see if youve ever been exposed to the TV pathogen so even if you don't know that youve ever had it before it's a test to determine if you've ever been exposed to that pathogen all right be aware that routine testing may cause an individual to build up a reactive tolerant level resulting in a positive skin test when doing the TB test even if the person is not affected all right so testing positive only indicates that you may have been exposed to the disease that not that you have it so again when they doing the skin test for TB and it comes up positive that doesn't mean you have it again it just means you were probably exposed to the pathogen so it's further testing you got to have an additional followup will be needed to determine whether the disease is active such as a radiologic test or even blood test to confirm in order to clear the results so if you ever get a a TV test and they come back positive you don't have to panic again that's just saying that you might have been exposed to the pathogen there's further testing to confirm whether or not you have it or not all right if you know that you're working with somebody or you're transporting somebody who has a communicable disease and you know you already had the disease or been vaccinated then your risk is significant ly reduced or eliminated so again if you've been vaccinated or you've had any one of these and you're transporting with somebody with any one of these you don't have to Panic it's not the end of the world that don't mean you going to catch it cuz again you've either been vaccinated or you've had it and developed natural immunity all right so personal protective equipment and practices okay each ambulance should be equipped with certain PPE so at a minimum when you're working with someone and this for any one of you guys at minimum when you're working with somebody always wear gloves put gloves on again I don't care how close you guys are I don't care how long you known them mom dad sister brother husband wife boyfriend girlfriend put gloves on all right that's the minimum put gloves on and eyewear if you got it gloves and eyewear um again you want to avoid um droplets you want to avoid people sneezing in your eyes cuz all that stuff so at a minimum you need eyewear and and gloves when you're working with somebody all right other things you can have facial protection again mask U mask um if you choose to wear again that is that is definitely your right you don't want if you really really want want to protect yourself again from those Airborne droplets mask is always Rec recommended uh n95 or n100 respirators all right those are Advanced um Airway Mas they basically um uh Airway filters obviously as a as a civilian or as a regular person you're not just going to be walking around or carrying a95 but if you do have one that is you know preferred mask if you going to mask up mask up to the best of your ability all right always wash your hands always wash your hands if we didn't learn nothing from uh going through a pandemic I'm assuming everybody know to wash their hands appropriately um use hand lotion don't don't be out here ashy y'all out here use lotion lotion is good for you lotion protects you it protects you from uh um it provides extra layer protection all right so use lotion stop walking around here being ashy um also frequent hand washing will cause your hands to crack because the natural oils will be removed all right we want to stay clean we want to wash our hands but at the same time your body has natural oils that are designed to protect you as well you don't want to get rid of those natural oils all right so wash your hands but don't be don't be one of those like uh what you call it um germaphobes cuz at the end of the day now you you done washed off all your body's natural oils and you created a different problem all right um protect your body you can wear mask and gowns are appropriate whenever you care for a patient who expl who's messy or bloody um incontinence various for those of you who don't know what the word incontinence means that mean basically they either relieve themselves urinary or the other way so incontinence you want to make sure you have a bearer you won't want to be exposed to anybody fluids all right you don't want to be exposed to anybody um you know so yeah make sure if you going to be dealing with that make sure you have a mask make sure you have gloves make sure you have a gown on all right so if you're dealing with a known person with TB or tuberculosis that's when that n95 comes in because again you want to make sure you have Max Max Max maximum protection when it comes to dealing with anybody who has um active TB and active tuberculosis all right so according to the World Health Health Organization estimat there were 10 million new cases of TB back in 2019 and 1.4 million um univance from TB all right and as you guys know if you seen the news there's a a TV um outbreak going on in Kansas right now so definitely pay attention to that make sure you are aware of what's going on cuz tuberculosis is not nothing to play with all right so y'all keep an eye on that out there so again if so yall pay attention to what I'm telling you if somebody has ACT TB a n95 mask is Paramount you cannot wear a regular surgical mask and be protected from TB you need an n95 mask to protect yourself from TB or tuberculosis all right and again guys make sure you sanitize and clean all equipment so anything that you use um anything that you use when you um working with somebody somebody you're responding to an emergency or you're responding to a patient make sure you keep it sanitized make sure you keep it clean um I take pride in that cuz again a lot of the stuff our monitors everything that we use we use that stuff on multiple patients man and I I think of my patients as if they were somebody I was running on in my family like I make sure it's clean yes I have to use this same monitor for everyone so I'm going to make sure it's clean for everyone I don't want to expose anybody um unnecessarily to another patient you get what I'm saying so always make sure you sanitized always make make sure you keep things nice and clean um when you when you decontaminating something use a commercial disinfectant agent for decontamination of equipment that has had Direct contact with the patient or the patient's bodily fluids all right bleach and water in a 1 to 10 ratio can be used disinfection kill disinfect kills many of microorganisms on the surface of your equipment all right be aware of types of disinfectant agents that you use not all disinfectants can be used on every surface and some are harmful if it comes in contact with your skin all right depending on the agent you may need to keep the surface wet with disinfectant for 5 minutes or more so when you're using these disinfectants I'm just spray them all over the place read research figure out what you need to do with certain situations all right because not every disinfectant works on every situation all right guys we going to go down uh to hos situations let me know when you get to the hosal situation slide we're there we're there we're on H we're there wait for a few more there there got it all right so potential hostile situations can often be identified using dispatch information such as a report that a patient is uncooperative so you hear somebody's un Cooper uncooperative hostile situation uh the patient is making verbal threats that's a hostile situation all right um be aware of the following call descriptions all right the types of calls so uh if you hear the type of call come in as a fight hostile situation uh stabbing hostile situation shooting hostile situation Riot hostile situation um domestic disturbance it's a hostile situation um person down hostile situation unknown medical anything that's unknown you act you react as if it's a hostile situation cuz there's no information you don't know what you're walking into all right and if you must respond to a hostile situation you you stage a safe distance away and wait for the scene to be secure so a lot of times I don't know if you guys remember when I was talking you get you guys on Monday in chapter one about scene safety if we feel the scene is hostile we're technically not supposed to go to that scene until law enforcement has secured that scene because again now you're messing with us like now we're putting our lives in danger now we putting our lives at risk it it's great we I mean yeah you have an emergency but what am I I'm no good to you if I get involved in emergency now I'm down and you're down you get what I'm saying so again it's always protect yourself first and foremost I know a lot of times you want to see now I'm down and you're down you get what I'm saying so again it's always protect yourself first and foremost I know a lot of times we want to be for the patient but you got to go home to your family you got to go home to your people man so you always want to protect yourself first so it's imperative that you seek any training to understand how to safely handle hostile situations all right never enter the scene first if the element of hostility is known or can't be anticipated in advance all right you want to always be reviewing your surroundings make sure you are aware of what's going on all right so this is how you deal with a hostile patient so if you're dealing with a hostile person if you're dealing with a hostile patient okay listen more and talk less and for my and for all the fellas in there you need to apply that to your relationship as well I'm telling you get you out a lot of trouble listen more and talk less um do not argue or ridicule um concentrate on deescalate the patient's emotions all right deescalation is critical deescalation on the patient's emotions show empathy and understanding on the scene be aware that hostile patients in their home are much more dangerous than anywhere else people are hostile when they are comfortable they are way more hostile when they are comfortable and again I feel like everything I told y'all fellas you need to take this and apply this you going to be very very happy in your relationships these steps for hostile patients how you do just telling you follow directions man knowledge of diverse cultures plays a significant role in effective communication all right you want to make sure that you are sensitive to other cultures not everybody worships the the way you do not everybody believes the way you do you want to be conscious and you want to be respectful that person's culture that that what they believe um cuz again you don't want to create a hostile situation where that doesn't need to be all right all right traffic incidents let me know let me know you guys are ready moving on to traffic incidents all right guys here we go Motor Vehicles may move at high speeds and may carry hazardous substances and may collide with one another in locations that are dangerous for you and all involved let me put I got to put this on the charge with me one second there we go don't want this to die out all right guys so continuing Motor Vehicles may move at high speeds and make carry hazardous substances and may collide with one another in locations that are dangerous for you and all that are involved all right it is important to stay away of your surroundings even the familiar ones distracted driving is becoming as problematic as driving under the influence of drugs or alcohol so you know everybody got a phone you know everybody out here texting and driving it's it's very dangerous out here these roads man be aware of other vehicles and onlookers so if you are working and you find yourself in emergency situation and you're on the side of the road or you're on the highway you have to pay attention these people are not paying attention to you all right you got to be aware of those surroundings again like I told you guys a lot of fatalities in this industry in EMS and law enforcement and in fire are traffic accidents it ain't us going down in the fire it's not um officers um you know being pew pew none of that stuff man it's actually just trying to do your job on the side of the road a person is not paying attention and you fall to a traffic incident so please please be aware of your surroundings even if you're out there changing your tire on the side of the road when you're on the side of that road be aware cuz telling you man it's it's dangerous out here believe you me best thing you can do is um again it is a law that you supposed to move over um when you see an emergency vehicle on the side of the road but you guys you guys drive out there you know that's not always the case you know people don't always do that so um just be aware of your surrounded if you ever find yourself on the side of the road dealing with an emergency situation all right so you want to begin making observations a mile or so before you even approach the scene of a traffic accident so if you are aware that a traffic accident is ahead start Keep Your Head on the slope right then in there cuz again you're driving for you and you're driving for everybody else around you cuz again you're going to have people not paying pay attention you got people on their phones like all that stuff man so you got to got to got to pay attention all right consider these things as you get closer to those objects you want to make sure you watch for traffic pay attention to the way the wind is blowing um look for smoke cuz again if you going towards and it's a hazardous chemical like you exposed to all that stuff all right so you want to make sure that you are paying attention it's like I say a mile out once you know it's traffic accident start you know turn turn your turn your awareness up and start looking around make sure you know what's going on you want to see the kinds of vehicles and obstacles you want to know if the traffic is handled or not handled yet cuz again you got you got to wait till emergency vehicles are even there so if you don't even see an emergency vehicle there and the accident happened in front of you you got a bunch of chaos running around so now again you got to awareness awareness awareness all right so as you're approaching a traffic incident or any kind of Mery dealing with the side of road or dealing with a a traffic accident make sure you visualize the entire surrounding you want to look for hazards before you approach the scene so if you see a a vehicle accident and you decide you want to help or you want to see what's going on you need to inspect the entire scene make sure you see what's going on make sure you look for any leaks from the vehicle make sure you look for any down power lines if they ran into a power pole and you got down power lines now you got a A Live Wire on ground you're not you're not paying attention you're just thinking I got to go help this person and again that's what we talk about seeing safety remember always always always first thing you then the safety of the scene if the scene is not safe don't get involved do not get involved Point Blank period you wait till that scene to Safe before you try to get involved so there are some states that have programs in place that help with traffic incident management I know the the state of Wisconsin actually initiated the time program which stands for traffic incident management enhancement this program teaches all emergency responders the safest way to set up a scene and how to identify hazards okay traffic may be only one of the many hazards at the scene of a motor vehicle crash but the primary concern is the safety for yourself and those around you identify as many hazards is possible before before you even do anything all right again like I was telling you guys power lines never touch down power lines never touch down power lines all right all right you want to make sure you mark off the danger zone so if you do see any hazards make sure you make note of these hazards for anybody else that might be coming around trying to help CU again you want to protect yourself or you want to protect others all right energized power lines especially high voltage lines behave very unpredictably all right be be very very careful at the scene of a motor vehicle collision above ground and below ground power lines may become hazards so keep your I cannot stress that enough man you guys be aware out there when you're dealing with those situations do not approach down wires or touch anything that wires have contacted including patience so if you see that wire touch anything you do not touch what that wire has touched all right if and that includes the patient if you if you see that wi has touched the patient that patient is a no-o you let somebody else handle that all right that is not a safe scene all right lightning is a complex natural phenomenon a repeated strike in the same area can occur so lightning can strike twice it is very rare but lightning can hit the same area twice all right so y'all be very very careful stay away from drainage dishes moist areas small depressions and wet ropes to avoid being injured by a ground current all right so if it's wet and there's a down line you want to stay away from anything wet stay stay where it's dry stay away from anything wet stay where it is dry all right if a lightning strike is imminent move to the lowest possible area so if you're dealing with lightning you in if you're in an area you feel a lightning strike is imminent the lower you are the less chance of you being struck the less chance of lightning stri striking you all right so again lightning strikes make sure you in the lowest possible area you can be if you are in an open area make sure you're the smallest possible Target so don't position yourself High don't stand up um for all my short people out there it's for you you you you you gold if light if you're in a open area you know and lightting is around you good cuz lightning aims for the tallest thing in the area so make yourself small and make yourself short all right make yourself small and make yourself short that is the best thing you can do when you are in the open area and lightning is is nearby if you see something tall you get shorter than that all right keep make yourself short avoid fences and other metal objects um distance yourself from others um also if you place a non-conductive object like a blanket under your feet um that that that helps a lot so if you are in open area if you feel yourself exposed to lightning at any point in time you got a blanket nearby slide that blanket under your feet that's going to help you I didn't know that I learned that didn't working in this field again I would have never thought about that I'm just going to grab a blanket and throw it on my sheet I throw it on my feet and I'll be fine but yeah a blanket will help you during a lightning strip uh oh yeah and get inside your car again get inside your vehicle the rubber tires are going to protect you from that lightning strike as well so get inside your vehicle if you can all right we're going to talk about stress we going to talk about stress and EMS let me know when you guys are there let me know when you guys are there we going to talk about stress wa there we ready to go let you know where you stress now don't don't let me know where you're stressed when you get to stress all right guys so EMS is obious see a high stress occupation a high stress job understanding the causes of stress and knowing how to deal with stress is crucial to your job performance to your health and to your interpersonal relationships um to prevent stress from negatively affecting your life you need to understand what stress is is physiologic effects what you can do to minimize those effects and how to deal with the stress on an emotional level all right so stress is an event that can cause a physical emotional or mental reaction stress events can be pleasant unpleasant mild or intense stress events can be pleasant unpleasant mild or intense Han the MD PhD considered the father of stress theory has defined biological stress as the non-specific response of the body to any demand made upon it okay stress is a bodily reaction to any agent or stimulant which is called the stressor so a stressor is any body is any bodily reaction to any agent or situation that requires the person to adapt again a stressor is a bodily reaction to any agent or situation that requires the person to adapt adaptation is necessary for meeting the demands of Everyday Life by itself stress is neither a good thing nor a Bad Thing stress should not be avoided stress is classified into two categories you stress which is positive stress so you stress is positive stress you stress is positive stress all right the kind that motivates a person to achieve so positive stress also called UST stress is the kind of stress that motivates a person to achieve all right distress NE is negative stress distress is negative stress the stress that a person finds overwhelming and debilitating okay know those difference know the difference between you stress and distress all right what triggers stress a stress response often begins with events that are perceived as stening or demanding the specific events that trigger the reaction vary enormously from person to person the following factors are the most common stress triggers in most people okay loss of a loved one or a valued possession personal illness or injury a major life event for example starting or finishing school marriage divorce pregnancy children leaving home all right those are all triggers those are all major life event stress triggers um job related stress okay during the past four decades there have been a number of studies on the phys on the psycholog excuse me the psychological stress levels and paramedics the studies usually examine life change the studies usually examine life change units lcus okay lcus were originally described by Adolf Meyer further explored by Thomas Holmes and Richard R to deal effectively with stress as a as a paramedic you need to make a personal appraisal of the stress triggers in your life and take or plan appropriate actions to minimize their effect all right so to deal with to deal to deal with stress effectively you need to figure out what triggers your stress and how to deal with it you know how to appropriately plan to minimize the effect those effects all right so in order to deal with stress you need to figure out what causes it and how to deal with it how to minimize its effects okay so the physiology of acute stress one of the fundamental models for stress evolved from studies of how humans responded to threats okay it was observed that when a person perceives an event as threatening a standard series of physiologic reaction was cheered okay these physiologic reactions prepare us for the fight or flight response by activating your sympathetic nervous system the physiologic reactions prepare us for the fight ORF flight response by activating the sympathetic nervous system in the modern world the fight ORF flight response to stressful circumstances is not as useful as it once was most of the stresses that you face today should not be solved by fighting or running away most negative stress responses are the result of an accumulation of smaller stress events thereby placing the body in a continuous unrelieved state of alert you should evaluate and handle every stress event immediately especially if it is negative in nature so reaction to stress can be categorized as three things pay attention reactions to stress can be categorized as three things acute delayed or cumulative acute delayed or cumulative an acute stress reaction occurs during a stressful situation you may feel nervous or excited uh your ability to focus may increase um you may experience a negative emotional and physical reactions to the stress if the situation becomes too great so acute stress is like an immediate reaction it happens right when something is happening so whenever you're exposed to something your immediate first reaction that's acute acute stress reaction action okay a delayed stress reaction manifest after the stressful event so once the events once the event is over so you can be in an emergency you can be dealing with an event and be cool calm and Collective and then once the event is over you get a chance to calm down you'll start to stress out a little bit that's delayed stress so again during the crisis you will be able to focus and function um and you may be left with nervous excited energy that continues to build after the crisis identify events that may cause the delayed stress stress reaction and learn stress management techniques to improve your ability to effectively manage stress when it occurs cumulative stress reactions can occur when you are exposed to a prolong to prolonged and excessive stress so cumulative stress reactions can occur when you are exposed to prolonged or excessive stress after the a stressful event is over you may be unable to shake off the effects each time another stressful event occurs you may find it harder to recover and you may become more and more exhausted overwhelmed cumulative stress can result in physical symptoms where your body feels uh it's kind of your body's way of saying there's a problem okay so your cumulative stress can result in your body having physical reactions so when people say you know they start to get sick from stress things of that nature so yeah when you start to get um you start to get sick you start to get um nauseous you you start to your hair starts to fall out like all those things are signs of cumulative stress which is prolonged stress all right that's your body's reaction to this prolonged stress okay um you can feel fatigue um changes in appetite um GI problems gastrointestinal problems so again like I'm saying you feeling just them pits in your stomachs your starting to feel having irregular bile movements all that results from cumulative stress okay headaches headaches is another thing cumulative stress um stress causes insomnia causes hypersomnia irritability inability inability to concentrate and hyperactivity okay stress may cause insomnia hypersomnia irritability inability to concentrate and hyperactivity so stress May manifest itself in psychological reactions such as fear dull or non-responsive Behavior depression over sensitivity anger irritability frustration isolation an inability to concentrate uh alcohol or drug abuse loss of interest in work or even lost in sexual activity so all those things can be a psychological reaction to stress okay prolonged or excessive stress has been proven to be a strong contributor to heart disease hypertension cancer depression and job burnout so again if you suffer from prolonged or excessive stress those things are a very strong contributed to heart disease hypertension which is high blood pressure cancer depression and job burnout all right it's extremely extremely important you guys to learn how to deal with your stresses so how people react to stressful situations again patients family members bystanders healthc Care Professionals who confront critical illness or injury respond in some ways to the stresses of each emergency okay responses to patients to illness to injury um they are all vary they all different everybody reacts differently um several common reactions include fear depression anxiety anger and confusion okay some people may also show one or more of the following psychological defense mechanisms so denial um which is for example people ignore or diminish the seriousness of the emergency situation so they'll deny oh it ain't that bad when it is more bad than you think um regression they'll regress um they'll actually like regress to a earlier uh earlier age level even or earlier um age level of behavior or emotional adjustment so stress can lead to to mentally like regress back to an earlier state in your development and then projection which is basically attributing your own personal feelings to others so people will project um a lot unfortunately when um uh it's just a defense mechanism so when you see someone stretched out and they're kind of attacking you or they're putting it towards you or they kind of taking it out on you it's a defense mechanism okay and then displacement displacement occurs when someone redirection em motion from the original cause to a more immediate substitute so they'll a lot of times they'll kind of put it on the back burner and put it towards something else again that's just another defense mechanism okay so we're going to go down to where I want you guys to go to where it says responses of families and friends and bystanders let me know when you get there oh before that though before we uh before we get there like should be the slide before or right before that I want to go over this so I want you guys to know that especially for many Americans uh they Place great emphasis on like making eye contact and having a firm headshake and respecting personal space but you got to realize that some people may not make eye contact because that culture believes that lowered eyes shows deference to your Authority and uniform so again you got to remember different cultures different people so just because we're here doesn't mean like say some cultures like they they show Respect by not giving you ey contact they'll actually just whatever you say they won't even look at you just I just need you to help me okay so keep that in mind so always obtain permission beforehand if possible when making physical contact again make always obtain permission beforehand if possible when making physical contact cuz again you have to you have to realize different cultures different people they do things differently they they react certain ways you have to be careful um when you're dealing with um different cultures all right don't take things personal plug in back up unplug my charger plug it back in thought I had a not juice all right here we go all right so responses of family friends and bystanders so bystanders family members May exhibit responses similar to those exhibits by the patients okay as a as a care provider don't take it personal you must recognize that these people have concerns too okay um do not take it personally remain calm and just reassure the family members that you're doing everything you can and that you have physician guidance available at all times so if any point in time they get a little nervous just let them know hey you got a doctor on standby you ready to go all right so reactions to stress are defined differently depending on the organization or resource okay these are the five most common reaction reactions to uh stress anxiety uh anxiety reactions include sweating trembling weakness nausea and vomiting those all come from anxiety so sweating trembling weakness nausea and vomiting are all symptoms of anxiety okay um blind panic which basically a person judgment seems to disappear entirely so people are dealing with stressful situations they just go into a blind panic all logic all reason goes out the door okay um depression depression is obviously a a reaction to stress as well so be mindful of that and overreaction okay overreaction again people who overreact tend to talk compulsively joke inappropriately and become overly active Okay so and as a provider as somebody who deals in emergency care as somebody who's responding to a scene as somebody who's dealing with any type of emergency you're not immune from stress okay learn to recognize it learn to uh minimize its effects and and first and foremost make sure that you speak with someone all right always make sure you talk to somebody don't be afraid to talk to anyone okay coping with your own stress coping with your own stress early warning signs of stress include heart heart palpitations rapid breathing chest tightness and sweating okay early warning signs of stress include heart palpitations rapid breathing chest tightness and sweating you may find that it is very very important and you may notice that rapid breathing and breathlessness unnecessary shouting and the use of inappropriate Lang language that you would not normally use okay those are all warning signs of stress you need to get a hold of ASAP all right um remember once you enter that fight of flight mode once you enter that fight or flight mode you are primarily functioning by Instinct so considering the following stress management techniques okay control deep breathing Progressive relaxation professional assistance control deep breathing Progressive relaxation professional assistance don't be afraid to talk to somebody all right all right go down to where it says burnout go go go down where it says burnout I'm G talk about burnout real quick all right so the only thing I want you guys to know about burnout okay so burnout is defined as the exhaustion of physical or emotional strength burnout is defined as the exhaustion of physical or emotional strength you may find that you no longer enjoy what you do you may lack the energy or the desires you once had okay and burnout is a result of chronic unrelieved stress so those are the only things I want you guys to know about burnout burnout needs to be uh burnout is defined as the exhaustion of physical or emotional strength you may find that you no longer enjoy or you lack the energy or desires that you once had and it is the consequence of chronic unrelieved stress all right guys it's the last slide we're going to go with the last subject the last subject for this evening okay bear with me we got got about want to say about 10 more minutes so we going to go down to where it says coping with uh unal living so go to where it says coping with unal living let me know when you guys get there good we ready we ready to go looks like we all ready all right let's let's get it all right so as a medical provider as someone who works in EMS as somebody who works in emergency medical care you're going to you're going to deal with an uning it's inevitable it's going to happen okay it's generally it's it's generally regarded as a traumatic experience okay every one of these encounters you have to consider it as an honor okay you're gonna be there when people are born or you're going to be there when people leave okay and you have to treat each one of those things as an honor okay to be the last person or to be with someone right before they transition or right before they leave you got to you got to be like again you got to consider that as honor CU it could have been anybody and it's it's you all right that's kind of how you got to look at it you got to trick your mind sometimes in order to deal with some of the things that you that you will see okay remember In some cultures uh leaving or transitioning to the next life is considered a uh it's considered what's the word I'm looking for a a holy time it's considered a great time so um if you are again cultural cultural awareness extremely important because again first and and and uh transitions to the next life are actually considered into uh holy times for certain cultures or sacred that's a good word too sacred times so be aware of that as well and always remember man like your face may be the face that that person sees that you might be the last face that person sees and you know how how you want them to leave leave this place you don't want to be you know give them the wrong type of impression or have them have them see you panicked or shocked or sad being the last thing they see when they leave this place man so never um always you know keep that in the back of your mind man so know the stages of of the the grieving process all right know the stages of the grieving process there are five stages of grief I know some of us know these but we going to go over them again know the five stages of grief all right denial anger bargaining depression and acceptance the five stages of grief denial anger bargaining depression acceptance okay so denial is a mechanism by which people attempt to ignore a problem or pretend it does not exist okay anger obviously when people can no longer deny the reality of a situation anger over the loss may replace denial bargaining trying to make some sort of deal in hopes of Po of postponing the inevitable U depression the feeling of enormous loss and acceptance people who are about to transition or people who are about to lead this place they prepare to disengage from the world around them so a lot of times especially if you deal with people in hospice they know what's coming they know what they they know what's about to happen so they've accepted it they made the proper preparations and they're just you know waiting for the time to come all right and these things don't happen in order sometimes they happen out of order so don't think that it just goes one through five sometimes these things things things can happen out of order but those are the five stages of of grief make sure you know those so when you're dealing with a patient who's um getting ready to transition and leave this earth always remember man people know their situation they know they they've been sick they know the illness they know what's about to happen okay they may want to talk to about it they may not want to talk about it you just you know you be respect respectful of people's wishes okay um Don't Be Afraid again to discuss that with because again these people have accepted what's about to happen and sometimes just want somebody to talk to all right um when you're dealing with a grieving family when you're dealing with a grieving family make sure that you are always respectful of the family's M wishes make sure you give them the time to properly grieve um again if you're on scene and you're dealing with a patient that's in cardiac arrest and you know the code has done that patient has moved on um let the family do what the family needs to do don't be rude don't be belligerent again treat it as if it was somebody in your own family all right um particularly when you're dealing with children be sensitive to Children's need show compassion be be be very very very empathetic when you're dealing with children um after you have dealt with the situation go talk to somebody if you need to talk to somebody don't don't bury it don't don't put it somewhere and hide it in a box man that's you just witness somebody pass away like go talk to somebody about it if you need to um again um over time especially working in this field you start to get numb to it because you see it so much but every now and again make sure you know you talk to some people and and let them know what's going on man cuz as we talked about with chronic unrelieved stress it leads to different things so we don't want chronic unrelieved stress all right all right guys that's going to be it that's going to be it for chapter 2 man that's all the stuff I want you guys to know about chapter