Workforce Safety and Wellness

MASTER TEACHING NOTES  Case Study Discussion  Teaching Tips Detailed Lesson Plan  Discussion Questions Chapter 2  Class Activities Workforce Safety and Wellness  Media Links 100–120 minutes  Knowledge Application  Critical Thinking Discussion

Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes I. Introduction Case Study Discussion 5 A. During this lesson, students will learn about methods of safeguarding  What are your priorities in this situation? themselves from stress, body substances, and other hazards.  What are your thoughts about how to B. Case Study proceed? 1. Present The Dispatch and Upon Arrival information from the chapter. 2. Discuss with students how they would proceed.

II. Emotional Aspects of Emergency Care—Death and Dying Teaching Tip 6 A. The five emotional stages can apply to dying patients, family members, or To help students relate to the five emotional patients experiencing nonfatal emergencies. stages of loss, ask them to think of examples B. Five emotional stages of each of the emotional reactions in response 1. Denial to a loss or disappointment in their own lives, 2. Anger such as loss of a job or important relationship. 3. Bargaining Even the impending loss of an important 4. Depression basketball or football game can bring about 5. Acceptance these feelings, although not as intensely. C. Dealing with the dying patient, family, and bystanders 1. Do everything possible to maintain the patient’s dignity. Class Activity 2. Show the greatest possible respect for the patient. Have students divide into small groups and 3. Communicate to the patient and family members. role play communicating with a dying patient 4. Allow family members to express themselves. or family members of a patient who has died, 5. Listen empathetically. using the guidelines under Dealing with the 6. Do not give false assurances. Dying Patient, Family, and Bystanders. After 7. Use a gentle tone of voice with the patient and family. ten to 15 minutes, ask each group to share 8. Take appropriate steps if the family wants to touch or hold the body after examples of things that demonstrated each of death. the guidelines listed. 9. Do what you can to comfort the family. Critical Thinking Discussion What impact can EMTs have on the family

PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 2 PAGE 1 Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes members of a dying patient?

Video Clip Go to www.bradybooks.com and click on the mykit link for Prehospital Emergency Care, 9th edition to access a video on grief and a child’s death.

Weblink Go to www.bradybooks.com and click on the mykit link for Prehospital Emergency Care, 9th edition to access a web resource on the Hospice Foundation of America.

III. Emotional Aspects of Emergency Care—High Stress Situations Discussion Question 6 A. The EMT experiences stress when external demands become greater than What are some examples of high-stress personal resources. situations in EMS? 1. Long hours 2. Boredom between calls Critical Thinking Discussion 3. Working too much, too hard Why is it important for EMT students to 4. Getting little recognition understand the emotional aspects of EMS 5. Having to respond instantly early in the EMT course? 6. Making life-and-death decisions 7. Fearing serious errors 8. Dealing with dying people and grieving survivors 9. Being responsible for someone’s life B. Some situations produce extreme levels of stress. 1. Multiple-casualty incidents (MCIs) 2. Abuse and neglect of children and adults 3. Emergencies involving infants and children 4. Injury or death of a coworker 5. Responding and providing emergency care to a relative or bystander 6. Severe traumatic injuries such as

PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 2 PAGE 2 Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes amputations

IV. Emotional Aspects of Emergency Care—Stress Reactions Teaching Tip 6 A. Types Ask students to recall some of the emotions 1. Acute stress reaction—Symptoms occur immediately and physical feelings they have felt when they 2. Delayed stress reaction—Symptoms are delayed (PTSD) have experienced a stressful situation. 3. Cumulative stress reaction—Common cause of burnout B. Common signs and symptoms of stress reactions Discussion Question 1. Irritability with coworkers, family, and friends How would you recognize a coworker who 2. Inability to concentrate was experiencing signs and symptoms of a 3. Difficulty sleeping and nightmares stress reaction? 4. Anxiety 5. Indecisiveness 6. Guilt 7. Loss of appetite 8. Loss of sexual desire or interest 9. Isolation 10. Loss of interest in work C. General categories of stress signs and symptoms 1. Thinking (e.g., confusion) 2. Psychological (e.g., mood swings) 3. Physical (e.g., headaches) 4. Behavioral (e.g., grinding teeth) 5. Social (e.g., increased interpersonal conflicts) V. Emotional Aspects of Emergency Care—Stress Management Weblink 6 A. Make lifestyle changes. Go to www.bradybooks.com 1. Take a look at diet. and click on the mykit link for Prehospital 2. Exercise more often. Emergency Care, 9th edition to access a web 3. Learn to relax. resource on stress management. 4. Avoid self-medication. B. Keep balance in your life. Discussion Question 1. Assess priorities. How can you “eat on the run” as EMS 2. Share your worries with someone. providers sometimes do, and still make 3. Accept that you will make mistakes. healthy choices about food and drink? C. Recognize the response of your family and friends. PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 2 PAGE 3 Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes 1. Points of stress for family and friends a. Lack of understanding Class Activity b. Fear of separation or of being ignored Divide students into small groups. Have each c. Worry about on-call situations group plan a healthy menu for breakfast, d. Inability to plan lunch, and dinner for a day at work. Have e. Frustrated desire for you to share groups share their ideas with the rest of the 2. Way to deal with family and friends class. a. Describe your feelings about what you do. b. Explain safety precautions you take. Knowledge Application c. Answer their questions.  Give a scenario in which a friend or family d. Encourage them to stay fit with you. member is experiencing stress due to the e. Make time to spend with them. EMT’s job. Ask students for responses to D. Make changes in your work environment. help the friend or family member 1. Develop a “buddy” system with a coworker. understand and cope. 2. Encourage and support your coworkers.  Describe various EMS work situations to 3. Request work shifts that allow you more time to relax with loved ones. the class. Ask what changes can be made 4. Request a rotation of duty assignment. to manage job-related stress. E. Seek professional help. 1. Mobilize your best coping strategies. 2. Learn effective ways to deal with stress in the future. VI. Emotional Aspects of Emergency Care—Critical Incident Stress 6 Management A. Critical incident stress debriefing 1. Held within 24 to 72 hours of critical incident 2. Peer counselors and mental health professionals help emergency service personnel work through seven phases. 3. Includes anyone involved in the incident B. Critical incident defusing 1. Version of CISD held within one to four hours following a critical incident 2. Attended only by those most directly involved in incident 3. Gives emergency service personnel an opportunity to vent their emotions and get information they may need before the larger group meets for CISD C. Controversy over whether CISD really helps emergency care personnel resolve stress D. Comprehensive critical incident stress management components 1. Preincident stress education PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 2 PAGE 4 Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes 2. On-scene peer support 3. One-on-one support 4. Disaster support services 5. Defusing 6. CISD 7. Follow-up services 8. Spouse and family support 9. Community outreach programs 10. Other health and welfare programs

VII. Scene Safety—Protecting Yourself from Disease Discussion Question 15 A. Diseases are caused by pathogens. What are simple ways you can protect yourself B. Types of pathogens from on-the-job illness and injury every day? A. Bacteria B. Viruses Teaching Tip C. Fungi Have examples of gloves, eye and face D. Protozoa protection, gowns, and other personal E. Helminths protective equipment available for students to C. How diseases spread see and try out. 1. Blood to blood contact 2. Contact with open wounds and exposed tissue Weblink 3. Contact with mucous membranes Go to www.bradybooks.com 4. Contaminated objects and click on the mykit link for Prehospital 5. Air Emergency Care, 9th edition to access a web D. Standard Precautions resource on proper hand washing techniques. 1. Handwashing 2. Personal protective equipment (PPE) (e.g., eye protection, protective gloves, gown, and masks) Video Clip 3. Additional guidelines Go to www.bradybooks.com a. Cleaning is the process of washing a soiled object with soap and and click on the mykit link for Prehospital th water. Emergency Care, 9 edition to access a video b. Disinfecting includes cleaning but also involves using a hospital- on putting on gloves. grade disinfectant or germicide to kill many of the microorganisms that may be present on the surface of the object. Knowledge Application c. Sterilization is the process by which an object is subject to a chemical Give several descriptions of patients. Ask what or physical substance that kills all microorganisms on the surface of types of PPE should be used. an object. d. Dispose of, clean, disinfect, and sterilize all equipment according to Class Activity PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 2 PAGE 5 Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes local guidelines and protocols. Have students research information from the 4. Immunizations newspaper (or other news media) or EMS a. Purified protein derivative (PPD) tuberculin test websites for articles that involved an EMS b. Tetanus prophylaxis response. Have students bring in their articles c. Hepatitis B vaccine and discuss what actions EMS personnel d. Influenza vaccine might have taken to protect their health and e. Polio immunization safety. f. Rubella (German measles) vaccine g. Measles vaccine h. Mumps vaccine i. Varicella vaccine 5. Reporting exposure

VIII.Scene Safety—Infectious Diseases of Concern to the EMT Discussion Question 10 A. Hepatitis B What are some examples of airborne and 1. Contracted through blood and body fluids blood-borne communicable diseases? 2. Signs and symptoms (Chronic carrier may have no signs or symptoms) Weblink 3. Standard Precautions Go to www.bradybooks.com B. Hepatitis C and click on the mykit link for Prehospital A. Transmitted through needle stick Emergency Care, 9th edition to access a web B. Signs and symptoms (Carriers often have no signs or symptoms.) resource on hepatitis B and the health care C. Standard Precautions worker. C. Tuberculosis 1. Transmitted by droplets in cough or sputum 2. Signs and symptoms 3. Standard Precautions D. Acquired Immune Deficiency Syndrome (AIDS) Video Clip 1. Caused by HIV Go to www.bradybooks.com 2. Modes of transmission include sexual contact, infected needles, infected and click on the mykit link for Prehospital blood or blood products, and mother-child transmission. Emergency Care, 9th edition to access a video 3. Signs and symptoms on the epidemiology of AIDS. 4. Standard Precautions E. Severe Acute Respiratory Syndrome (SARS) 1. Transmitted by respiratory droplets from a cough or sneeze 2. Signs and symptoms Critical Thinking Discussion 3. Standard Precautions  What are some communicable diseases F. West Nile Virus that have received attention in the media PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 2 PAGE 6 Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes 1. Transmitted through the bite of an infected mosquito recently? 2. Signs and symptoms (Many people may not show signs or symptoms.)  What are the implications for EMS 3. Standard Precautions providers? G. Multidrug-Resistant Organisms 1. Pathogens that have adapted to and have developed the ability to resist standard antimicrobial drugs 2. Common types a. Methicillin/oxacillin-resistant Staphylococcus aureus (MSRA) b. Vancomycin-resistant enterococci (VRE) c. Penicillin-resistant Streptococcus pneumoniae (PRSP) d. Drug-resistant Streptococcus pneumoniae (DRSP) 3. Standard Precautions

IX. Scene Safety—Protecting Yourself from Accidental and Work- Discussion Question 15 Related Injury What kinds of calls may put you at risk for A. Hazardous materials exposure to hazardous materials? 1. Use binoculars to look for signs or placards before approaching. 2. Identify the substance using the Emergency Response Guidebook. Teaching Tip 3. If possible, call in a specialized hazardous materials team. Pass around a copy of the DOT Emergency 4. Provide emergency care only after scene is safe and patients have been Response Guidebook for students to review. decontaminated. B. Rescue situations Class Activity 1. Life-threatening rescue situations Give small groups of students five to ten a. Downed power lines or other potential for electrocution minutes to think of potential response-related b. Fire or threat of fire hazards in addition to those listed in the text. c. Explosion or threat of explosion Have each group share their ideas with the d. Hazardous materials rest of the class. e. Possible structural collapse f. Low oxygen levels in confined spaces Knowledge Application g. Trenches that are not properly secured Give several descriptions of scene situations. h. Biological, nuclear, and chemical weapons Ask what actions and additional resources are 2. Call for assistance from specialized teams as needed. necessary to ensure EMT and patient safety. 3. Wear at least the protective equipment that others on the scene are required to wear. 4. Rescue personnel responding to accidents or other emergencies on or near a roadway are required to wear high-visibility apparel (Class 1, Class 2, or Class 3). C. Violence and crime PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 2 PAGE 7 Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes 1. If you suspect potential violence, call law enforcement before entering the scene. 2. While providing emergency care, take specific precautions to preserve the chain of evidence. X. Wellness Principles—Physical Well-Being Teaching Tips 25 A. Physical fitness  Plan a stretching or relaxation exercise for 1. Cardiovascular endurance—Calculating target heart rate the class. 2. Muscle strength  Have a personal trainer or exercise 3. Muscle endurance physiologist present a lecture on physical 4. Muscle flexibility fitness. 5. Body composition B. Adequate sleep Class Activity A. Select an environment that mimics nighttime (cool and dark). Ask each student to calculate his target heart B. Select a time when a block of sleep can be achieved uninterrupted. rate for aerobic exercise. C. Do not eat a heavy meal, drink caffeine, or exercise immediately prior to sleep time. Discussion Questions D. Reduce the amount of interruptions (e.g., turn of pager, put a sign on  Besides jogging or running, what are some your door). examples of aerobic exercise? C. Smoking cessation  What are some ways to improve sleep D. Alcohol- and drug-related issues habits?  What are some of the health risks associated with tobacco use? XI. Wellness Principles—Mental Well-Being Knowledge Application 15 A. Stress associated with EMS can easily affect mental well-being. Ask each student to write down three goals for B. Improve mental well-being improving or maintaining well-being. 1. Talk to family members or friends 2. Exercise. Critical Thinking Discussion 3. Relax. What are some ways EMTs can incorporate 4. Engage in activities you enjoy. wellness principles into a, sometimes hectic, work day? XII. Follow-Up Case Study Follow-Up Discussion 5 A. Answer student questions.  What are the various factors that make B. Case Study Follow-Up this a stressful incident? 1. Review the case study from the beginning of the chapter.  What can you do to lessen the personal 2. Remind students of some of the answers that were given to the impact of such events—before, during discussion questions. and after the event? 3. Ask students if they would respond the same way after discussing the PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 2 PAGE 8 Chapter 2 objectives can be found in an accompanying folder. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes chapter material. Follow up with questions to determine why students Class Activity would or would not change their answers. Alternatively, assign each question to a group C. Follow-Up Assignments of students and give them several minutes to 1. Review Chapter 2 Summary. generate answers to present to the rest of the 2. Complete Chapter 2 In Review questions. class for discussion. 3. Complete Chapter 2 Critical Thinking. D. Assessments Teaching Tips 1. Handouts  Answers to In Review and Critical Thinking 2. Chapter 2 quiz questions are in the appendix to the Instructor’s Wraparound Edition. Advise students to review the questions again as they study the chapter.  The Instructor’s Resource Package contains handouts that assess student learning and reinforce important information in each chapter. This can be found under mykit at www.bradybooks.com.

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