As an Emergency Medical Responder, you will encounter many stressful situations. Whatever the situation, you must act professionally. It is important that you learn how to recognize the signs and symptoms of stress in yourself and others.
Critically ill or injured patients may experience grief, which is a normal response to a loss of any kind. The five stages of grief are denial, anger, bargaining, depression, and acceptance. Remember that a person going through grief may skip a stage, go through more than one stage at the same time, or go through each stage more than once. Cultural factors influence how a person experiences grief.
Patients may experience any number of emotions in response to their illness or injury. As an Emergency Medical Responder, you must be respectful of each patient. Listen with empathy to the patient's concerns, but do not give the patient false hope. In dealing with the patient's family or friends or with bystanders, you may need to use many of the same approaches you use in dealing with patients.
Some patients may not want aggressive efforts aimed at reviving them when they are dying. These patients may have an advance directive or a Do Not Resuscitate (DNR) order. An advance directive is a legal document that details a person's healthcare wishes when he or she becomes unable to make decisions for him- or herself. A Do Not Resuscitate order is written by a physician. It instructs medical professionals not to provide medical care to a patient who has experienced a cardiac arrest.
The signs of obvious death include decapitation (beheading), putrefaction (decomposition), dependent lividity, and rigor mortis. If a person shows signs of obvious death, do not disturb the body or scene. The police or medical examiner will need to authorize removal of the body. You should document the victim's position and his or her injuries. You should also document the conditions at the scene, as well as statements of persons at the scene.
As an EMS professional, you will experience personal stress and will encounter patients and bystanders in severe stress. A stressor is any event or condition that has the potential to cause bodily or mental tension. In order to be an effective Emergency Medical Responder, you must learn to recognize the physical, behavioral, mental, and emotional signs of stress.
You should manage stress through lifestyle changes. These changes include developing good dietary habits, exercising, and practicing relaxation techniques. You should also seek to create balance in your life, including time with family and friends.
Professional help may be needed to help you cope with stress. Many organizations have employee assistance programs that offer confidential counseling to prehospital professionals.
Critical Incident Stress Management (CISM) is a program that assists emergency workers in coping with stressful situations. A Critical Incident Stress Debriefing (CISD) is a formal group meeting led by a mental health professional and peer counselors. A defusing is a shorter, less formal version of a debriefing. The goal of these forms of stress management is to speed up the normal recovery process after a critical incident. The results of some studies raise doubts about the effectiveness of CISM.
An Emergency Medical Responder is responsible for ensuring the safety of the crew, the patient, and bystanders. However, an Emergency Medical Responder's first priority is ensuring his or her own safety at all scenes. This responsibility includes protecting oneself against disease transmission, which includes using personal protective equipment (PPE) and getting the proper vaccinations. It also involves safety at hazardous materials scenes, motor vehicle crashes and rescue scenes, and violent scenes.
