1. Emotional Aspects of Emergency Care
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One item which often deters individuals from helping in an emergency situation is the idea of how they are going to react. Some individuals are much better at handling their emotions than others (provide example Tommy and Joe). Some individuals become so deensitized to certain situations that they are considered to be less caring.
However, this is not necessarily true, it is simply that they have found techniques in which to control their emotions. So good, some bad. What ever method they choose in most cases allows them to continue their work.
This chapter deals with the idea of how to recognize and control emotions during stressful situations this includes yours and the individuals you are treating. In fact, in some cases, emotional support may be all that is necessary to manage the situation.

2. You Are the Emergency Medical Responder
Lesson 3: The Well-Being of the Emergency Medical Responder
You Are the Emergency Medical Responder
Your police unit responds to a call for a medical emergency involving a man who has collapsed in front of a school building. When you and your partner arrive, you see that the man is bleeding from the mouth and face. Vomit and blood are on the ground around him. “His face hit the ground when he fell,” a bystander says. The victim does not appear to be breathing.

3. Stressful Situations Dangerous situations
Physical and psychological demands
Critically injured or ill people
Death and dying patients
Overpowering sights, smells and sounds
Multiple-patient situations
Angry or upset patients, family and bystanders

4. Emotional Crises
Steps that will help the EMR to deal with a dying victim and his or her family members
Recognizing that the victims needs include sharing, communication, privacy, and control
Allowing family members to express emotions, know that its usually not personal
Listening empathetically
Not offering false reassurance
Using a gentle tone of voice
Letting the victim know that everything that can be done to help will be done
Comforting the patient and family

5. Exceptions to Resuscitation
Valid Do Not Resuscitate (DNR) order present at the scene
Patient with obvious signs of death
Tissue decay
Rigor mortis
Obvious mortal wounds
Dependent lividity – pooling of blood
Situation endangering to EMR’s life

6. Stages of Grief Denial – denies seriousness of situation
Anger – toward other people
Bargaining – negotiate with a spiritual being
Depression – sadness and grief
Acceptance – accepts the situation

7. Warning Signs of Stress
Difficulty sleeping and nightmares
Irritability
Sadness, anxiety or guilt
Indecisiveness or lack of concentration
Loss of appetite or interest in sexual activity or work
Isolation or hopelessness
Alcohol or drug misuse/abuse

8. Critical Incident Stress Reactions
A critical incident is a specific situation that causes an EMR to have an unusually strong emotional reaction that interferes with his or her ability to function immediately after the event and later on. This reaction can produce stress called Critical Incident Stress
Confusion, shortened attention span or poor concentration
Denial, guilt, depression or anger
Change in interactions with others
Increased or decreased eating
Uncharacteristic or excessive humor or silence
Any other unusual behavior

9. Critical Incident Stress
Strong emotional reaction that interferes with ability to function
Can build-up over days, weeks, months, or years
May require professional counseling
A critical incident stress debriefing (CISD) is a type of meeting held within 24 to 72 hours of an incident.
During a CISD, participants are encouraged to have an open discussion of feelings, fears, and reactions triggered by the incident.
Defusing
Less formal and less structured

10. Activity
You are the first to arrive on the scene of a multi-vehicle collision involving a tractor trailer and several cars. The driver of the tractor trailer is severely injured with a portion of his hand partially severed. A person in one of the cars, a young teenager, has been thrown through the windshield and is lying in a contorted position on the side of the road. Another person is trapped in the car and unable to move her leg.

11. Steps to Relieve Stress After an Incident
Quick relaxation techniques
Healthy meal
No caffeinated beverages
Avoidance of alcohol and drugs
Event review
Rest
Involvement in physical activity
Debriefing/defusing

12. Enrichment: Health of the Emergency Medical Responder
Physical well-being
Physical fitness, nutrition and sleep
Prevention of disease transmission
Safety, including protection from the sun
Mental well-being
Stress management techniques
Balance of work and life demands
Avoid alcohol or drug use or misuse
Read Enrichment pages 38-40