EMER 108 Health and Safety Flashcards
Biomedical waste
refers to a portion of medical wastes that require special precautions due to the waste being:
Infectious
Sharps
Cytotoxic
Especially sensitive due to the nature of the waste (i.e., human body parts)
Sanitation
removal of pathogenic microorganisms from inanimate (non-human) articles by mechanical or chemical means
Canadian Forces (CF) Protective Ensemble
One-piece multi-layer protective system that has a layer of activated carbon in the foam
The outer layer has a liquid repellent fabric
treatment for Episodic acute stress
interventions on a number of levels and professionals help
Biological Agents
can be almost completely undetectable
Most of these diseases caused by these agents will be similar to other minor illnesses commonly seen by EMS
grouped as viruses, bacteria, and neurotoxins
chlamydia
Women remain asymptomatic
Sexual contact
Treated with antibiotics
gloves
Social integration:
concept used to describe number of social roles that you have and lack of isolation
Genital herpes
Chronic
Generally transmitted through oral secretions
Or
Sexual contact
gloves
Standard Operating Procedures
deal with potentially violent incidents
They are specific procedures for response to drug labs, civil disturbances and hostage or barricade incidents
what are Systemic effects
neurological, cardiovascular, renal and heptic effects
Often develop overtime
Local effect
see effects immediately at site
The goals of Crisis Intervention are to:
Relieve the anxiety of crisis event
Facilitate recovery processes in typical individuals who are experiencing typical reactions to an atypical situation or event
Return to normal, adaptive functioning
when did nutrition labels become mandatory
December 12, 2007
Parasite
line in or on another living creature and take advantage of host by feeding off its cells and tissues
Hepatitis D
Requires host to have HBV for infection to occur
Percutaneous exposure
Gloves
Don’t go through pockets of iv drug users
Communicability
How easily the disease is able to spread from one human to another.
3 main ways to manage anger:
Emotions
Thinking pattern
Behaviors
Required sleep
Toddlers: 11-14 hours a night Preschoolers: 10-13 hours a night School-aged children: 9-11 hours a night Teens: 8-10 hours a night Adults: 7-9 hours a night Older adults: 7-8 hours a night
Measles
Common in children: Viral
Airborne: Inhalation of droplets
Vaccination, gloves, goggles, mask on the patient
Importance of health relationships
Affect mental health, behavioral choices and overall physical health
Healthy relationship usually leads to healthy choices
Can directly affect menta health by reducing impact of stress
triage RPM
respiration
profusion/circulation
mental status
Insomnia
inability to fall asleep or stay asleep
More common in woman
Associated with poor sleep habits
Treatment focuses on relaxation, sleep habits and pharmacology
Unintentional tort
negligence
Metabolic Agents Treatment
Amyl Nitrite
Pragmatism
Suggestions must be practical in order to work
4 levels of PPE
Level A
Level B
Level C
Level D
Liability or responsibility
when a person experiences an injury, it must be determined who was responsible
Changes in your body due to stress
Tense muscles Rapid breathing and heart rate Headaches Difficulties sleeping well Fatigue Changes in sex drive Weaker immune system
Metabolic Agents: Signs and Symptoms
High does of cyanide will produce following symptoms: Shortness of breath and gasping respirations Tachypnea Flushed skin Tachycardia Altered mental status Seizures Coma Apnea Cardiac arrest Apear within several minutes Death likely to occur if pt isn’t treated quickly
how many sleeping disorders are there
80 sleep disorders
Rubella
Viral (German Measles)
Airborne: inhalation of droplets
Vaccination, gloves, goggles, mask on the patient
neurotoxin treatment
respiratory and cardiovascular support
G Agents
Developed by Germans for WWI AND WWII
3 G series agents
BLACK triage
do not have a pulse and are not breathin
Surface-active agents
sometimes called surfactants or wetting agents
decrease the tension between molecules and allow a liquid to spread evenly and thoroughly wet a solid surface
decontamination
removes or neutralizes the contaminants
will always occur in the warm zone
Microbiology Laboratory Wastes
consist of all microbiology laboratory cultures (whether positive or negative), stocks or specimens of microorganisms, live or attenuated vaccines, human or animal cell cultures used in research, as well as laboratory material that has come into contact with such
Chain of Infection
A break in any of the links of the Chain of Infection will result in no infection occurring
physical activity requirements
adults require min 2.5 hrs of moderate to vigorous activity per week
strengthening 2 days a week
children 5-17 min of 60mins per day of moderate to vigorous activity every day
strengthening 3 exercises per week
low level disinfectant:
should kill vegetative bacteria and lipid viruses
Nerve Agents: Signs and Symptoms and Treatment
SLUDGEM
DUMBELS
S – Salivation L – Lacrimation U – Urination D – Defecation G - GI Distress E - Emesis M - Miosis
D – Defecation U – Urination M - Miosis B - Bradycardia, Bronchorrhea, Bronchoconstriction E - Emesis L – Lacrimation S – Salivation
The documentation of crime scene should also include things such as:
Nature of call
How access was gained
Condition of the scene on access
- Obvious signs (e.g. furniture moved, signs of forced entry, broken glass, etc.)
- Lights on or off
- Windows/doors open or closed
Anyone present
Circumstances surrounding patient(s) -Position on arrival Condition of clothing -Extent of injury -Items found in vicinity / on the patient (purse, wallet, cell phone, jewelry, etc.)
Who entered the scene and how
What was disturbed, touched or moved (how and why) – you may need to make a sketch
If the patient was moved—how and why; what their original position was
Anything that appears “not right” or out of place
avoid documenting entrance or exit wounds or how you think they got there, even if there is a weapon in view
radiological attack Indicators of high level exposure are:
Localized burns with no apparent cause
Group of individuals with nausea and vomiting or abnormal blood counts and no noted disease cause
Human Anatomical Waste
any waste that consists of human tissues, organs, and body parts, including those parts that have been preserved, but excludes teeth, hair, and nails
Reservoirs:
place in which infectious agents live, grow and reproduce
People
Water
Food
4 types of supportive behaviors and describe them
Emotional
Expressions of empathy, love, trust and caring
Instrumental
Tangible aid and service
Informational
Advice, suggestions and info
Appraisal
Info that is useful for self evaluation
Red or Hot
(contamination) zone
PPE
All inside are considered contaminated
Fungi
similar to bacteria in that they can grow rapidly innthe precense of nutrients and organic material
Tort
the wrongful act that gives rise to a civil suit
Microbiology Chemical Wastes container
yellow
biohazard symbol
Acute stress
Most common form
Comes from demands and pressures of recent and past
Thrilling and exciting in small doses
Overdoing short term stress can cause psychological distress, tension headaches, upset stomach etc
Botulinum Toxin results
affects the nervous systems ability to function
Voluntary muscle control will diminish as the toxin spreads
cause muscle paralysis that begins at the head and face and travels downward through the body
accessory muscles and diaphragm will become paralyzed and the patient will go into respiratory arrest
Vesicants (Blister Agents) skin sign and symptoms
Burning, reddening Pain Large blisters Grey discoloration Lewisite and Phosgene Oxime Swollen or closed eyes Blindness
tetanus
Toxoid
Common in agricultural area with animal waste
Found in intestines of horses and other animals
Puncture wound
Contaminated street drugs
Gloves
Teatnus booster every 10 years
steps to solve difficult problems
Step 1: how to know if you have a problem Step 2: what is the problem Step 3: how will I know when I get there Step 4: Possible solutions Step 5: What’s the best solution Step 6: put your solution into action Step 7: check up on your progress
behaviors that promote sleep
Finding a room temperature that is comfortable for you
Minimize noise if the sound is keeping you awake
Playing soft music or white noise
Darken room
Develop a bedtime routine
Go to bed when feeling tired not before
Avoid excessive mental stimulation just before bed
Avoid day time naps if
interfering with night sleep
Void just before bed
Relax before bed with bath or reading
Limit alcohol, caffeine, and nicotine from the later afternoon on
Have a light snack, not a big meal before bed
Avoid strenuous exercise just before bed
If have pain take analgesic 20-30 minutes prior to bed
If necessary, medication ( herbal or prescription)
rout of exposure for
sarin
tabun
soman
V agent
sarin: Respiratory, Skin
tabun: Contact and vapour hazard
soman: Skin, min vapour hazard
v agent:Skin, no vapour hazard unless aerosolized
4 Moments for Hand Hygiene
before initial patient/patient environment contact
before an aseptic procedure
after body fluid exposure risk
after patient contact/ patient environment contact
Tuberculosis
Bacterial lung infection
Airborne
Gloves, goggles, masks & gowns, testing
Cover/Concealment
over is something that could potentially stop a bullet or an edged weapon from hurting you i.e., Brick wall, engine block of a car. Concealment is something that you can hide behind i.e., Bush’s, an overturned table. Taking cover is finding a position that both hides and protects your body from projectiles.
Moment of inertia
property of an object to resist changes in angular motion
obstructive sleep apnea
Due to obstruction of upper airway
Causes related to age, obesity, gender, ethnicity, smoking, alcohol, family history
Treatment is CPAP machine while sleeping
2 basic Subunits of Law
Substantive Law
Procedural law
Critical incident
any incident that overwhelms ability of someone to cope with the experience
Sharps Waste
yellow
biohazard symbol and cytotoxic symbol when necessary
what is social wellbeing
not afraid to trust and we treat others with respect and consideration companionship a social support system emotional support encouragement guidance
Sharps Wastes and disposal
consists of any objects that can penetrate the skin or have or are likely to have come in contact with infectious agents
Immediate disposal in a puncture-resistant sharps container that is clearly marked as a biohazard
Biomedical waste is comprised of, but not limited to, the following categories:
Cytotoxic Chemical Wastes Human Anatomical Wastes Human Blood and Body Fluids Wastes Microbiology Laboratory Wastes Sharps Wastes
Received Social Support
“actual receipt of support or helping behaviours from others”
Helps relieve stress
May not be considered helpful if it’s unwanted
neurotoxins signs and symptoms of inhalation exposure
Fever Chill Nausea Irritation of the eyes, nose, and throat Profuse sweating Headache Muscle aches Nonproductive cough Chest pain Dyspnea Pulmonary edema Severe lung inflammation Cyanosis Convulsions Respiratory failure
false imprisonment
a person is intentionally and unjustifiably detained against their will
If paramedic transports a patient without the patient’s consent or uses restraints in a wrongful manner
factors that affect sleep
sleeping disorders, depression, illness, pain, medication, and hormonal changes
elderly woman are most afffected
Environment hazards
Weather: snow or ice covered surfaces, rain, or storms
Terrain issues: mud, rocks, etc.
Illumination difficulties: nighttime, power outages
Difficulty accessing scene
Unstable structures, surfaces, or environments – may be buildings, vehicles, work sites, etc.
When to change social support network
Not enough support
Change in lifestyle
Basic Extrication Principles
Assessment process for transferring, lifting and repositioning of patients
Preparation Process for transferring, lifting or repositioning a patient
Factors that may allow violence
Disrespect Med changes Gang activity Involuntary transport Hunger Loss of employment Lack of privacy Police presence Drug or alcohol abuse Medical causes
v agent (vx)
Clear oily agent that has no odour and looks like baby oil. VX is 100 times more lethal than Sarin and is extremely persistent. In the right conditions, VX can remain unchanged for weeks to months.
Hepatitis E
50% of hepititas cases in developing countries
Fecal- oral route
gloves
mindfulness: attention
curiosity
Attention: take time to focus on physical sensations, thoughts, environment around us
Curiosity: we notice things that come to our attention without judging; interested in the experience without trying to change
Innovation
Be creative to manage different situations
Describe Situations where Emergency Evacuation May be Required
done without the aid of an assistive device either due to the urgency of the situation or to reduce or prevent further injury
Fire or danger of fire.
The danger of explosion or the presence of hazardous materials.
Unsecured accident scene.
The patient’s position prevents you from giving lifesaving care
High Risk PPE- Trained Observer Donning Sequence
Hand hygiene Shoe/boot covers Hand hygiene Nitrile gloves Surgical gown Full face shield Extended cuff nitrile gloves Inspection
Components of Social Support
Perceived social support
Received Social Support
Disadvantages of Chlorine Based Disinfectants
Corrosive to metals and degrades plastics and rubber
Must be diluted fresh daily
Unpleasant odor and irritating to skin and eyes
Inactivated by organic matter
Only sporadical at high concentrations
Spoils clothes if accidentally spilled
Vesicants (Blister Agents) respiratory sign and symptoms
Hoarseness or stridor
Severe cough
Hemoptysis (coughing up blood)
Severe Dyspnea (shortness of breath)
Symptoms of burnout include:
Chronic fatigue Irritability Negative attitudes Lack of desire to work Changes in sleep patterns Emotional instability Feeling of hopelessness Loss of interest in hobbies Constant aches and pains Anxious Panicky Demanding
Angular kinetics
the forces which produce changes in angular motion
court of first instance
Regardless of the type of case being brought forward, it will always be heard in a Court Of First Instance, hence the name
A ruling will be made by the judge in question which shall be the final verdict in the case given a preponderance of the evidence
chronic stress
Grinding stress that wears people away
Comes when a person never sees a way out of a miserable situation
Gives up searching for solutions
People get used to it
Kills through suicide, violence, heart attack, stroke and perhaps even cancer
Lyme disease
Bacterium spread by tick bites
Affects skin, heart, joints and nervous system
Not transmitted from person to person
Long sleeve shirt and pants in tick infested areas
Insecticides
Inspection of exposed skin
Pulmonary Agents (Choking Agents) signs and symptoms
Shortness of Breath (SOB) Chest tightness Hoarseness Stridor Gasping Coughing Nausea
Distress stress
negative stress
Detrimental effect on health
Causes anxiety, concern, decreased performance and can lead to mental and physical problems
negative impacts of shift work on health
Family and friend relationships – missed special events or holidays, responsibilities shifted to a spouse that does not work shift work which can cause relationship strain
Anxiety and depression
Increase in gastrointestinal disorders – may be due to eating habits while at work
Reduced quality and quantity of sleep
Constant fatigue
Increased risk for cardiovascular disorders such as angina, hypertension and heart attack
Disruption of circadian rhythm
hot zone
warm zone
cold zone
Hot Zone – Where the contaminate is
Warm Zone – Where decontamination occurs
Cold Zone – Clean area where treatment can occur
sleep apnea
When anindividual stops breathing for 10 secs or more while sleeping
2 forms of stress
eustress and distress
Portals of exit
ways in which infectious agent leaves the reservoir
Blood
Secretions
Excretions
Skin
4 dimensions of mental health
Thoughts
Body reactions
Behaviors
emotions
Bubonic/Pneumonic Plague
from rodents and fleas
infects the lymphatic system
-patient’s lymph nodes become infected and grow
can spread through the body leading to sepsis and death
not contagious
Section 34 of the Canadian Criminal Code
Factors
the court will review the incident in its entirety and see if the actions you took to remove yourself from the incident were reasonable in nature.
treatment for chronic stress
may include extended medical and behavioural treatment
Donning Sequence - Low Risk
Hand hygiene Surgical gown Mask Full face shield Nitrile gloves
Advantages of Chlorine Based Disinfectants
Economical and readily available
Rapid antibacterial action
Kills tubercle bacilli and viruses
Effective in diluted solutions
The factors that will affect your decision of how and when the patient will be moved, as well as which device, if any to be used are:
The patient’s medical condition
The treatment being given
The need for urgency.
The environmental situation.
Ambient temperature.
Risk of fire, explosion, violence, etc.
Device accessibility
The number of trained partners available.
The Principles of Crisis Intervention are:
Simplicity Brevity Innovation Pragmatism Proximity Immediacy Expectancy
changes in your thoughts due to stress
Struggling to concentrate, remember or make decisions
Losing your self-confidence
Having a negative attitude towards yourself and your life
results of ricin
causes pulmonary edema, respiratory and circulatory failure leading to death
symptoms don’t show for 4-8hrs
social inequality
society’s resources unequally distributed
CBRNE incident indicators:
Group of individuals displaying unusual behavior, sign, and symptoms or unexplained illness
Fogs or clouds and an unusual odour
Devices or packages that have been abandoned
Unexplained pools of fluid
Dead animals
An explosion
Influenza
Viral
Direct & Indirect contact with droplets on surfaces and washing hands
Vaccination, gloves, goggles, mask on the patient
Sleep problems
Trouble falling asleep Trouble staying asleep Early morning waking Behaviors that interfere with sleep Sleeping too much or for too long Excessive sleepiness Excessive fatigue
triage RPM
respiration
Reposition head to clear airway
If respirations don’t return, mark as black tag
If patient begins breathing after reposition mark as red immeddiate
Respirations over 30 mark as red immediate
If respirations are below 30 proceed to profusion assessment
Level B PPE
Chemical resistant suit with its own air supply (SCBA) but does not have as high vapour protection as Level A
Can be encapsulating or non-fully with only a hood
forming stage of team development
period of orientation and getting acquainted with one another
Mindfulness
is simple act of recognizing what’s going on inside of ourselves and what’s going on around us
define wellness
an individual’s physical, mental, spiritual, social and cultural well-being
Wellness also means improving quality of life.
Infectious agents
microorganisms capable of causing disease or illness
Bacteria
Fungi
Parasites
Prions
define social support
Physical and emotional support given to you by your family, friends, coworkers and others
Slander
verbally making a false statement that injures a person’s good name
Disinfecting
rapidly kills or inactivates most infectious diseases
should not be used as a general cleaning agent
eliminates virtually all recognized pathogens but not necessarily all microbial forms
libel
making a false statement in the written form that injures a person’s good name
ten ways to defuse incidents with abusive patients:
Respect All Individuals’ Personal Space
Be Aware of Your Own Body Position
Be Empathic to Others’ Feelings
Keep Nonverbal Cues Nonthreatening
Ignore Challenging Questions
Set and Enforce Reasonable Limits
Permit Verbal Venting When Possible
Identify Real Reason for the Behaviour
Stay Composed, Avoid Overreacting
Use Physical Techniques Only as a Last Resort
Radiological Attack:
can only be detected with specialized detection devices
Only high levels will cause immediate effects
Alcohols as Disinfectants
Ethyl alcohol (ethanol) and isopropyl alcohol (isopropanol) are the only two alcohols useful as disinfectants
Preparation Process for transferring, lifting or repositioning a patient
Assess the need for assistance:
Ensure the patient is transferred the shortest possible distance:
Eliminate or manage environmental risks:
Prepare the equipment:
Eliminate or manage personal risks:
Eliminate or manage patient risks:
HIV/AIDS
Destroys the immune system
Bloodborne & located in some bodily fluids
Gloves, goggles, post-exposure prophylaxis
Human Anatomical Waste container
red
Biohazard Symbol
Patient awareness
always remember patient has ability to harm you either physically or with weapon
General Waste
Items that have had contact with blood, exudates, or secretions but are not saturated or dripping with blood do not require segregation, labeling, or special transport and disposal procedures
Why CBRNE Agents
Often chosen for acts of terror
CBRNE agents are often cheap to construct
The materials are readily available
Little weaponry knowledge is required to construct due to the widespread information on the internet
The effects of the incidents reach further than a traditional shooting or bombing. It may only kill or injury few, but it creates terror in thousands
They are difficult to detect with traditional screening methods
There is a time lag between activation and release allowing the perpetrator time to escape
Can be used as an indicator of an impending attack
factors that contribute to physical health
adequate nutrition following Canada’s Food Guide regular exercise smoke-free environments limiting alcohol consumption adequate sleep safety regarding injury, falls, and poisoning infection control measures seeking medical help when required
Adult gangs in Saskatchewan include the following:
Native Syndicate Indian Posse Red Alert Saskatoon Warriors Crazy Cree Mixed Blood Tribal Brothers Westside Soldiers Hells Angels Fallen Saints
YELLOW
serious but non-life threatening injuries
Sarin (GB)
g agent
Highly volatile and lethal colorless and odorless liquid which turns to a gas seconds after exposure to room temp.
Sask Occupational Health and Safety Regulations
Employer must ensures that the waste:
is segregated at the place where the waste is located or produced;
is contained in a secure, clearly labeled package or container that holds the contents safely until it is cleaned, decontaminated or disposed of; and
is cleaned, decontaminated or disposed of in a manner that will not endanger the health or safety of any worker.
Proximity
The most effective contacts should be placed closer to operational zones
Communicable period
period where a person can transmit illness to someone else
define crisis
“an acute emotional reaction to a powerful stimulus or demand”
Containment and Labeling
container must be appropriate
available through Materials Management
all container must display biohazard symbol and words ‘Biohazard’
Medical and Threat Assessments AOI principle
Ability: does this person have physical strength or strength in numbers to hurt me or immediate access to weapon?
Believe so until proven
otherwise
Opportunity: are you viewed as prey? Violence will not happen if attacker considers their opportunity questionable
Have strong presence visually, vocally and strategically
Intent: does violent attack make sense to them? Mental state? If you are viewed as difficult attack it wont happen
battery
when the defendant (the paramedic) touches another person (the patient) in a harmful or offensive way without consent
rabies
Highly neurotropic virus
Once symptoms begin 7-14 days till death
Bite of infected animal
Vaccine
Droplet Precautions
Droplet precautions will be implemented when droplets larger than 5 µm are present
Hypothalamus in relation to circadian rhythm
Hypothalamus receives signal to release melatonin
Can influence eating habits, digestion and body temp
How to improve social support network
Don’t be afraid to take social risks
Get more from the support you have
Reach out
Be a joiner
Be patient
Avoid negative relationships
Take care of your relationships
6 recommendations for reducing risk in EMS
Protect workers and promote safety, health, and well-being through workplace policies, programs, and activities.
Promote safe patient-handling techniques.
Protect workers from exposures to blood and other potentially infectious body fluids.
Prevent slips, trips, and falls.
Improve motor vehicle safety.
Prevent violence by patients.
interview stance
Arms length away Body at 45 degree angle to person Feet shoulder width apart Knees slightly bent Palms facing forwards
Cleaning
removes foreign material from a surface
physically removes the microorganism rather than kill it
key to proper cleaning is to use friction and detergent
Vesicants (Blister Agents)
Skin is primary route of exposure
Vapour can be produced when vesicant is left on skin/clothes long enough
-Vapour can enter through respiratory tract
Vesicant creates burn like blisters
Agents consist of Sulfur, Mustard, Lewisite and Phosgene Oxime
Usually cause most damage in damp moist areas ex armpits, groin, and respiratory tract
Constitutional right to take legal action against doctor, nurse, paramedic or other but must prove what
Person suing must prove that the medical providers caused harm by failing to meet accepted standards of care
Has to prove all the elements of negligence