Chapter 2-1 Lecture

• Paramedics provide pre-hospital emergency care and transport, a demanding yet gratifying job.
• Personal wellness and safety, both on and off scene, are crucial for paramedics.

Scene Safety Issues

• Scene hazards.
• Environmental conditions.
• Human-made threats.
• Violence against first responders.
• Infectious diseases.

Injury and Fatality Statistics

• EMS has one of the lowest overall fatality rates among emergency services, but transportation crashes are a major cause of death.
  • Ambulance crashes: 1,500 occur annually in the US.
  • 59% during emergent response, 34% non-emergent.
  • 2007-2011: Over 3,000 ambulance crashes, over 1,400 injuries, 29 fatal crashes with 33 fatalities.
• EMS exceeds other emergency professions in nonfatal injuries, sprains and strains most common, especially to the back.
• Fatigue and sleep deprivation are major contributing factors.
• Scene is never safe, EMS providers should always be aware.

Wellness Defined

• Wellness (1654): Quality or state of being in good health, an actively sought goal.
• Three components: physical, mental, and emotional; some include spiritual.
• Top physical condition aids quicker recovery from injuries.

Physical Well-being

• American Heart Association's Life Simple 7 improves heart health.
  • Be active.
  • Control cholesterol.
  • Eat better.
  • Manage blood pressure.
  • Lose weight.
  • Reduce blood sugar.
  • Stop smoking.
  • These steps also improve mental well-being.
• Poor nutrition consequences: heart disease, type 2 diabetes, obesity, and other medical conditions.
• Many EMS workers work 24-hour shifts with limited breaks, challenging healthy lifestyles.

Dietary Guidelines

• USDA's myplate.gov offers dietary guidelines for Americans (2020-2025).
• Six food categories: vegetables, fruits, grains, dairy, protein foods, and oils, in suggested portions.
• Nutritional requirements should be designed for individual needs.

Vegetables

• Any vegetable or 100% vegetable juice counts.
• Raw, cooked, fresh, frozen, canned, dried, dehydrated, whole, cut up, or mashed.
• Vary vegetables; eat more dark green and orange vegetables, beans, and peas.
• Half of the plate should be fruits and vegetables.

Fruits

• Any fruit or 100% fruit juice counts.
• Fresh, frozen, canned, or dried; whole, cut up, or puree.

Grains

• Wheat, rice, oats, cornmeal, barley, or other cereal grains.
• Bread, pasta, oatmeal, breakfast cereals, tortillas, and grits are examples.
• Make one half of grains whole grains.
• Whole grains contain nutrients that reduce the risk of disease, more protein and fiber.

Dairy

• Fluid milk products and many foods made from milk.
• Choose low-fat or fat-free items.
• Foods made from milk retaining calcium are included.
• Foods made from milk with little calcium (cream cheese, cream, butter) are not included.
• Calcium-fortified soy milk is part of the dairy group.

Protein Foods

• Meat, poultry, seafood, beans, peas, eggs, processed soy products, nuts, and seeds.
• Beans and peas are also part of the vegetable group.
• Choose low-fat or lean meats and poultry; bake, broil, or grill them.
• Vary choices with fish, beans, peas, nuts, and seeds.

Oils

• Fats liquid at room temperature; from plants and fish.
• Not a food group, but provide essential nutrients.
• Make most fat sources from fish, nuts, and vegetable oils.
• Limit solid fats (butter, stick margarine, shortening, lard) and avoid trans fats (partially hydrogenated oils).
• Read nutrition labels; review sodium, fat, and carbohydrate composition.
• Be aware of high-fiber content in fat-free processed foods.
• Salt intake should be monitored

Weight Control

• USDA guidelines: healthy eating pattern across lifespan.
• Focus on variety, nutrient density, and amount.
• Limit calories from added sugars and saturated fats; reduce sodium.
• Shift to healthier food and beverage choices.
• Gradual weight reduction is key, requires planning.

Exercise

• Regular exercise: linked to body weight, nutritional status, hydration.
• Exercise program should target cardiovascular endurance, flexibility, and strength.
• Doctor consultation recommended before starting program.
• Gradually increase physical activity to avoid injury.
• Adults: 30 minutes of moderate to vigorous activity daily.

Target Heart Rate

• AHA suggests target HR between 50-69% of maximum heart rate.
• Calculate max HR: 220 - age in years.
• E.g., 40 years old: 220 - 40 = 180 bpm.*
• Multiply max HR by 0.5 to 0.69 to find target heart rate range.
• E.g., 180 x 0.5 = 90 bpm, 180 x 0.69 = 124 bpm; target range: 90-124 bpm.
• If known resting heart rate:
• Subtract age from 220.
• 220 - 40 = 180.
• Subtract resting heart rate.
• 180 - 60 = 120.
• Multiply by 0.5 to 0.8.
• 120 x 0.5 = 60, 120 x 0.8 = 96.
• Add resting heart rate to the range.
• 60 + 60 = 120, 96 + 60 = 156; target range: 120-156 bpm.

Smoking

• Negative health effects increasing.
• Resurgence among millennials with vapor devices.
• Everyone responds differently to smoke; have cessation options.
• E-cigarettes (electronic nicotine delivery systems/personal vaporizers): simulate smoking by vaporizing flavored liquid.
• Full danger not determined, but should be avoided.

Alcohol

• A drug modifying brain's stress perception.
• Cannot alleviate stress; discomfort persists.
• Can lead to dependence.

Circadian Rhythms

• Body's natural timing system, controlled by brain areas.
• govern's internal clock.
• Ignoring: difficulties with sleep, higher thought functions, physical coordination, social functions.
• Determine natural rhythms and design schedule.
• Tips for shift work: avoid caffeine, eat healthy, maintain regular sleep schedule. -Lack of sleep is similar to intoxication on mind and body.

Health Risk Assessment

• Periodic assessment needed, hereditary factors can influence health.
• Work with physician to schedule and build into routine.

Lifting Techniques

• Paramedics lift and move patients.
• Minimize total body lifts using power stretchers and lifts.
• Coordinate lifts and minimize weight.
• Lift with legs, not back; breathe when lifting.
• Use wheels, ask for help.

Stress Management

• Stress activates fight or flight response.
• Physiologic responses help, long-term mental health requires coping skills.
• Paramedics: control emotions regardless of situation.
• Balance work and home life.
• Deal with patient disability and death, frequent flyers, combative patients.
• Take coworker concerns seriously; seek assistance if needed.

Spirituality

• Unseen dimension of human experience, addressed with formal religion.
• Medical care: supports dignity, value of life, sacredness of all people.