First Responder EMS Curriculum for Training Centers in Eurasia

and family. Do not become defensive. Be tolerant and empathetic. Remaincomposed.4. Bargaining. An agreement, which in the patient’s mind, will temporarily postponeinevitable death. “OK, but first let me…”5. Depression. This is a stage of overwhelming sadness and despair and a feeling ofhopelessness.6. Acceptance. This is the final stage of the grieving process. The patient will oftenreach this stage earlier than family or bystanders. Support, understanding, andcompassion remain vitally important.The First Responder must be able to deal with dying patients and their friends or family.Always remember the needs of the patient: dignity, respect, privacy, control, sharing,and communication. Let the patient know that everything that can be done to help willbe done. Comfort the patient and family, reassuring them that all appropriate measuresare being taken. Use a gentle, firm voice and a reassuring touch, when appropriate.Listen to, and communicate with, the patient and family. Do not falsely reassure. Allowthe patient and family members to express anger, rage, and despair.c. Stress ManagementStress can be managed at several different levels. These range from awareness ofwarning signs, to making changes in lifestyle and the workplace, and to seekingprofessional help, if necessary.1. Recognize warning signs. Maintaining an awareness of the way in which stressreveals itself may help prevent emotional and physical injury to an individual orhis/her co-workers, family, or friends. These symptoms of stress may includeirritability toward others, inability to concentrate, insomnia/difficulty sleeping,anxiety, indecisiveness, guilt, loss of interest in work, loss of interest in sex, loss ofinterest in previously enjoyed activities, and isolation.2. Make changes in lifestyle. Maintaining a healthy lifestyle will often help maintaina healthy attitude toward work, family, and friends. It may help with “job burnout.”Altering your diet to include reduced fat, sugar, caffeine, and alcohol promoteswell-being. Exercise and relaxation also are vital to the well-being of the FirstResponder.3. Achieve balance. Balance work with appropriate amounts of time for recreation,exercise, family, and friends.4. First Responders and emergency medical services (EMS) personnel should try toshare their experiences, questions, and frustrations with other emergency personnel.Communicate the stresses of the job with family and friends. Caring for peoplerequires a support network of people.5. Make changes in the work environment. Always consider ways to make theworkplace a healthier environment.6. Seek/refer professional help, if necessary. The job of the First Responder involvesdealing with a variety of stressful situations. Included in the support network aremental health professionals, social workers, and clergy.d. Comprehensive Critical Incident Stress ManagementCritical incident stress management requires a comprehensive approach to best serve theFirst Responders and other personnel in the EMS system. The first step, as outlinedabove, is education regarding stressful situations. Other important elements in thisFirst Responder EMS Curriculum/AIHA, July 2002 13