First Responder EMS Curriculum for Training Centers in Eurasia

comprehensive approach include medical direction support, peer support, follow-upservices for workers and families, and community awareness and support programs.Critical incident stress debriefing (CISD) is a discussion among peer emergency andmedical direction personnel of the events surrounding a stressful incident. Opencommunication, recognition of strengths and weaknesses in dealing with a particularmedical or traumatic emergency, and peer support will ultimately lead to a moreeffective and responsive EMS system.e. Critical Incident StressThe EMS system should provide effective measures to help emergency workers copewith stressful situations. Stress is a normal response to abnormal situations. Acceleratedrecovery from the stress of certain critical incidents is a worthwhile goal. This systemusually involves peer counselors and mental health professionals. Not every medical ortraumatic situation requires a formal debriefing. Certain incidents, however, shouldwarrant in-depth discussion. These situations include line-of-duty death or seriousinjury, multiple casualty incident, suicide, serious injury or death of a child, events withmedia interest, victims known to the responding emergency personnel, and any disaster.Techniques for enhancing the recovery process include:1. Defusings. This technique is shorter, less formal, and less structured than a formaldebriefing. Defusing should take place within a few hours after an event and usuallywill last less than 30 minutes. It offers time for emergency personnel to ventfeelings, frustrations, and concerns and to ask questions.2. Debriefings. This is a formal meeting held 24 to 72 hours after a critical incident.Debriefings provide an open discussion of the events, feelings, concerns, andreactions. It is not meant to be an interrogation or investigation. Peer emergencypersonnel, medical direction, and mental health professionals evaluate theinformation discussed and offer suggestions on overcoming the stress of the criticalincident. All information must be confidential.3. Body Substance Isolation (BSI)Emergency medical care for patients with medical and traumatic illness or injury involvescertain inherent risks to the First Responder. First Responders must be aware of these riskswhen approaching all patients and must take the appropriate precautions. Exposure to apatient’s bodily fluids, airborne particles, and hazardous materials at the scene may all belimited significantly by the use of appropriate precautions and safety equipment. FirstResponders are exposed to infectious diseases when treating patients. They should assessthe potential risk involved and take appropriate precautions. Personal protective equipmentshould be used as needed. Barrier devices or ventilation masks should be used whenventilating a patient.a. Infection ControlThe primary goal is prevention of disease transmission. The most important technique toprevent disease transmission is hand washing/personal hygiene. Cleaning, disinfecting,and replacing used equipment also is vitally important.BSI includes the use of eye protection, gloves, gowns, and masks whenever the FirstResponder is at risk for transmission of disease.14First Responder EMS Curriculum/AIHA, July 2002