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One of the hardest parts of this job: The call after Planning for trauma: How to protect EMS providers’ mental health

Rickey Stokes

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Posted by: RStokes
rstokes1450@gmail.com
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Date: Nov 01 2019 7:16 PM

A paramedic details how EMS providers carry the weight of difficult calls with them through their next interactions with patients and families



By Lindsey Stein, MS, NRP, FP-C


You’ve just carried the tiniest dead baby into the ER, found unresponsive after co-sleeping. Told a husband of 40 years that his wife, who was released from the hospital last night with chest pain, is now dead. Pumped on the chest of an elementary schooler while his mom wails in the background. Told the wife of a heroin addict that it’s too late for Narcan this time. Been asked by the suicide attempt why he’s still alive, only for him to die minutes later. Told a wife and young son that their husband and father, who was healthy and well hours earlier, is now dead. Zipped up the body bag of a young woman who drove drunk, another who took her own life, one who shot up too much heroin after being clean for months.


And then, before your ambulance is put back together, you get toned for abdominal pain. You smile and say hello, and ask what’s wrong today. You tell them that you’re sorry they’re not feeling well, that that’s no way to spend a Saturday. You apologize for asking the same question twice. You make sure they’re comfortable, ask if they’re too hot or too cold.


You empathize with the elderly man who’s had diarrhea for three weeks and just can’t seem to get better. With the mom whose only child cut her head open and needs a stitch or two. With the woman whose migraine today is worse than it’s ever been. You tell them there will be a little pinch, and ask if they’d like some medication for nausea. You touch their arm, tell them the nurses will take great care of them, and that you hope they feel better soon.


And it’s exhausting. They don’t know that you still need to document the futile efforts of a pediatric code. That there’s blood on your boots you didn’t notice yet from a suicide. That you’re questioning if you should’ve worded that death notification differently or tubed that patient earlier or moved faster on that scene.


They don’t know, and they never should. It’s our job to treat every patient like our only patient - a near inhuman task at times, and a necessary one. But after we take care of our patients, it’s our job to take care of ourselves and each other. Ask. Talk. Cry. Question. Understand. Do what you need to do to make sure your partner’s OK. The next patient depends on it, and so does your partner. 


You empathize with the elderly man who’s had diarrhea for three weeks and just can’t seem to get better. With the mom whose only child cut her head open and needs a stitch or two. With the woman whose migraine today is worse than it’s ever been. You tell them there will be a little pinch, and ask if they’d like some medication for nausea. You touch their arm, tell them the nurses will take great care of them, and that you hope they feel better soon.


And it’s exhausting. They don’t know that you still need to document the futile efforts of a pediatric code. That there’s blood on your boots you didn’t notice yet from a suicide. That you’re questioning if you should’ve worded that death notification differently or tubed that patient earlier or moved faster on that scene.


They don’t know, and they never should. It’s our job to treat every patient like our only patient - a near inhuman task at times, and a necessary one. But after we take care of our patients, it’s our job to take care of ourselves and each other. Ask. Talk. Cry. Question. Understand. Do what you need to do to make sure your partner’s OK. The next patient depends on it, and so does your partner. 


Planning for trauma: How to protect EMS providers’ mental health


Communication at home, recognizing PTSD throughout the ranks and preparing in advance can help paramedics and EMTs handle the consequences of the trauma they experience


By Lieutenant Brad Bouchillon, Statesboro (GA) Fire Department


Practice is an important element in success. A football team practices plays over and over again to have their playbook memorized. An actor practices lines until they are memorized. Practicing response as a public safety professional is no different.


Paramedics, EMTs, firefighters and police officers must train extensively on a myriad of topics to be both effective and remain safe. Law enforcement officers perform active-shooter drills; firefighters hold live-fire training burns; and EMTs simulate mass casualty incidents to be prepared to respond in any situation. Yet, one of the most damaging experiences for these men and women is one that very few actually prepare .


Public safety personnel are often exposed to horrific scenes in the line of duty. These professionals respond to tragic events that permeate all senses including sight, sound and smell. Unfortunately, there is little to no training offered to adequately prepare public safety professionals to process trauma. This training gap doesn’t make sense: Firefighters, EMTs, and police are far more likely to experience trauma, so why is there not more training to prepare them?  


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