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Emotional Well Being

Cases with High Emotional Stress

  • MCIs (Multiple-casualty incidents).
  • Child abuse and neglect.
  • Abuse of the elderly.
  • Incident involving a friend, relative, or coworker.
  • Traumatic injuries.
  • Dealing with patients and family members involved in death and dying.

Coping with Death and Dying

  • For patients: Treat dying patients with dignity and respect. Communicate to the patient what you are planning to do and let the patient know that you are doing everything you can to help. This will bring assurance to the patient and establish trust. Even if the patient may look unconscious, he or she may still be able to hear and understand what you say.
  • For family members: Be compassionate to the patient's friends and relatives who may be around. An important skill is to be able to listen empathetically to the grieving of family members. Assure that you are doing everything you can for the patient, but at the same time do not give false assurances. Be honest with the relatives about the patient's status, but also be tactful. Good judgment should leave the family members with an accurate understanding of the patient's condition and also allow them to have some hope.
  • For yourself: Prepare yourself emotionally to encounter death and dying situations and be able to cope with it. One aspect is to recognize and understand the five stages of denial, anger, bargaining, depression, and acceptance. Learning to recognize and accept these emotional stages in your patients can help you come to terms with death and dying. Learn to realize if you are in stress and participate in programs to relieve stress.

Recognizing and Managing Stress

  • There are three stress reactions with symptoms that include anxiety, irritability, nausea, guilt, isolation, and loss of concentration, appetite, and interest in life. Learn to recognize them in yourself and in others and manage them accordingly.
  • Acute Stress Reaction: occurs immediately after an emotionally traumatic incident.
  • Delayed Stress Reaction: occurs after a delayed period after an incident. One example is the Posttraumatic stress disorder.
  • Cumulative Stress Reaction: occurs as a result of many stressful reactions over time.
  • Stress management involves both physical and mental adaptations.
  • Exercise: Activity provides an outlet for emotions, releases positive hormones, and improves physical condition.
  • Diet: Take up a healthy diet and avoid dependence on caffeine or alcohol.
  • Relax: Slow and deep breathing, yoga, and vacations all help relieve stress.
  • Participate in programs of stress management such as social networks, professional services, and programs sponsored by your EMS for stress management.
  • CISM (Critical Incident Stress Management): System to manage the stress of EMS workers. Involves stress education, peer support and CISD (Critical Incident Stress Debriefing).

Physical Well Being


  • Body substance isolation involves using proper equipment to prevent the transmition of infectious diseases.
  • The equipment used in BSI is called PPE (Personal protective equipment). These include gloves, eyewear, gowns and masks.
  • Handwashing: The single most effective way to prevent the spread of infectious diseases is by washing your hands thoroughly after each incident, even if gloves were worn. The guidelines for handwashing is 10-15 seconds of vigorous scrubbing with soap and rinsing with the hottest water that you can bear.
  • Report exposure to body substances such as blood and body fluids promptly to your supervisor by following your local policies and protocols.


  • Annually vaccinate against or test for PPD (Purified Protein Derivative) tuberculin test and Influenza.
  • Tetanus prophylaxis every 10 years.
  • Hepatitis B vaccine.
  • MMR (Measles, Mumps, and Rubella).
  • Varicella
  • Polio

Scene Safety

  • Hazmat: Look out for hazardous materials by identifying signs and placards listed in the Emergency Response Guidebook available inside every ambulance.
  • Violence: Do not enter scenes with potential violence. These include scenes of fights, aggression, and weapon use. When in doubt, call law enforcement to check for scene safety.
  • Do not try to handle hazardous scenes without the proper training and protective gear.