Health and Wellness

Nothing should supercede the health and wellness of emergency service personnel. According to the National Fire Protection Association (NFPA), heart attacks are the No. 1 killer of fire service personnel.1 Although most NFPA data relates to firefighters, many firefighters are also EMS-certified providers. Pointing the finger at any one specific health issue for EMS is much more difficult, since no central data collection exists for EMS activities. Regardless, healthy, prudent lifestyles allow emergency service providers to perform more effectively and efficiently. What we eat, drink, inhale or otherwise subject our bodies to affects every function of it. Guarding against disease and the regular practice of physical activities impact our everyday lives, and are thus extremely important to our well-being.

Risks associated with heart disease alone are applicable to many of the EMS functions we perform. High blood pressure and smoking are the two major contributing factors. In addition, excess weight, age, race, alcohol, family history, diabetes and modern stressors play vital roles in promoting heart disease. An educated provider is an informed provider, and is more likely to lead a prudent lifestyle.

Adopting a Healthy Lifestyle

Wellness is a broad topic that may be addressed best by understanding general components of wellness that, when practiced, will have a positive effect on your health.

Wellness is typically divided into two components: physical and emotional. The physical component deals with nutrition, exercise, disease and sleep. The emotional component often involves stress factors.2

According to the American Dietetic Association (ADA), comprehensive nutrition services are an integral aspect of basic healthcare. The ADA says that early identification of nutrition-related diseases and conditions leads to "improved health outcomes resulting in economic benefits and improved quality of life."3 A well-balanced eating plan can help providers maintain the required energy to perform efficiently on and off the job.

Exercise is also an important component of a healthy lifestyle. Just think: 30 minutes a day of dedicated aerobic activity, coupled with a balanced eating plan, is all it takes to lead you to the road of improved health. Activity as simple as brisk walking, swimming, jogging or riding a bike can build endurance and sustained energy.

EMS providers continually learn about bloodborne pathogens and infectious diseases. Most of the emphasis is placed on protecting oneself from potential harmful work environments. To achieve wellness, EMS providers should take the context of prevention a step higher. The conscious awareness of germs and simple prevention of the transmission of the common cold is one primary example. According to the Centers for Disease Control and Prevention, hand-washing alone is the single most effective means to prevent the transmission of disease. This should be no surprise, but remember that when you wash your hands and then touch other objects, it is possible that the person who touched the same objects before you did not wash theirs.

Eight hours of sleep is considered the quintessential number. One-third of our life is spent sleeping, but what about the quality of that sleep? According to the National Sleep Foundation, an independent nonprofit organization dedicated to improving public health and safety by achieving understanding of sleep and sleep disorders, certain activities can affect sleep. Smoking, alcohol, caffeine, lack of exercise, room temperature, light and darkness, and noise may alter your sleep pattern.4

It's no secret that emergency service providers have very high-stress jobs. Administrative hassles, threat of injury, exposure to infectious disease, the added hours involved in volunteering, traffic, weather extremes and the consuming nature of the work itself are all contributors.

Too much stress can hinder your performance. It can affect your memory, spark interpersonal conflict, ruin morale and increase accidents. It can also make you sick. High stress is a contributing factor in heart disease, hypertension, ulcers, cancer, diabetes, depression and other problems.

Knowing how to recognize stress and what to do about it is an important safety issue. The nearly universal signs of being overstressed include:

Persistent fatigue: When you don't feel refreshed even after many hours of sleep.

Negativity and cynicism: Worsens where it already exists and starts where it didn't exist before.

Diminished job motivation: If an activity starts to hurt, it's natural to become less motivated to do it.

There are other signs and symptoms as well. Physically, stress can promote general muscular tension, headache and a stiff neck, pain between your shoulder blades or in your lower back, respiratory illness and gastrointestinal upset. You may feel like a "coiled spring," or find yourself clenching your jaws or fist.

Emotionally, you may feel overwhelmed, helpless or hopeless, isolated or relentlessly pressured. After a while, it may feel as if everyone is making demands for your help. You may also cry easily, sleep and eat too much or too little, become irritable or begin to overuse alcohol, caffeine, nicotine or other "comforting" substances.

Action Steps

Here are some things you can do to help create a healthy lifestyle:

Eat healthfully-A well-balanced diet will facilitate needed energy and help ward off weight gain. Three to six mini-meals a day are generally healthier than 2-3 moderate to large meals. Five to seven servings of vegetables and fruits are suggested.

Exercise-Among the many benefits are improved fitness and a general sense of well-being and self-control. Exercise 4-6 times per week, rotating types of exercise. Begin with short increments of 10-15 minutes and progress to 30-60 minutes over several weeks.

Progressive muscle relaxation-Do concentrated relaxation techniques at rest and when you go to bed.

Learn deep breathing-This is done with the diaphragm, not the upper chest, and is inherent to many martial arts, yoga and meditation. Practice deep breathing on and off throughout the day to gain composure and obtain clear thought processes.

Take time off-Take a break: a vacation, a few days off, maybe just less overtime. Always make time for yourself on a regular basis. It may involve doing absolutely nothing, practicing a hobby, or something as simple as mowing the grass.

Expand your social circle-Be involved in non-emergency service-related functions and organizations.

Rekindle an old hobby-Golf, golf and more golf! Or whatever you enjoy in your free time.

Unwind appropriately-Unwind from a day's work during your drive home, or allow a few minutes of personal wind-down time when you reach home. Leave work at work. When you arrive home, your time is for family and other interests. Try exercising, but not immediately before bedtime, and avoid heavy meals before bedtime.

Don't smoke-Enough said.

Drink responsibly-More than enough said.

Practice good hygiene-Need we say more?

Get adequate rest-Want a better night's sleep? The Sleep Foundation suggests the following:

• Consume less or no caffeine and avoid alcohol.
• Drink less fluid before going to sleep.
• Avoid heavy meals close to bedtime.
• Avoid nicotine.
• Exercise regularly, but do so in the daytime, preferably after noon.
• Try a relaxing routine, like soaking in warm water (a hot tub or bath) before bedtime.
• Establish a regular bedtime and wake-time schedule.

Conclusion

Your wellness is essential to your overall good health, which in turn helps ensure your quality of life, your safety and the safety of your colleagues and family, on and off the job. Eat smart, exercise regularly, think about what you put into your body, take time for yourself, get quality rest and enjoy life. These factors will assist you and your organization to continue to provide outstanding public safety services without the hindrance of an unhealthy lifestyle.

Until next time-be safe!

References

1. Karter M, Jr., Molis J. Firefighter Injuries, NFPA Journal, Nov/Dec 2003.
2. Sanders MJ. Mosby's Paramedic Textbook, 2nd Ed. Mosby Lifeline, 2001.
3. American Dietetic Association website: www.eatright.org.
4. Sleep Foundation: www.sleepfoundation.org.

Bibliography

• American Sleep Association, www.americansleepassociation.org.
• EMS Safety: Techniques and Applications, United States Fire Administration.
• Pearson J, Hayford J, Royer W. Comprehensive Wellness For Firefighters, 1995.