Treating psychological injury

Editor’s Note:

Editor's note: Responders turned out for a public hearing Wednesday to oppose a bill that would curb eligibility for permanent coverage for mental illnesses under Maine workers' compensation law. Many testified against the bill, saying some have suffered from post-traumatic stress disorder and other serious emotional disabilities for just doing their jobs. Editorial advisor Art Hsieh says for the vast majority of workers, to receive some benefit is vital and potentially life-saving while they heal from their injuries, both mentally and physically.

This is an article full of landmines.

On one side, I can see what the bill is trying to curb — abuse by employees and their health care providers to rationalize their disabilities through nonphysical fraud. There have been stories printed in my local paper that describe unbelievable circumstances of worker compensation abuse, all paid for by other employees in the system and ultimately by other taxpayers.

Fortunately those cases are few. For the vast majority of workers, to receive some benefit is vital and potentially life-saving while they heal from their injuries, and return to work. That's where the bill has to tread lightly, or it risks throwing out the proverbial baby with the bath water.

I can imagine what the police officer must have witnessed that drove him to pull his weapon on himself. That type of tragedy affects each of us differently and to varying depths. Unlike a physical injury like a broken ankle or strained back, not as much is known about the effects associated with a psychological injury.

Today I am at a county-wide, mandatory in-service training. Part of the class is reviewing and practicing seldom used skills such as cricothyrotomy, Intraosseous insertion, and pediatric intubation. As I practiced, I remembered the different cases I've had to handle over the years where I last used some of these skills.

Some of the cases were truly tragic, causing sadness not only for the patient or surviving family, but also for the rescuers involved. I'm certain that a few colleagues had left the profession because of a single or cumulative series of cases. These are tough situations to handle, and it can only be made worse for an employer to be limited in his or her ability to recognize and manage these incidents.

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.

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