CISM

1
CISM

• Critical Incident Stress Management
• for
• Emergency Services Personnel

2
(No Transcript)
3
WHAT ARE CRITICAL INCIDENTS?

• Events which may cause strong emotional effect on
  an emergency worker

4
WHAT ARE CRITICAL INCIDENTS?

• Line of duty Death or Major Injury

5
WHAT ARE CRITICAL INCIDENTS?

• Death or Major Injury of a child

6
WHAT ARE CRITICAL INCIDENTS?

• Prolonged Search and Rescue Efforts

7
WHAT ARE CRITICAL INCIDENTS?

• Mass Casualty Incidents

8
WHAT ARE CRITICAL INCIDENTS?

• Operations involving extensive media coverage

9
CRITICAL INCIDENTS ARE..

• Knowledge of the victim
• Long extrication
• Loss of a fellow Emergency Worker

10
OR..Any situation that causes stress to the
Emergency Worker
11
ONE OF THE LEADING CAUSES OF DEATH IN EMERGENCY
SERVICE WORKERS IS STRESS-RELATED CARDIAC ARREST

• Educational programs for dealing with stress on a
  daily basis are essential in reducing stress.

12
New Castle County CISM Team

• Member of
• Delaware Volunteer Firemens Association - DVFA
• New Castle County Volunteer Firemens Association
  - NCCVFA
• International Critical Incident Stress Foundation
  - ICISF
• Established 1989

13
NEW CASTLE COUNTY CISM TEAM

• Volunteer/Paid Personnel
• Fire Fighters
• Ladies Auxiliary
• Paramedics
• Police
• Nurses
• Clergy
• Mental Health Providers
• Disaster Workers

14
GOAL

• Assist Emergency Service Workers who face a
  Critical Incident
• Provide pre-incident education and information on
  how to overcome stress reactions
• Prompt activation of the New Castle County CISM
  Team

15
(No Transcript)
16
SERVICES

• On-scene support
• Demobilization Services
• Defusing
• Formal debriefings

17
SERVICES

• On-scene support

18
ON SCENE SUPPORT

• One-on-one support for Emergency Personnel at the
  scene
• Provide advice and support incident commanders at
  the scene on topics of stress management
• Assist the victims and family members until other
  help arrives

19
SERVICES

• On-scene support
• Demobilization Services

20
DEMOBILIZATION SERVICES FOR LARGE SCALE EVENTS

• (highly intense or unusual)
• Establish a location away from the scene for
  out-of-service units
• Provide support and information on stress effects
  resulting from the incident
• Provide a place for command to issue incident
  updates
• Provide reassurance that help is only a phone
  call away

21
SERVICES

• On-scene support
• Demobilization Services
• Defusing

22
DEFUSING

• Initial session for releasing stress
• Performed 1-3 hours following an incident
• Provides information and support about managing
  stress for all personnel involved in the incident
• Lasts about 45-60 minutes
• TOTALLY CONFIDENTIAL

23
SERVICES

• On-scene support
• Demobilization Services
• Defusing
• Formal debriefings

24
FORMAL DEBRIEFINGS

• The next step in the Stress Management process
  for workers that have been involved in a critical
  incident
• Occurs as a result of follow-up requests
• Led by a mental health professional with the aid
  of peer support
• TOTALLY CONFIDENTIAL

25
THE EMOTIONAL RESPONSES TO CRITICAL INCIDENTS
ARE.NORMAL REACTIONS BY NORMAL PEOPLE TO
ABNORMAL SITUATIONS.
26
(No Transcript)
27
EMERGENCY SERVICES

• A very demanding profession -
• career or volunteer
• Daily emotional and physical demands leading to a
  strain on minds and bodies
• Continuous stress without resolution - lessens
  productivity and shortens careers

28
CISM INTERVENTION

• The required preventive maintenance of our minds
  and bodies

29
STRESSES FACED BY EMERGENCY SERVICE WORKERS

• Always on alert
• Dealing with tragedy
• Dealing with death

30
(No Transcript)
31
PHYSICAL SIGNS OF STRESS

• Tension - chest pains, trembling, fidgeting,
  fumbling
• Jumpiness - easily startled
• Cold sweats, dry mouth, pale skin
• Pounding heart - lightheaded, dizzy
• Shortness of breath
• Nausea

32
PHYSICAL SIGNS OF STRESS

• Bowel or bladder disturbance
• Incontinence
• Fatigue
• Frequent Illness
• Day dreaming

33
EMOTIONAL SIGNS OF STRESS

• Changes in behavior
• Anxiety
• Irritability
• Lack of attention

• Lost train of thought
• Trouble sleeping
• Grief
• Crying

34
EMOTIONAL SIGNS OF STRESS

• Memory Problems
• Depression
• Anger
• Loss of confidence
• Rapid Mood Change
• Taking unnecessary chances
• Excessive use of Drugs or Alcohol

35
SIGNS/SYMPTOMS - a cry for help Watch for
signs in yourself and co-workersBeing aware
enables you to help someone.

• KEEP AN EYE ON EACH OTHER, BECAUSE NO ONE ELSE
  CAN.

36
FEELING STRESSED?

• Keep calm and in control
• Focus on immediate assignment
• Talk to someone, anyone, everyone
• Take a deep breath
• Shrug your shoulders to reduce tension
• Keep a sense of humor
• Stay in touch with your colleagues

37
(No Transcript)
38
FEELING STRESSED?

• Exercise
• Eat properly
• Talk to friends and family, let them know what
  you are going through
• REMEMBER
• STRESS REACTIONS
• ARE NORMAL

39
Keep in touch with loved ones.
40
WHEN A CRITICAL INCIDENT HAPPENS.

• Contact your OIC
• Officer contacts the New Castle County CISM team
  via Fire board
• The CISM coordinator will set up a team and
  schedule a time for a defusing or debriefing

41
THINGS THE COORDINATOR NEEDS TO KNOW.

• Why CISM is needed?
• What signs of stress are present?
• Who was involved? ( of persons)
• When session can take place?
• Where to meet and who to contact?

42
WHAT TO DO WHILE THE TEAM IS RESPONDING.

• Support your
• co-workers

43
AN INCIDENT MAY TRIGGER REACTIONS FROM A PRIOR
INCIDENT
44
STRESS CAN ACCUMULATEDont let it build
upTalk Talk Talk!!!
45
STRESS IS EVERYWHERETake care of Stress
Before it takes care of YOU!!
46
Emergency Workers do not snore, burp, sweat or
pass gas. There fore, they must Bitch or they
will BLOW UP!!
47
REMEMBER.THE EMOTIONAL RESPONSES TO CRITICAL
INCIDENTS ARE.NORMAL REACTIONS BY NORMAL
PEOPLE TO ABNORMAL SITUATIONS.