Critical Incident Stress

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Critical Incident Stress

• Developed as part of the National Emergency
  Services Curriculum Project

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CISM Defined

• Critical Incident Stress Management (CISM) may be
  defined as a group discussion about a traumatic
  event, or series of traumatic events.

• CISM is solidly based in crisis intervention
  theory and educational intervention theory.

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Purpose

• The process is designed to mitigate the
  psychological impact of a traumatic event, e.g.,
  plane crash, natural disaster, serious incident
  or accident.

• It serves as an early identification mechanism
  for individuals who may require professional
  mental health follow-up subsequent to a traumatic
  event.

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No one in emergency services is immune to
critical incident stress, regardless of past
experiences or years of service.
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What is it?

• Critical Incident Reactions
• Happen after intense, unusual, or abnormal events
• Aircraft Accident Site
• Fatalities
• Not finding a missing person or aircraft
• May not appear right away
• Reactions are normal

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Reactions are classified as PHYSICAL EMOTIONAL CO
GNITIVE BEHAVIORAL
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Reaction Types

• PHYSICAL
• Nausea
• Fatigue
• Headaches

• EMOTIONAL
• Denial
• Fear
• Depression

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Reaction Types Continued

• COGNITIVE
• Nightmares
• Sleep Disturbance
• Memory Problems

• BEHAVIORAL
• Antisocial
• Withdrawal
• Restlessness

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Critical Incident Stress Debriefing Meeting

• Non specific expectations
• Confidential
• Discussion
• Review
• Resources Available
• Referrals

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CISM Team Makeup

• Medically qualified personnel
• A psychiatrist, psychologist, social worker,
  mental health nurse, or 7-level mental health
  technician. The team chief will be a mental
  health professional.

• Peer Representative
• A non-caregiver advocate for involved individuals
  who will bring to the team expertise in CAP
  benefits and personnel issues.

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CISM Team Continued

• Chaplains
• An emergency services qualified mission chaplain.

• Medical
• A physician, senior medical technician with
  trauma experience or intensive care experience,
  or nurse with trauma or intensive care
  experience.

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CISM Support Requests

• During, or immediately following each rescue or
  disaster relief mission, a review of the need for
  CIS intervention should be made for all personnel
  participating in the mission whether or not the
  mission was concluded successfully.

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CISM Support Requests Continued

• If the mission is closed or suspended and a
  member(s) experiences the need for a critical
  incident stress intervention or observes the need
  in another member(s), he/she should express that
  need directly to the incident commander or wing
  commander.

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CISM Support Requests Continued

• Incident commanders or unit commanders will pass
  requests for CIS intervention to the wing
  commander, as proper CIS support will often
  require support long after a mission is closed or
  suspended.

• It should also be noted that personnel not at the
  front-line of a mission might require CIS
  intervention just as much as the ground team
  dealing with a crash site.

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Critical Incident Stress Tasks

• There are no specific Critical Incident Stress
  Tasks, but all members of the emergency services
  team should be conscious of the problems that
  could occur from being involved in stressful
  missions and seek help as necessary

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QUESTIONS?
THINK SAFETY