Critical Incident Stress
Tragedies, deaths, serious injuries, hostage situations, threatening situations – are known as “Critical Incidents.” People responding to emergencies encounter highly stressful events. Sometimes an event is so traumatic or overwhelming that emergency responders may experience significant stress reactions.
Critical Incident Stress Management (CISM) represents an integrated “system” of interventions which is designed to prevent and/or mitigate the adverse psychological reactions that so often accompany emergency services, public safety, and disaster response functions. CISM interventions are especially directed towards the mitigation of post-traumatic stress reactions.
The Critical Incident Stress Debriefing (CISD) process is specifically designed to prevent or mitigate the development of post-traumatic stress among emergency services professions.
Recognizing Critical Incident Stress
Critical incidents may produce a wide range of stress symptoms, which may appear immediately at the scene, a few hours later or within days of the incident. Stress symptoms usually occur in four different categories: Cognitive (thinking), Physical (body), Emotional (feelings) and Behavioural (actions). The more symptoms experienced, the more powerful the stress reaction. The longer the symptoms persist, the more potential there is for lasting harm. The following is only a sample of stress symptoms that can show up after a critical incident.
poor concentration, memory issues, reduced attention span, difficulty making decisions, slow at problem solving, difficulties with calculations
muscle tremors, chest pain, gastrointestinal distress, difficulty breathing, headaches, elevated blood pressure
guilt, grief, depression, anxiety, fear, loss of emotional control, feeling lost or overwhelmed
excessive silence, sleep disturbances, unusual behaviours, changes in eating habits, withdrawal from family and friends, changes in work habits
Stress Survival Suggestions:
When emergency personnel experience significant stress from a critical incident, the following steps may help to reduce the stress until the incident is over or until a trained CISM team is located.
- Limit exposure to sights, sounds and odours
- Provide an immediate rest break of at least 15 minutes
- Have a friend stay with the distressed person
- Provide fluids, non-alcoholic and non-caffeinated
- Provide foods low in salt, sugar and fat content
- Allow the person to talk about the experience
- Do not rush the person to return to work
- Protect the person from bystanders and the media
- Reassure the person that the stress experience is normal; most people recover very well from stress
- Show appreciation for the person’s work
- Do nothing to embarrass the person
- Help the person make decisions