Transcript CRITICAL INCIDENT STRESS A PRESENTATION BY THE …

CISM in NOVA SCOTIA
CRITICAL INCIDENT STRESS
MANAGEMENT
A PRESENTATION BY
THE CRITICAL INCIDENT STRESS
MANAGEMENT TEAM
FIRE OFFICER’S ASSOCIATION
OF NOVA SCOTIA
HISTORY
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Trauma has been around forever
During WW I it was called shell shock
In WW II we called it “lack of moral fibre”
Twice as many Viet Nam vets have
committed suicide as were killed in the war
Canada’s Gen Dallaire and other
peacekeepers have been affected.
We’re learning how to manage traumatic
stress
CISM is not psycho therapy
Sharing of thoughts
WHAT KINDS OF INCIDENTS CAN
TRIGGER CIS?
A line of duty death
 The death of a child
 Incidents involving single / multiple
casualties or injuries
 Significant injury/threat to
firefighters
 Incidents attracting heavy media
coverage
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SOME EXAMPLES FROM
OUR EXPERIENCE
Two toddlers drown in a pond
 Family delivering presents involved in
fatal Christmas eve MVA
 Father and two children die in house
fire. One of the firefighters was
born in the house and, as a heavy
equipment operator, had to demolish
it the next day.
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HOW WILL I KNOW IF I’M
SUFFERING FROM CIS?
There are a number of physical,
emotional and cognitive symptoms of
CIS. You may experience one or a
combination of the following:
CIS Physical Reactions May
Be
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Sleep disturbance
Fatigue
Changes in eating
habits
Menstrual cycle
changes
Headaches
Nausea
CIS Emotional Reactions May Be
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Anxiety
Irritability
Depression
Sense of loss
Change in need for
intimacy
Feelings of isolation
Guilt
Flashbacks
CIS Cognitive (Thinking)
May Be
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Reactions
Confusion
Difficulty making decisions
Impaired thinking
Difficulty problem-solving
Memory loss
Calculation difficulties
Anomia (difficulty remembering
names of things)
REMEMBER
CIS IS
A NORMAL REACTION
TO AN
ABNORMAL EXPERIENCE
WHY WE’RE VULNERABLE TO CIS
CHARACTERISTICS OF
FIREFIGHTERS
 ACTION ORIENTED
 EXPECT SUCCESS
 LIKE TO CONTROL
SITUATIONS
 NEED TO CONTROL
OURSELVES
CHARACTERISTICS OF
EMERGENCIES
 IMPEDIMENTS TO
ACTION
 UNSAVEABLE
SITUATIONS
 NATURALLY CHAOTIC
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SITUATION
PERSONALIZED
HOW DO WE MANAGE
CIS?
We do this through a program called Critical
Incident Stress Management. The
components of CISM are:
 PRE-INCIDENT EDUCATION
 ON SCENE INTERVENTIONS
 DEFUSINGS
 DEBRIEFINGS
 FOLLOW UP
DEFUSING
Ideal time 1-2 hours after incident
 20-45 minutes in length
 Done in a group, led by a team of Peer
debriefer(s)
 Not an operational critique but
venting of emotions
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DEFUSING PROCESS
Three stages:
INTRODUCTION
 EXPLORATION
 INFORMATION
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DEBRIEFINGS
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A more in depth version of a Defusing
They are held 24-72 hours after an
incident
Done in a group led by a team of at least
one mental health professional, trained in
the fire service, and one firefighter
trained in CISM.
Not an operational critique but venting of
emotions
THE DEBRIEFING
PROCESS
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INTRODUCTION AND GROUND RULES
DESCRIPTION OF THE FACTS
RESPONDERS THOUGHTS
RESPONDERS REACTIONS
EXPLANATION OF CIS SYMPTOMS
STRATEGIES FOR COPING WITH CIS
CONCLUSION
HOW DO WE KNOW IF WE NEED A
DEFUSING OR DEBRIEFING ?
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A call involving a fatality, especially a child, line of
duty death, significant injury or serious incident
outside your department’s normal duties can
trigger CIS
If you or any of your fellow firefighters
experience CIS symptoms.
If in doubt then have one – prevention is
everything.
Remember, only members involved in the incident
attend debriefings.
Members not experiencing CIS symptoms should
attend as their input can often be very helpful.
HOW DO WE ARRANGE
A DEBRIEFING?
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IT’S EASY. Simply call the Fire Marshall’s
office. They’ll collect details from you and
call out the Critical Incident Stress
Response Team
Like you, CISRT members are volunteers and
provide the service for free.
1-800-559-3473
24 / 7
DOES CISM WORK?
A STUDY, BY MARY HANNEMAN, OF N.S. FIREFIGHTERS
WHO HAD EXPERIENCED A DEBRIEFING FOUND
DEBRIEFINGS:
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PROVIDED A COMPLETE PICTURE OF THE INCIDENT
ALLOWED FIREFIGHTERS TO VENT
FACILITATED THE EXPRESSION OF EMOTIONS
HELPED FIREFIGHTERS KNOW THEY WEREN’T ALONE
IN THEIR REACTOINS
BOOSTED MORALE AMONG FIREFIGHTERS
HELPED FIREFIGHTERS UNDERSTAND THEMSELVES
AND EACH OTHER BETTER
RESULTED IN DEEPER, MORE MEANINGFUL
DISCUSSIONS THAN USUAL.
HOW TO GET MORE
INFORMATION
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Talk to a member of the CISM team
Visit our website: www.nsfirecism.ca
this site will give you additional
information on CISM and some good
links
CONCLUSION
You provide a valuable service – the
job isn’t easy
 The likelihood of you being exposed
to a critical incident is increasing
 Just as you take care of your
equipment, you need to take care of
yourselves
 We are proud to provide you with
CISM support and encourage you to
call on us
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