Transcript CISM

CISM
Critical Incident Stress
Management
for
Emergency Services
Personnel
WHAT ARE CRITICAL INCIDENTS?
• Events which
may cause
strong
emotional
effect on an
emergency
worker
WHAT ARE CRITICAL INCIDENTS?
• Line of duty
Death or
Major Injury
WHAT ARE CRITICAL INCIDENTS?
• Death or
Major Injury
of a child
WHAT ARE CRITICAL INCIDENTS?
• Prolonged Search and Rescue Efforts
WHAT ARE CRITICAL INCIDENTS?
• Mass
Casualty
Incidents
WHAT ARE CRITICAL INCIDENTS?
• Operations
involving
extensive
media
coverage
CRITICAL INCIDENTS ARE…..
• Knowledge of the victim
• Long extrication
• Loss of a fellow Emergency
Worker
OR……..
Any situation that
causes stress to the
Emergency Worker
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.
New Castle County CISM Team
• Member of
• Delaware Volunteer Firemen’s
Association - DVFA
• New Castle County Volunteer
Firemen’s Association - NCCVFA
• International Critical Incident
Stress Foundation - ICISF
• Established 1989
NEW CASTLE COUNTY
CISM TEAM
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Volunteer/Paid Personnel
Fire Fighters
Ladies Auxiliary
Paramedics
Police
Nurses
Clergy
Mental Health Providers
Disaster Workers
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
SERVICES
• On-scene support
• Demobilization Services
• Defusing
• Formal debriefings
SERVICES
• On-scene support
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
SERVICES
• On-scene support
• Demobilization Services
DEMOBILIZATION SERVICES
FOR LARGE SCALE EVENTS
(highly intense or unusual)
• Establish a location away from the scene for outof-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
SERVICES
• On-scene support
• Demobilization Services
• Defusing
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
SERVICES
• On-scene support
• Demobilization Services
• Defusing
• Formal debriefings
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
THE EMOTIONAL
RESPONSES TO CRITICAL
INCIDENTS ARE….
NORMAL REACTIONS BY
NORMAL PEOPLE TO
ABNORMAL SITUATIONS.
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
CISM INTERVENTION
The required preventive maintenance
of our minds and bodies
STRESSES FACED BY
EMERGENCY SERVICE WORKERS
• Always on alert
• Dealing with tragedy
• Dealing with death
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
PHYSICAL SIGNS OF
STRESS
• Bowel or bladder disturbance
• Incontinence
• Fatigue
• Frequent Illness
• Day dreaming
EMOTIONAL SIGNS OF
STRESS
• Changes in behavior
• Lost train of thought
• Anxiety
• Trouble sleeping
• Irritability
• Grief
• Lack of attention
• Crying
EMOTIONAL SIGNS OF
STRESS
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Memory Problems
Depression
Anger
Loss of confidence
Rapid Mood Change
Taking unnecessary chances
Excessive use of Drugs or Alcohol
SIGNS/SYMPTOMS -
a cry for help
Watch for signs in
yourself and co-workers
Being aware enables you to help
someone.
KEEP AN EYE ON EACH OTHER,
BECAUSE NO ONE ELSE CAN.
FEELING STRESSED?
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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
FEELING STRESSED?
• Exercise
• Eat properly
• Talk to friends and family, let them know
what you are going through
• REMEMBER…
STRESS REACTIONS
ARE
NORMAL
Keep in touch with loved ones.
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
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?
WHAT TO DO WHILE THE
TEAM IS RESPONDING….
Support your
co-workers
AN INCIDENT MAY TRIGGER
REACTIONS FROM
A PRIOR INCIDENT
STRESS CAN ACCUMULATE
*Don’t let it build up*
Talk
Talk
Talk!!!
STRESS IS EVERYWHERE
Take care of Stress
Before it takes care of
YOU!!
Emergency Workers do not snore, burp, sweat or pass gas.
There fore, they must
“Bitch or they will BLOW UP!!
REMEMBER….
THE EMOTIONAL RESPONSES TO
CRITICAL INCIDENTS ARE….
NORMAL REACTIONS BY
NORMAL PEOPLE TO
ABNORMAL
SITUATIONS.