Critical Incident Stress Critical Incident Stress ManagementManagement

What is it and Who needs it?What is it and Who needs it?

Vaughn Donaldson – District Chief

Midland Fire Dept.

Midland, TX

What is a Critical Incident?What is a Critical Incident?

Critical IncidentCritical Incident

Any event which a Any event which a stressful impact sufficient stressful impact sufficient enough to overwhelm the enough to overwhelm the usually effective coping usually effective coping skills of either an individual skills of either an individual or group.or group.

Typically sudden powerful Typically sudden powerful events which are outside events which are outside the range of ordinary the range of ordinary human experience.human experience.

Critical IncidentsCritical Incidents

1.* Line-of-duty death / death at the 1.* Line-of-duty death / death at the workplaceworkplace

2.* Serious line-of-duty / workplace injury2.* Serious line-of-duty / workplace injury3.* Suicide of co-worker, friend, 3.* Suicide of co-worker, friend, 4.* Multi-casualty incident /disaster4.* Multi-casualty incident /disaster5. *Police shooting or injury or death to a 5. *Police shooting or injury or death to a

civilian as a result of operational civilian as a result of operational procedures /events with extreme threatprocedures /events with extreme threat

6. Significant events involving children6. Significant events involving children7. Victim relative or known to helper7. Victim relative or known to helper8. Prolonged incidents especially with 8. Prolonged incidents especially with

loss loss9. Excessive media interest9. Excessive media interest10. Any powerful event which 10. Any powerful event which

overwhelms a person’s usual ability overwhelms a person’s usual ability to copeto cope

Miscellaneous EventsMiscellaneous EventsRepetitive horrible eventsRepetitive horrible eventsSymbolic eventsSymbolic eventsMultiple eventsMultiple eventsEvents with personal meaningEvents with personal meaningThreatening eventsThreatening eventsAdministrative abandonmentAdministrative abandonment

What is Critical Incident Stress?

The reaction a person or group has to a critical incident.

Five Ways We Can Be Affected By Five Ways We Can Be Affected By Critical Incident StressCritical Incident Stress

PhysicallyPhysicallyEmotionallyEmotionallyCognitivelyCognitivelyBehaviorallyBehaviorallySpirituallySpiritually

Common Signs and Common Signs and Symptoms of Symptoms of

Critical Incident Critical Incident StressStress

PhysicalPhysicalExcessive sweatingExcessive sweatingNauseaNauseaIncreased heart rateIncreased heart rateElevated blood pressureElevated blood pressureRapid breathingRapid breathingDizzy spellsDizzy spells

CognitiveCognitive

ConfusionConfusionDifficulty making decisionsDifficulty making decisionsLowered concentrationLowered concentrationMemory dysfunctionMemory dysfunctionLowering of all higher cognitive Lowering of all higher cognitive

functionsfunctions

Pre-frontal lobes Limbic system

Brainstem

ETOH

Pre-frontal lobes Limbic system

Brainstem

Pre-frontal lobes Limbic system

Brainstem

Pre-frontal lobes Limbic system

Brainstem

Pre-frontal lobes Limbic system

Brainstem

Stress

Pre-frontal lobes Limbic system

Brainstem

Pre-frontal lobes Limbic system

Brainstem

Pre-frontal lobes Limbic system

Brainstem

EmotionalEmotional

Emotional shockEmotional shockAngerAngerGriefGriefDepressionDepressionFeeling overwhelmedFeeling overwhelmed

BehavioralBehavioralChanges in ordinary behaviorChanges in ordinary behaviorChanges in eatingChanges in eatingDecreased personal hygieneDecreased personal hygieneProlonged silencesProlonged silencesWithdrawal from othersWithdrawal from othersChangesChanges

SpiritualSpiritual

Anger at GodAnger at GodQuestioning basic beliefsQuestioning basic beliefsLoss of meaning or purposeLoss of meaning or purposeWithdrawal from place of worshipWithdrawal from place of worshipSense of isolation from GodSense of isolation from GodAnger at clergyAnger at clergy

Stress Response Stress Response SyndromesSyndromes

Immediate - up to 24 hrsImmediate - up to 24 hrsDelayed - 24 to 72 hrsDelayed - 24 to 72 hrs

Post-traumatic stress is a Post-traumatic stress is a normal reaction in a normal reaction in a normal person, to an normal person, to an

abnormal event.abnormal event.

Critical Incident Stress Critical Incident Stress Management (CISM)Management (CISM)

A comprehensive, A comprehensive, systematic program for the systematic program for the mitigation of critical mitigation of critical incident related stress.incident related stress.

Goals of Goals of Critical Incident Stress Critical Incident Stress

ManagementManagementPrevent traumatic stressPrevent traumatic stressMitigate traumatic stressMitigate traumatic stressIntervene to assist recovery from Intervene to assist recovery from

traumatic stresstraumatic stress

Goals cont.Goals cont.

Accelerate recovery Accelerate recovery whenever possiblewhenever possible

Restore to functionRestore to functionMaintain worker health and Maintain worker health and

welfarewelfare

CISD ObjectivesCISD ObjectivesEducationEducationVentilationVentilationReassuranceReassuranceForewarningForewarningPositive contact with MHPPositive contact with MHPImprove interagency cooperationImprove interagency cooperation

Objectives cont.Objectives cont.

Contradict fallacy of Contradict fallacy of uniquenessuniqueness

Increase group Increase group cohesivenesscohesiveness

Restore self confidenceRestore self confidenceFacilitate follow-upFacilitate follow-up

Critical Incident Stress Critical Incident Stress ManagementManagement

Pre-crisis preparationPre-crisis preparationDemobilization (large groups of public Demobilization (large groups of public

safety)safety)Crisis Management Briefings (large Crisis Management Briefings (large

groups primary victims)groups primary victims)DefusingDefusingPastoral crisis interventionPastoral crisis intervention

Critical Incident Stress Critical Incident Stress ManagementManagement

Critical Incident Stress DebriefingCritical Incident Stress DebriefingOne-on-one crisis interventionOne-on-one crisis interventionFamily CISMFamily CISMOrganizational crisis Organizational crisis

intervention/consultationintervention/consultationFollow-up and referral mechanismsFollow-up and referral mechanisms

CISM - Who needs it?CISM - Who needs it?

Those exposed to critical incidents including:Those exposed to critical incidents including:

CorpsCorps IndustryIndustry

MilitaryMilitary CommunicationsCommunications

Fire Fire FamiliesFamilies

Law EnforcementLaw Enforcement EMSEMS

HospitalHospital CiviliansCivilians

SchoolsSchools SAR……..Etc.SAR……..Etc.

For More Info ContactFor More Info ContactVaughn DonaldsonVaughn Donaldson

vdonaldson@texasonline.netvdonaldson@texasonline.netwww.cism1.comwww.cism1.com

www.icisf.orgwww.icisf.org (432) 560-5207 wk.(432) 560-5207 wk.