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

• 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 out-of-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

• Anxiety

• Irritability

• Lack of attention

• Lost train of thought

• Trouble sleeping

• Grief

• Crying

EMOTIONAL SIGNS OF STRESS

• 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?

• 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.