Identification & Resolution

What is critical incident stress?Emotional or physical reactions following a

traumatic or stressful eventIt is common, and in fact normal, to experience

emotional aftershocks (stress reactions) after experiencing a traumatic event

Critical incident stress can occur immediately following a stressful event or it can be delayed by hours or even a few days. In some cases, CIS can be delayed weeks or months after a traumatic event

Symptoms may be short in duration or longer

Potentially Traumatizing EventsIndividual CommunityAutomobile AccidentSexual AssaultAny life threatening

experience to self or otherRobberySerious physical injury to

self or significant otherPerception of threat to

self or significant otherWitnessing violence

EarthquakeHurricaneFireFloodLarge scale

environmental threatMultiple injury eventsTerrorismHigh publicity crimes of

violence

Common Signs of Stress Reaction:Physical Signs

Chills Elevated BPThirst Rapid Heart RateFatigue Shock SymptomsNausea/Vomiting Teeth GrindingFainting Visual ProblemsTwitches/Tremors Profuse

SweatingDizziness Breathing DifficultiesChest Pain Headaches

Common Signs of Stress Reaction:Cognitive Signs

Confusion Disorientation

Nightmares Lowered Awareness

Uncertainty Increased Startle Reflex

Hypervigilance Poor ConcentrationSuspiciousness Memory ProblemsIntrusive Thoughts Impaired Thinking

Common Signs of Stress Reaction:Emotional Signs

Fear DepressionGuilt Intense AngerGrief ApprehensionPanic Emotional ShockDenial Emotional OutburstsAnxiety Feeling

OverwhelmedAgitation Blunted AffectIrritability

Common Signs of Stress Reaction:Behavioral Signs

Withdrawal Changes in Appetite

Aggression Hyper-alertnessRestlessness Increased

Alcohol UseChanges in Socialization Changes in

SpeechErratic Movements Pacing

With Critical Incident Stress

Strategies for Coping:Within the first 24-48 hours alternating periods of

appropriate physical exercise with relaxation will alleviate some physical reactions

Structure your time – keep busyRemember that you are having normal reactions-

don’t label your reactions as abnormal– you are NOT crazy!

Talk to people- talking is the most healing medicine

Be aware of numbing the pain with overuse of drugs and alcohol- don’t complicate the problem

Strategies continued… Reach out to others- let them know how you

are feeling – spend time with othersMaintain as normal a schedule as possibleCheck-in on your co-workers, sharing feelings

and checking out how they are doingGive yourself permission to feel rottenKeep a journal, write your way through

sleepless hoursTreat yourself – do something that feels good

to you

Strategies Continued…Avoid making important, life changing decisionsDo make as many small daily decisions as

possible which will help you feel control over your life i.e. if someone asks you what you want to eat- provide an answer do not respond “I don’t care”

Get plenty of restEat well balanced and regular meals (even if

you don’t feel like it)Remember that re-occurring thoughts, dreams,

& flashbacks are normal- don’t fight them they’ll decrease over time

In Sum:Traumatizing/ stressful events can lead to immediate

or delayed emotional and physical symptoms Emotion& physical reactions to stress are normal and

usually temporaryYou can mediate or resolve the effects of

traumatizing events by attending to the coping strategies included in this presentation

If your symptoms severely impair your daily functioning and do not resolve over appropriate period of time consult with professional to help you resolve critical incident stress (psychologist, social worker, pcp)