1. Critical Incident Stress Management What is it and Who needs it? Vaughn Donaldson – District Chief Midland Fire Dept. Midland, TX

2. What is a Critical Incident?

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

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

5. Critical Incidents 1.* Line-of-duty death / death at the workplace 2.* Serious line-of-duty / workplace injury 3.* Suicide of co-worker, friend, 4.* Multi-casualty incident /disaster 5. *Police shooting or injury or death to a civilian as a result of operational procedures /events with extreme threat

6. 6. Significant events involving children 7. Victim relative or known to helper 8. Prolonged incidents especially with loss 9. Excessive media interest 10. Any powerful event which overwhelms a person’s usual ability to cope

7. Miscellaneous Events Repetitive horrible events Repetitive horrible events Symbolic events Symbolic events Multiple events Multiple events Events with personal meaning Events with personal meaning Threatening events Threatening events Administrative abandonment Administrative abandonment

8. What is Critical Incident Stress? The reaction a person or group has to a critical incident.

9. Five Ways We Can Be Affected By Critical Incident Stress Physically Physically Emotionally Emotionally Cognitively Cognitively Behaviorally Behaviorally Spiritually Spiritually

10. Common Signs and Symptoms of Critical Incident Stress

11. Physical Excessive sweating Excessive sweating Nausea Nausea Increased heart rate Increased heart rate Elevated blood pressure Elevated blood pressure Rapid breathing Rapid breathing Dizzy spells Dizzy spells

12. Cognitive Confusion Confusion Difficulty making decisions Difficulty making decisions Lowered concentration Lowered concentration Memory dysfunction Memory dysfunction Lowering of all higher cognitive functions Lowering of all higher cognitive functions

13. Pre-frontal lobes Limbic system Brainstem ETOH

14. Pre-frontal lobes Limbic system Brainstem

15. Pre-frontal lobes Limbic system Brainstem

16. Pre-frontal lobes Limbic system Brainstem

17. Pre-frontal lobes Limbic system Brainstem Stress

18. Pre-frontal lobes Limbic system Brainstem

19. Pre-frontal lobes Limbic system Brainstem

20. Pre-frontal lobes Limbic system Brainstem

21. Emotional Emotional shock Emotional shock Anger Anger Grief Grief Depression Depression Feeling overwhelmed Feeling overwhelmed

22. Behavioral Changes in ordinary behavior Changes in ordinary behavior Changes in eating Changes in eating Decreased personal hygiene Decreased personal hygiene Prolonged silences Prolonged silences Withdrawal from others Withdrawal from others Changes Changes

23. Spiritual Anger at God Questioning basic beliefs Loss of meaning or purpose Withdrawal from place of worship Sense of isolation from God Anger at clergy

24. Stress Response Syndromes Immediate - up to 24 hrs Immediate - up to 24 hrs Delayed - 24 to 72 hrs Delayed - 24 to 72 hrs

25. Post-traumatic stress is a normal reaction in a normal person, to an abnormal event.

26. Critical Incident Stress Management (CISM) A comprehensive, systematic program for the mitigation of critical incident related stress.

27. Goals of Critical Incident Stress Management Prevent traumatic stress Prevent traumatic stress Mitigate traumatic stress Mitigate traumatic stress Intervene to assist recovery from traumatic stress Intervene to assist recovery from traumatic stress

28. Goals cont. Accelerate recovery whenever possible Accelerate recovery whenever possible Restore to function Restore to function Maintain worker health and welfare Maintain worker health and welfare

29. CISD Objectives Education Education Ventilation Ventilation Reassurance Reassurance Forewarning Forewarning Positive contact with MHP Positive contact with MHP Improve interagency cooperation Improve interagency cooperation

30. Objectives cont. Contradict fallacy of uniqueness Contradict fallacy of uniqueness Increase group cohesiveness Increase group cohesiveness Restore self confidence Restore self confidence Facilitate follow-up Facilitate follow-up

31. Critical Incident Stress Management Pre-crisis preparation Pre-crisis preparation Demobilization (large groups of public safety) Demobilization (large groups of public safety) Crisis Management Briefings (large groups primary victims) Crisis Management Briefings (large groups primary victims) Defusing Defusing Pastoral crisis intervention Pastoral crisis intervention

32. Critical Incident Stress Management Critical Incident Stress Debriefing Critical Incident Stress Debriefing One-on-one crisis intervention One-on-one crisis intervention Family CISM Family CISM Organizational crisis intervention/consultation Organizational crisis intervention/consultation Follow-up and referral mechanisms Follow-up and referral mechanisms

33. CISM - Who needs it? Those exposed to critical incidents including: CorpsIndustry MilitaryCommunications Fire Families Law EnforcementEMS HospitalCivilians SchoolsSAR……..Etc.

34. For More Info Contact Vaughn Donaldson vdonaldson@texasonline.net vdonaldson@texasonline.net vdonaldson@texasonline.net www.cism1.com www.cism1.com www.cism1.com www.icisf.org www.icisf.org www.icisf.org (432) 560-5207 wk. (432) 560-5207 wk.