Safety Health and Survival ROTW: Post Dramatic Stress Disorder

Near Miss Report Fireground Emergency has Long-Term Impact This week’s report tells the story of one incident that spawned two crisis situations- one immediately recognizable and mitigated, and one delayed and difficult to diagnosticate, but just as potentially deadly.

Near Miss Report Event Description “I was assisting the initial attack line down the steps, sounding for them, when the basement door closed behind me. Unfortunately, there was no door knob on the inward swinging side of the door and I was trapped on the steps. The crews on the opposite side were evacuated and was not aware that I was trapped. Visibility was zero, and my TIC was “whiting out” due to the high heat conditions at the top of the steps. The air in my cylinder had become heat saturated. This made it hot to breathe, and I felt as if I was being stung by a million yellow jackets.”

Near Miss Report The Long Term Impact “Before this event, I had no knowledge or education dealing with mental health and my personal care or knowledge of signs and symptoms of post-traumatic stress disorder (PTSD). I had 16 years of experience but began having trouble sleeping, re-experiencing the fire and nightmares. I felt detached from everyone but my children. I was depressed and very emotional. I had all the beginning signs of post-traumatic stress and did not realize it.”

Post Dramatic Stress disorder Indicator Signs: Intrusive Memories Also called re-experiencing symptoms, these memories can start from the persons own thoughts, or can be triggered by words, object or situations that are reminders of the traumatic event. Intrusive memories include: Recurring, unwanted distressing memories of the traumatic event reliving the event as if it were happening again, Upsetting dreams about the event, and Severe emotional distress or physical reactions (heart racing, hands sweating) to something that reminds you of the event.

Post Dramatic Stress disorder Indicator Signs: Avoidance Avoiding places, objects, activities or people that remind you of the event, Increased negative feelings about self or others, Feeling emotionally numb or inability to experience positive or negative emotions, Losing interest in activities that were enjoyable in the past, Feeling strong guilt, depression or worry, Memory problems including not remembering important aspects of the traumatic event, Difficulty maintaining close relationships.

Post Dramatic Stress disorder Indicator Signs: Hyper-arousal Symptoms Irritability, feeling tense or “on guard,” Difficulty sleeping, Angry outbursts or aggressive behaviors, Being on constant guard for danger, Feelings of overwhelming guilt or shame, Self-destructive behaviors, Trouble concentrating or sleeping, and Being easily startled or frightened.

First Responders Unique Stressors Chronic fatigue levels Cumulative stress because of repeated exposure to trauma Exposure to mass violence and destruction Prolonged or failed rescue operations Repeated exposure to death, dismembered body parts and human remains, which may include those of fellow first responders. Seeing a peer or partner killed or injured in the line of duty Witnessing the death of a child.

Awareness the first step to recovery First Responders are at a much greater risk for experiencing PTSD Source: International Association of Fire Fighters

Early Intervention and screening protocols

Removing Barriers to Prevention and treatment Create a proactive support program with easy access Eliminate the stigma of seeking support for PTSD Establish peer level counseling Make behavioral health as important as physical fitness

Sixteen Fire and life safety initiatives Thirteen - Firefighters and their families must have access to counseling and psychological support.

Resources for behavioral health support

QUESTIONS? SHARE YOUR STORY. Protect the next shift . . . International Association of Fire Chiefs Firefighter Near Miss Program NearMiss@IAFC.org Tel: (703) 273-0911 Fax: (703) 273-9363