1. Critical Incident Stress
Identification & Resolution

2. What is critical incident stress?
Emotional or physical reactions following a traumatic or stressful event
It 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

3. Potentially Traumatizing Events
Individual
Community
Automobile Accident
Sexual Assault
Any life threatening experience to self or other
Robbery
Serious physical injury to self or significant other
Perception of threat to self or significant other
Witnessing violence
Earthquake
Hurricane
Fire
Flood
Large scale environmental threat
Multiple injury events
Terrorism
High publicity crimes of violence

4. Common Signs of Stress Reaction: Physical Signs
Chills Elevated BP Thirst Rapid Heart Rate Fatigue Shock Symptoms Nausea/Vomiting Teeth Grinding Fainting Visual Problems Twitches/Tremors Profuse Sweating Dizziness Breathing Difficulties Chest Pain Headaches

5. Common Signs of Stress Reaction: Cognitive Signs
Confusion Disorientation
Nightmares Lowered Awareness
Uncertainty Increased Startle Reflex
Hypervigilance Poor Concentration
Suspiciousness Memory Problems
Intrusive Thoughts Impaired Thinking

6. Common Signs of Stress Reaction: Emotional Signs
Fear Depression Guilt Intense Anger Grief Apprehension Panic Emotional Shock Denial Emotional Outbursts Anxiety Feeling Overwhelmed Agitation Blunted Affect Irritability

7. Common Signs of Stress Reaction: Behavioral Signs
Withdrawal Changes in Appetite Aggression Hyper-alertness Restlessness Increased Alcohol Use Changes in Socialization Changes in Speech Erratic Movements Pacing

8. With Critical Incident Stress
Strategies for Coping
With Critical Incident Stress

9. Strategies for Coping:
Within the first hours alternating periods of appropriate physical exercise with relaxation will alleviate some physical reactions
Structure your time – keep busy
Remember 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

10. Strategies continued…
Reach out to others- let them know how you are feeling – spend time with others
Maintain as normal a schedule as possible
Check-in on your co-workers, sharing feelings and checking out how they are doing
Give yourself permission to feel rotten
Keep a journal, write your way through sleepless hours
Treat yourself – do something that feels good to you

11. Strategies Continued…
Avoid making important, life changing decisions
Do 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 rest
Eat 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

12. In Sum:
Traumatizing/ stressful events can lead to immediate or delayed emotional and physical symptoms
Emotion& physical reactions to stress are normal and usually temporary
You 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)