Critical Incident Stress Management What is it and Who needs it? Vaughn Donaldson – District Chief Midland Fire Dept. Midl...
What is a Critical Incident?
Critical Incident <ul><li>Any event which a stressful impact sufficient enough to overwhelm the usually effective coping s...
<ul><li>Typically sudden powerful events which are outside the range of ordinary human experience. </li></ul>
Critical Incidents <ul><li>1.* Line-of-duty death / death at the workplace </li></ul><ul><li>2.* Serious line-of-duty / wo...
<ul><li>6. Significant events involving children </li></ul><ul><li>7. Victim relative or known to helper </li></ul><ul><li...
Miscellaneous Events <ul><li>Repetitive horrible events </li></ul><ul><li>Symbolic events </li></ul><ul><li>Multiple event...
What is Critical Incident Stress? The reaction a person or group has to a critical incident.
Five Ways We Can Be Affected By Critical Incident Stress <ul><li>Physically </li></ul><ul><li>Emotionally </li></ul><ul><l...
Common Signs and Symptoms of Critical Incident Stress
Physical <ul><li>Excessive sweating </li></ul><ul><li>Nausea </li></ul><ul><li>Increased heart rate </li></ul><ul><li>Elev...
Cognitive <ul><li>Confusion </li></ul><ul><li>Difficulty making decisions </li></ul><ul><li>Lowered concentration </li></u...
Pre-frontal lobes Limbic system Brainstem ETOH
Pre-frontal lobes Limbic system Brainstem
Pre-frontal lobes Limbic system Brainstem
Pre-frontal lobes Limbic system Brainstem
Pre-frontal lobes Limbic system Brainstem Stress
Pre-frontal lobes Limbic system Brainstem
Pre-frontal lobes Limbic system Brainstem
Pre-frontal lobes Limbic system Brainstem
Emotional <ul><li>Emotional shock </li></ul><ul><li>Anger </li></ul><ul><li>Grief </li></ul><ul><li>Depression </li></ul><...
Behavioral <ul><li>Changes in ordinary behavior </li></ul><ul><li>Changes in eating </li></ul><ul><li>Decreased personal h...
Spiritual <ul><li>Anger at God </li></ul><ul><li>Questioning basic beliefs </li></ul><ul><li>Loss of meaning or purpose </...
Stress Response Syndromes <ul><li>Immediate - up to 24 hrs </li></ul><ul><li>Delayed - 24 to 72 hrs </li></ul>
Post-traumatic stress is a normal reaction in a normal person, to an abnormal event.
Critical Incident Stress Management (CISM) <ul><li>A comprehensive, systematic program for the mitigation of critical inci...
Goals of  Critical Incident Stress Management <ul><li>Prevent traumatic stress </li></ul><ul><li>Mitigate traumatic stress...
Goals cont. <ul><li>Accelerate recovery whenever possible </li></ul><ul><li>Restore to function </li></ul><ul><li>Maintain...
CISD Objectives <ul><li>Education </li></ul><ul><li>Ventilation </li></ul><ul><li>Reassurance </li></ul><ul><li>Forewarnin...
Objectives cont. <ul><li>Contradict fallacy of uniqueness </li></ul><ul><li>Increase group cohesiveness </li></ul><ul><li>...
Critical Incident Stress Management <ul><li>Pre-crisis preparation </li></ul><ul><li>Demobilization (large groups of publi...
Critical Incident Stress Management <ul><li>Critical Incident Stress Debriefing </li></ul><ul><li>One-on-one crisis interv...
CISM - Who needs it? <ul><li>Those exposed to critical incidents including: </li></ul><ul><li>Corps Industry </li></ul><ul...
For More Info Contact Vaughn Donaldson <ul><li>[email_address] </li></ul><ul><li>www.cism1.com </li></ul><ul><li>www.icisf...
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Pre-incident Education

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Pre-incident Education

  1. 1. Critical Incident Stress Management What is it and Who needs it? Vaughn Donaldson – District Chief Midland Fire Dept. Midland, TX
  2. 2. What is a Critical Incident?
  3. 3. Critical Incident <ul><li>Any event which a stressful impact sufficient enough to overwhelm the usually effective coping skills of either an individual or group. </li></ul>
  4. 4. <ul><li>Typically sudden powerful events which are outside the range of ordinary human experience. </li></ul>
  5. 5. Critical Incidents <ul><li>1.* Line-of-duty death / death at the workplace </li></ul><ul><li>2.* Serious line-of-duty / workplace injury </li></ul><ul><li>3.* Suicide of co-worker, friend, </li></ul><ul><li>4.* Multi-casualty incident /disaster </li></ul><ul><li>5. *Police shooting or injury or death to a civilian as a result of operational procedures /events with extreme threat </li></ul>
  6. 6. <ul><li>6. Significant events involving children </li></ul><ul><li>7. Victim relative or known to helper </li></ul><ul><li>8. Prolonged incidents especially with loss </li></ul><ul><li>9. Excessive media interest </li></ul><ul><li>10. Any powerful event which overwhelms a person’s usual ability to cope </li></ul>
  7. 7. Miscellaneous Events <ul><li>Repetitive horrible events </li></ul><ul><li>Symbolic events </li></ul><ul><li>Multiple events </li></ul><ul><li>Events with personal meaning </li></ul><ul><li>Threatening events </li></ul><ul><li>Administrative abandonment </li></ul>
  8. 8. What is Critical Incident Stress? The reaction a person or group has to a critical incident.
  9. 9. Five Ways We Can Be Affected By Critical Incident Stress <ul><li>Physically </li></ul><ul><li>Emotionally </li></ul><ul><li>Cognitively </li></ul><ul><li>Behaviorally </li></ul><ul><li>Spiritually </li></ul>
  10. 10. Common Signs and Symptoms of Critical Incident Stress
  11. 11. Physical <ul><li>Excessive sweating </li></ul><ul><li>Nausea </li></ul><ul><li>Increased heart rate </li></ul><ul><li>Elevated blood pressure </li></ul><ul><li>Rapid breathing </li></ul><ul><li>Dizzy spells </li></ul>
  12. 12. Cognitive <ul><li>Confusion </li></ul><ul><li>Difficulty making decisions </li></ul><ul><li>Lowered concentration </li></ul><ul><li>Memory dysfunction </li></ul><ul><li>Lowering of all higher cognitive functions </li></ul>
  13. 13. Pre-frontal lobes Limbic system Brainstem ETOH
  14. 14. Pre-frontal lobes Limbic system Brainstem
  15. 15. Pre-frontal lobes Limbic system Brainstem
  16. 16. Pre-frontal lobes Limbic system Brainstem
  17. 17. Pre-frontal lobes Limbic system Brainstem Stress
  18. 18. Pre-frontal lobes Limbic system Brainstem
  19. 19. Pre-frontal lobes Limbic system Brainstem
  20. 20. Pre-frontal lobes Limbic system Brainstem
  21. 21. Emotional <ul><li>Emotional shock </li></ul><ul><li>Anger </li></ul><ul><li>Grief </li></ul><ul><li>Depression </li></ul><ul><li>Feeling overwhelmed </li></ul>
  22. 22. Behavioral <ul><li>Changes in ordinary behavior </li></ul><ul><li>Changes in eating </li></ul><ul><li>Decreased personal hygiene </li></ul><ul><li>Prolonged silences </li></ul><ul><li>Withdrawal from others </li></ul><ul><li>Changes </li></ul>
  23. 23. Spiritual <ul><li>Anger at God </li></ul><ul><li>Questioning basic beliefs </li></ul><ul><li>Loss of meaning or purpose </li></ul><ul><li>Withdrawal from place of worship </li></ul><ul><li>Sense of isolation from God </li></ul><ul><li>Anger at clergy </li></ul>
  24. 24. Stress Response Syndromes <ul><li>Immediate - up to 24 hrs </li></ul><ul><li>Delayed - 24 to 72 hrs </li></ul>
  25. 25. Post-traumatic stress is a normal reaction in a normal person, to an abnormal event.
  26. 26. Critical Incident Stress Management (CISM) <ul><li>A comprehensive, systematic program for the mitigation of critical incident related stress. </li></ul>
  27. 27. Goals of Critical Incident Stress Management <ul><li>Prevent traumatic stress </li></ul><ul><li>Mitigate traumatic stress </li></ul><ul><li>Intervene to assist recovery from traumatic stress </li></ul>
  28. 28. Goals cont. <ul><li>Accelerate recovery whenever possible </li></ul><ul><li>Restore to function </li></ul><ul><li>Maintain worker health and welfare </li></ul>
  29. 29. CISD Objectives <ul><li>Education </li></ul><ul><li>Ventilation </li></ul><ul><li>Reassurance </li></ul><ul><li>Forewarning </li></ul><ul><li>Positive contact with MHP </li></ul><ul><li>Improve interagency cooperation </li></ul>
  30. 30. Objectives cont. <ul><li>Contradict fallacy of uniqueness </li></ul><ul><li>Increase group cohesiveness </li></ul><ul><li>Restore self confidence </li></ul><ul><li>Facilitate follow-up </li></ul>
  31. 31. Critical Incident Stress Management <ul><li>Pre-crisis preparation </li></ul><ul><li>Demobilization (large groups of public safety) </li></ul><ul><li>Crisis Management Briefings (large groups primary victims) </li></ul><ul><li>Defusing </li></ul><ul><li>Pastoral crisis intervention </li></ul>
  32. 32. Critical Incident Stress Management <ul><li>Critical Incident Stress Debriefing </li></ul><ul><li>One-on-one crisis intervention </li></ul><ul><li>Family CISM </li></ul><ul><li>Organizational crisis intervention/consultation </li></ul><ul><li>Follow-up and referral mechanisms </li></ul>
  33. 33. CISM - Who needs it? <ul><li>Those exposed to critical incidents including: </li></ul><ul><li>Corps Industry </li></ul><ul><li>Military Communications </li></ul><ul><li>Fire Families </li></ul><ul><li>Law Enforcement EMS </li></ul><ul><li>Hospital Civilians </li></ul><ul><li>Schools SAR……..Etc. </li></ul>
  34. 34. For More Info Contact Vaughn Donaldson <ul><li>[email_address] </li></ul><ul><li>www.cism1.com </li></ul><ul><li>www.icisf.org </li></ul><ul><li>(432) 560-5207 wk. </li></ul>

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