1. The video provides an overview of the role of a trauma chaplain in responding to mass casualty incidents and providing spiritual and emotional care. It discusses how trauma affects individuals physically, cognitively, emotionally, and spiritually. 2. It outlines the GRACE model for trauma chaplaincy, which focuses on getting information, building relationships, maintaining awareness, supporting community, and providing extended ministry. 3. The video also includes a hypothetical scenario of a soldier sustaining a head wound and demonstrates how the chaplain might respond by providing presence, supporting medical decision making, and caring for the patient and their family.

1. https://www.youtube.com/watch?v=sOeVRLtpvrU

2. Mass Casualty and
Medical Ministry
Chaplain Jim Russell
HHBN 1CD
james.b.russell14.mil@mail.mil

3. Trauma Defined
a: an injury (as a wound) to living tissue caused by
an extrinsic agent
b: a disordered psychic or behavioral state resulting
from severe mental or emotional stress of physical
injury
From: http://www.merriam-webster.com/dictionary

4. Trauma is:
• Sudden
• Severe
• Shocking
• We don’t see it coming, and we
can’t plan for it

5. Trauma:
• Effects our ability to function
normally
• Can shake our belief system
• Can change our worldview
“Trauma is a thief. It steals from
people. It takes away their sense of
well-being, security, predictability, and
safety.” – Dr. H. Norman Wright

6. Trauma Affects the Whole Person
Physical
• Disfigurement
• Internal
injuries
• Disabilities
Cognitive
• Memory loss
• Confusion
• Inability to
make
decisions
• Permanent
brain damage
Emotional
• Fear
• Depression
• Anxiety
• Anger
Spiritual
• Doubting
• Anger
• Withdrawal
• Increased
spirituality

7. What is Trauma
• A serious injury or shock to the body, as from
violence or an accident.
• An emotional wound or shock that creates
substantial, lasting damage to the psychological
development of a person, often leading to
neurosis.
• An event or situation that causes great distress
and disruption

8. What does a Trauma Chaplain do?
The Trauma Chaplain does not try to
convert, but rather observes needs;
listens to the anger, hurt, frustration,
and pain!

9. 1. Symbolic Representation
2. Tangible Evidence
9

10. a. Professional Spiritual Healer
b. Caring Presence
c. Calming Presence
d. Pastor to Staff
10

11. SACRED
STORY

12. 1.What is the role of the Chaplain with the
patients
2.What is the role of the Chaplain with the unit
family, ?(Squad, Team, Company, BC/CSM)
3.What is the role of the Chaplain with the BN
Aid Station Staff? (Doctor, Nurses, Medics)
4.What information would be helpful prior to
meeting with the family?

13. Anesthesia
Medic Medic
Nurse Nurse
Trauma
MD
Medication
Nurse
X-Ray
Chaplain
Recorder
Nurse
Head
R L
TRAUMA TEAM
MEMBERS

14. •G-Get the Information
•R-Relationships
•A-Awareness of Surroundings
•C-Community
•E-Extended Ministry
GRACE in the ED

15. • Get the patient's name from the EMTs
Medics, ID Tags.
• Know the injury or illness of the patient.
• Find out from Medics who if anyone has
followed the patient to the Emergency
Department.
• Move to the patient's head on the side of
the patient where there is room. This is
generally on the left. However, if the
medical team is working on the left side
move to the right. (DO NOT GET IN THE
WAY OF THE MEDICAL STAFF!)
G – Get the Information

16. • Introduce yourself. (Hello I am Chaplain
______ I come down for every
emergency! Let the patient know that
they are being taken care of by the best
trained staff.
• Helping them to relax by using rhythmic
breathing as a source to calm them and
helping the staff to focus on the injury
can be very helpful.
• Touching the patient is encouraged.
However do not cause more pain or get
in the way of the medical treatment being
given.

17. • A short prayer or a Scripture Verse can
be useful. (Caution: some patients see
a Chaplain as a DEATH deliverer.
Choose Scripture with care.)
• If possible, find out the names of the
patient’s Commander, family,
significant relationship or care giver.
This will help later in the waiting area
meeting with family.

18. • Establishing a relationship with the
Command team/family with an
introduction. (“Hello, I’m Chaplain
Russell, one of the ED staff. Do you
mind if we talk?")
• Minister to them and allow them to
accept or reject the offer.
R- Relationships

19. • Grieving a loss or having anxiety over the
trauma is to be expected with the family.
Privacy for those in the family can be
facilitated with the two quiet rooms located
within the waiting areas outside the ED. If a
death occurs, your ministry is critical to the
family/command as well as the staff.
• Give the family time to grieve. They will
usually give verbal or non-verbal cues when
they are ready to move.
A- Awareness of Surroundings

20. Some family members may want to view their
loved one’s body. Others may not. Either way let
them make the choice and do not ask if they want
to view. This may place them into an awkward
emotional state. Allow the family to ask if they can
see their loved one.
Inform the staff that the family would like some
time to see the body. Let the staff have some time
to clean and prepare the body. (Many times the
staff will move the body out of the trauma room to
a secondary room.)

21. • Always view the body prior to escorting the
family. Describe to the family what they will see.
• Escort the family to the viewing and position
yourself close to the next of kin.
– If it is a legal case, the family may not be able
to touch the body. Have this information
before you escort the family to see the body.
– If someone faints, try to lower them to the
floor and call for the Medical Staff to assist in
their care.
• When the family is ready, escort them back to
the quiet room and ask them if they have any
questions for the doctor. After that arrange for
the AOD or the social worker to come in and
attend to any paperwork that needs to be
completed.

22. • Debriefing the staff can be achieved in two
ways. (Personal and Informal)
Personal debriefings: give yourself a few
moments to decompress before going to
another call or to a patient on the wards. Drink
some water and catch your breath.
Informally debrief the staff by letting them know
you are there for them. It may be helpful to pull
the staff off to the side and allow them to take a
knee. Do not force yourself on them!
C-Community

23. – Pediatric cases can be more
traumatizing to the staff and to
the Chaplain.
– Follow up with the staff later as
well. Some people need time to
process the event internally
before they will open up to the
Chaplain, so make rounds when
time permits.

24. • Enter the event into the Duty log!! Remember
to give the Trauma #, the patient’s name, the
type of injury, the patient’s religious
preference, the time event started and
finished, where the patient ended up (CT/ OR/
Ward-Room #) and if you spoke to the family
members. Inform the Senior Clinical Chaplain
and report all the information at the
morning/shift report.
E- Extended Ministry

25. Review of Main Points
1. Identified the two ministry of presence roles
the Chaplain performs on the Trauma Team
2. Stated the four responsibilities of the
Chaplain on the Trauma Team
3. Listed the functions of the Chaplain as Priest
and Pastor on the Trauma Team
4. Identify the GRACE concept in Trauma
Ministry
25

26. 26
QUESTIONS

27. Your Reactions to Trauma
Expect:
• Strong emotions like anger,
sadness, and nausea
• Challenges to your beliefs, habits,
behaviors
• Are you ready to step out of your
comfort zone?

28. Vignette
Dec 2015
Casualty type Army Navy Marine Air Force Total
Hostile 2536 64 852 29 3481
Non Hostile 697 39 171 23 930
Total 3233 103 1023 52 4411
Casualty
type
Army Navy Marine Air Force Total
Hostile
Total
22,229 646 8626 450 31951
Total Wounded
Total Deaths

29. What Might you sense?
See: Blood, Broken Bones, Burns,
Controlled chaos
Hear: Yelling, Sounds of Combat, Nothing at
all!
Smell: Burt flesh, Garlic smell, Pine,
Taste: Salty sweat, dirt.
Feel: Anger, Fear, Sadness, and Nausea,
High adrenalin Rush.
Dec 2015

30. Combat Trauma
Green Phase
Red Phase
Black Phase

31. Gun Shot Wound Avulsion
Open tib-fib fraction

32. Vignette

33. Chaplain Vignette
• You are the Chaplain of the 2/7 Cavalry
1CD. On your first day of deployment one of
your fire teams is attacked by a sniper with
one casualty. SPC Waterson has a head
wound and is evacuated to the BAS. When
you arrive with the command team you
encounter the Doctor, Nurse Anesthetist, PA
and the Medics arguing over to continue
care on SPC Waterson or to terminate care.

34. Chaplain Vignette
1. SPC Waterson is still conscious,
however, the head wound is expected
to end in his death.
2. Who is/are the identified patient/s?
3. What is your role in the situation to
continue care?
4. How do you perform you 3 major
chaplain competencies?

35. HIPPA
• Everyone who will be on-call at
CRDAMC must be HIPPA Certified.
• Take a copy of your Certificate to the
DMPC with your SSN on it. This is to
be placed in your file for security
reasons.
• https://medchart.ngb.army.mil/lod/Public/HIPPA.aspx

36. Resources
• Gateway To PTSD Information
GriefNet
International Society for Traumatic Stress Studies
National Center for PTSD
• Books:
• "Compassion Fatigue: Coping with Secondary Traumatic Stress." Charles Figley,
PhD.
"CopShock, Surviving Posttraumatic Stress Disorder." Allen R. Kates.
"Covering Violence: A Guide To Ethical Reporting About Victims and Trauma." .
William Cote and Roger Simpson, Columbia University Press.
"Disasters: Mental Health Interventions (Crisis Management Series).". John D.
Weaver, PhD.
The International Handbook of Traumatic Stress Syndromes Dr. John P. Wilson &
Dr. Beverly Raphael, Editors, Plenum 1993.
"Post-Traumatic Stress Disorder-A complete guide to PTSD." Aphrodite Matsakis,
Ph.D. Author, New Harbinger Publications, Inc., 1994.
"Post Traumatic Therapy and Victims of Violence." Brunner Mazel Publishers
Frank M. Ochberg, M. D. (1988).
• https://www.dmdc.osd.mil/dcas/pages/report_oif_woundall.xhtml