Line of Duty Death & Critical Incident Stress Chief Terry Lipinski, Oak Forest Fire Department Bill Neumann, Orland Fire District Communications Joe McGrath, Oak Lawn Emergency Communications Mark Sikorski, R.E.D Center Lee Jones, Orland Fire District Communications

Critical Incident Stress Life Changing Experiences

A Life Changing Experience Anyone can experience a critical incident The death of a parent, spouse, child, significant family member or friend Conventional wisdom, law enforcement, fire service and emergency medical services personnel are at greater risk

As emergency responders, we portray ourselves as “tough” professional unemotional about our work We often find comfort with other responders Tend to believe our families/friends will not understand (those not involved in public safety) We use humor as a defense mechanism “Self medicate” with alcohol or drugs/medications

Statistically…. Less than 5% of emergency services personnel will develop long-term PTSD That percentage increases when responders endure a line of duty death

Critical incidents: Traumatic events which those who are exposed to it have powerful, emotional reactions Every profession can list their own scenarios that can be categorized as critical incidents

The Terrible Ten of public safety Line of duty deaths Suicide of a colleague Serious work related injury Multi-casualty / disaster / terrorism incidents Events with a high degree of threat to the personnel

6. Significant events involving children Events in which the victim is known to the personnel Events with excessive media interest Events that are prolonged and end with a negative outcome Any significantly powerful, overwhelming distressing event

It is not a question of IF … It is a questions of when When you, your agency or coworker(s) will experience An event that will have a profound affect An impact so great that it will change behavior

When your colleague, coworker, friend or you may need help Signs and Symptoms When your colleague, coworker, friend or you may need help Reactions vary, depending on the incident and the person Symptoms are what is felt, what you feel or told Signs are what you, or others, see

Any of these symptoms may require medical attention The stress reaction can manifest in the following ways; physically behavioral emotional psychological Any of these symptoms may require  medical attention

Physical Grinding of teeth Visual difficulties Vomiting   Grinding of teeth Visual difficulties Vomiting Profuse sweating Dizziness Headaches Weakness Chest pain Difficulty breathing Elevated BP Rapid heart rate Muscle tremors Chills Thirst Fatigue

Thoughts of suicide/homicide Emotional Thoughts of suicide/homicide Inappropriate emotional responses/outbursts Intense anger

Fear Guilt Grief Panic Agitation Anxiety Irritability Depression Apprehension Feeling overwhelmed Denial

Psychological Uncertainty & Suspiciousness Hyper-vigilance, watchful Intrusive images / Nightmares Blaming someone Poor problem solving, concentration & memory Difficulty identifying objects or person Increased or decreased awareness of surrounding

Behavioral Increased alcohol use/substances abuse Withdrawal/Change in social activity Increased alcohol use/substances abuse Inability to rest/Change in sleep pattern Pacing / Erratic movements Change in speech patterns Loss or increase of appetite Hyper-alert or sensitive to environment Change in usual communications

Critical Incident Stress Intervention The purpose of the intervention process Identify those in trouble Provide them the assistance they need Establish or set the new normal stress levels as low as possible

Types of intervention The type of intervention used varies, depending on The situation Number of people involved Their proximity to the event

Individual follow-up care The Approach Addressing the various stages of progression Grief Counseling Defusing Debriefing Individual follow-up care

Grief Counseling Designed to: Provide the individual an understanding of their reaction to the event their grief help them move along in their grieving Goal Promote a healthy atmosphere of openness and dialogue

Can be presented in a structured group form or individually Should occur within 3 days of the event Effective in coping with the lost of a co-worker or fellow employee Helpful in assisting staff with a personal loss of a friend or family member

Defusing Allows the involved an opportunity to vent Share their emotions and address immediate needs Defusing is limited to the individuals directly involved Should be conducted by persons trained in CISM/CISD Done informally, same day, sometimes at the scene or 1 to 4 hours after Short in duration, a few informal questions and a great deal of listening

Defusing (continued) Designed to assure the those involved that their feelings are normal Provides information on what signs & symptoms to look for Provides information of where they can reach someone they can talk to

Debriefing Formal approach to stress intervention Usually the second level of intervention for those directly affected by the incident Often the first for those not directly involved Done within 72 hours of the incident Conducted by a trained CISD/CISM professional Can be in a group format or individual bases

A Debriefing session is Designed to mitigate the impact of potential stress Allows participates to; Talk about their experience How it has affected them Understand coping mechanisms Identifies individuals at risk Provides inform about services available A follow up is performed within 7 days of the debriefing To ensure they’re safety and are coping well Refer for professional counseling

Critical Incident Stress Management Critical incident stress management (CISM) The purpose of CISM is to: Enable people to return to their daily routine more quickly Decrease the likelihood of post-traumatic stress The goal: Help people deal with their trauma one incident at a time Allowing them to talk about the incident when it happens Without judgment Without criticism

returning them to a normal level of functioning Peer-driven Most are first responders or mental health professionals All interventions are strictly confidential If it is determined the person being helped is a danger to them self or to others, appropriate action is taken. The emphasis is ensuring their safety & returning them to a normal level of functioning

Normal is different for everyone It’s not easy to quantify Critical incidents raise stress levels dramatically in a short period of time After treatment a new normal is established However it is always higher than the old level

Where to find help Your employer Employee Assistance Program (EAP) Health care insurance plan Local health systems Local or community hospital County health services Local EMS system Friends, family and others Church Survivor networks