Critical Incident Stress Identification & Resolution

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

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

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

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

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

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

With Critical Incident Stress Strategies for Coping With Critical Incident Stress

Strategies for Coping: Within the first 24-48 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

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

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

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)