Critical Incident Stress Management - Recipients

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Critical incidents are traumatic events that cause powerful emotional reactions in people who are exposed to those events. The most stressful of these are line of duty deaths, co-worker suicide, multiple event incidents, delayed intervention and multi-casualty incidents. Every profession can list their own worst case scenarios that can be categorized as critical incidents. Emergency services organizations, for example, usually list the Terrible Ten. They are:

  1. Line of duty deaths
  2. Suicide of a colleague
  3. Serious work related injury
  4. Multi-casualty / disaster / terrorism incidents
  5. Events with a high degree of threat to the personnel
  6. Significant events involving children
  7. Events in which the victim is known to the personnel
  8. Events with excessive media interest
  9. Events that are prolonged and end with a negative outcome
  10. Any significantly powerful, overwhelming distressing event

While any person may experience a critical incident, conventional wisdom says that members of law enforcement, fire fighting units, and emergency medical services are at great risk for posttraumatic stress disorder (PTSD). However, less than 5% of emergency services personnel will develop long-term PTSD symptomatology. That percentage increases when responders endure the death of a co-worker in the line of duty. This rate is only slightly higher than the general population average of 3–4%, which indicates that despite the remarkably high levels of exposure to trauma, emergency workers are resilient, and people who join the field may self-select for emotional resilience. Emergency responders tend to portray themselves as “tough,” professional, and unemotional about their work. They often find comfort with other responders, and believe that their families and friends in other professions are unable to completely understand their experiences. Humor is used as a defense mechanism. Alcohol or possibly other drugs/medications may be used to self-medicate in "worst case" situations.

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