CISM

1. CISM Critical Incident Stress Management for Emergency Services Personnel

3. WHAT ARE CRITICAL INCIDENTS? • Events which may cause strong emotional effect on an emergency worker

4. WHAT ARE CRITICAL INCIDENTS? • Line of duty Death or Major Injury

5. WHAT ARE CRITICAL INCIDENTS? • Death or Major Injury of a child

6. WHAT ARE CRITICAL INCIDENTS? • Prolonged Search and Rescue Efforts

7. WHAT ARE CRITICAL INCIDENTS? • Mass Casualty Incidents

8. WHAT ARE CRITICAL INCIDENTS? • Operations involving extensive media coverage

9. CRITICAL INCIDENTS ARE….. • Knowledge of the victim • Long extrication • Loss of a fellow Emergency Worker

10. OR……..Any situation that causes stress to the Emergency Worker

11. ONE OF THE LEADING CAUSES OF DEATH IN EMERGENCY SERVICE WORKERS IS STRESS-RELATED CARDIAC ARREST Educational programs for dealing with stress on a daily basis are essential in reducing stress.

12. New Castle County CISM Team • Member of • Delaware Volunteer Firemen’s Association - DVFA • New Castle County Volunteer Firemen’s Association - NCCVFA • International Critical Incident Stress Foundation - ICISF • Established 1989

13. NEW CASTLE COUNTY CISM TEAM • Volunteer/Paid Personnel • Fire Fighters • Ladies Auxiliary • Paramedics • Police • Nurses • Clergy • Mental Health Providers • Disaster Workers

14. GOAL • Assist Emergency Service Workers who face a Critical Incident • Provide pre-incident education and information on how to overcome stress reactions • Prompt activation of the New Castle County CISM Team

16. SERVICES • On-scene support • Demobilization Services • Defusing • Formal debriefings

17. SERVICES • On-scene support

18. ON SCENE SUPPORT • One-on-one support for Emergency Personnel at the scene • Provide advice and support incident commanders at the scene on topics of stress management • Assist the victims and family members until other help arrives

19. SERVICES • On-scene support • Demobilization Services

20. DEMOBILIZATION SERVICES FOR LARGE SCALE EVENTS (highly intense or unusual) • Establish a location away from the scene for out-of-service units • Provide support and information on stress effects resulting from the incident • Provide a place for command to issue incident updates • Provide reassurance that help is only a phone call away

21. SERVICES • On-scene support • Demobilization Services • Defusing

22. DEFUSING • Initial session for releasing stress • Performed 1-3 hours following an incident • Provides information and support about managing stress for all personnel involved in the incident • Lasts about 45-60 minutes • TOTALLY CONFIDENTIAL

23. SERVICES • On-scene support • Demobilization Services • Defusing • Formal debriefings

24. FORMAL DEBRIEFINGS • The next step in the Stress Management process for workers that have been involved in a critical incident • Occurs as a result of follow-up requests • Led by a mental health professional with the aid of peer support • TOTALLY CONFIDENTIAL

25. THE EMOTIONAL RESPONSES TO CRITICAL INCIDENTS ARE….NORMAL REACTIONS BY NORMAL PEOPLE TO ABNORMAL SITUATIONS.

27. EMERGENCY SERVICES • A very demanding profession - career or volunteer • Daily emotional and physical demands leading to a strain on minds and bodies • Continuous stress without resolution - lessens productivity and shortens careers

28. CISM INTERVENTION The required preventive maintenance of our minds and bodies

29. STRESSES FACED BY EMERGENCY SERVICE WORKERS • Always on alert • Dealing with tragedy • Dealing with death

31. PHYSICAL SIGNS OF STRESS • Tension - chest pains, trembling, fidgeting, fumbling • Jumpiness - easily startled • Cold sweats, dry mouth, pale skin • Pounding heart - lightheaded, dizzy • Shortness of breath • Nausea

32. PHYSICAL SIGNS OF STRESS • Bowel or bladder disturbance • Incontinence • Fatigue • Frequent Illness • Day dreaming

33. EMOTIONAL SIGNS OF STRESS • Changes in behavior • Anxiety • Irritability • Lack of attention • Lost train of thought • Trouble sleeping • Grief • Crying

34. EMOTIONAL SIGNS OF STRESS • Memory Problems • Depression • Anger • Loss of confidence • Rapid Mood Change • Taking unnecessary chances • Excessive use of Drugs or Alcohol

35. SIGNS/SYMPTOMS - a cry for helpWatch for signs in yourself and co-workersBeing aware enables you to help someone. KEEP AN EYE ON EACH OTHER, BECAUSE NO ONE ELSE CAN.

36. FEELING STRESSED? • Keep calm and in control • Focus on immediate assignment • Talk to someone, anyone, everyone • Take a deep breath • Shrug your shoulders to reduce tension • Keep a sense of humor • Stay in touch with your colleagues

38. FEELING STRESSED? • Exercise • Eat properly • Talk to friends and family, let them know what you are going through • REMEMBER… STRESS REACTIONS ARE NORMAL

39. Keep in touch with loved ones.

40. WHEN A CRITICAL INCIDENT HAPPENS…. • Contact your OIC • Officer contacts the New Castle County CISM team via Fire board • The CISM coordinator will set up a team and schedule a time for a defusing or debriefing

41. THINGS THE COORDINATOR NEEDS TO KNOW…. • Why CISM is needed? • What signs of stress are present? • Who was involved? (# of persons) • When session can take place? • Where to meet and who to contact?

42. WHAT TO DO WHILE THE TEAM IS RESPONDING…. Support your co-workers

43. AN INCIDENT MAY TRIGGER REACTIONS FROM A PRIOR INCIDENT

44. STRESS CAN ACCUMULATE*Don’t let it build up*TalkTalkTalk!!!

45. STRESS IS EVERYWHERETake care of Stress Before it takes care of YOU!!

46. Emergency Workers do not snore, burp, sweat or pass gas. There fore, they must “Bitch or they will BLOW UP!!

47. REMEMBER….THE EMOTIONAL RESPONSES TO CRITICAL INCIDENTS ARE….NORMAL REACTIONS BY NORMAL PEOPLE TO ABNORMAL SITUATIONS.