Mental Health for the First Responder Flashcards
What does ‘fight or flight’ refer to?
A physical and psychological response to any demand
What are some physical signs of stress?
- Pupils
- Heart Rate (HR)
- Blood Pressure (BP)
- Respiratory Rate (Resps)
- Metabolic changes
What is stress?
A syndrome which occurs when one or more body functions are adversely affected by persistent exposure to emotional and physical stress which is not effectively managed
What does ‘GAS Syndrome’ stand for?
General Adaptation Syndrome
What are some physical manifestations of stress?
- Decreased immunity
- Heart disease
- Chronic fatigue
What can emotional manifestations of stress include?
Any number or combination of psychiatric disorders
What are the types of stress?
- EPISODIC (acute)
- WORK RELATED
- EPISODIC (acute) NON-WORK RELATED
- CHRONIC WORK RELATED
- CHRONIC NON-WORK RELATED
What is a crisis?
An emotionally significant event which acts as a turning point for better or worse in a person’s life
What is Critical Incident Stress?
A state of emotional turmoil following a serious interruption in the steady state or equilibrium of a person, family or group
What are some sources of stress?
- Organizational (infrastructure, management, supervisors)
- Occupational (type of job, chronic and episodic)
- Single Incident Stress (professional, personal)
What are the responses to stress?
- Acute (specific to incident)
- Delayed (spurred by secondary event, after initial incident)
- Cumulative (BURNOUT)
What are the physical symptoms of Critical Incident Stress?
- Sleep disturbances
- Headaches
- Frequent illness
- Neck/shoulder tightness
- Cold or sweaty hands
- Increased or prolonged fatigue
- Teeth grinding
- Rashes
- Constipation/diarrhea
- GI problems
What cognitive symptoms may arise from Critical Incident Stress?
- Difficulty focusing
- Irritability and impatience
- Uncharacteristic nervousness
- Quick to anger
- Apathy
- Depression
- Lack of confidence
- Low self-esteem
- Helplessness
What behavioral symptoms can indicate Critical Incident Stress?
- Overeating
- Procrastination
- Increased risk taking
- Amnesia
- Increased substance abuse (smoking, alcohol, drugs)
- Argumentative
- Negativity
- Social withdrawing
What factors may affect the severity of reactions to a stressful event?
- Severity and nature of the event
- Nature of the worker’s role in the event
- Physical and psychological proximity to the event
- Previous experience in handling personal crisis
- Nature and effectiveness of what has been done by others at the event
- Support or ostracism by others
- Number and type of episodic and chronic stressors in one’s life at the time
What are some coping strategies before an incident occurs?
- Pre-Incident training
- Being informed about expectations
- Teamwork philosophy
- Developing a good support network
- Self-improvement
- Good physical condition
- Proper nutrition
- Developing relaxation skills
- Positive attitude towards self and others
What should be done during an incident to cope effectively?
- Be Active
- Rotate through rest periods
- Eat good food
- Release emotions when appropriate
- Use humor with awareness of bystanders
- Check on others
- Disengage non-essential staff
What are some after-incident coping strategies?
- Rest
- Eat good food
- Get exercise
- Maintain your schedule, if possible
- Expect dreams and flashbacks
- Express your feelings
What are some don’ts after an incident?
- Drink alcohol excessively
- Use illicit substances to numb consequences
- Withdraw from friends, family and co-workers
- Stay away from work
- Look for easy answers to explain the incident
- Have unrealistic expectations for recovery
What are some do’s for maintaining good mental health?
- Eat breakfast
- Eat 5-6 small, balanced meals a day
- Decrease caffeine intake
- Watch your sugar intake
- Balance hormones (insulin/glycogen)
What are warning signs of acute stress?
- Physical signs
- Cognitive signs
- Emotional signs
- Behavioral signs
What are some physical warning signs of acute stress?
- Nausea
- Tremors/shakes
- Uncoordinated movements
- Diaphoresis
- Chills
- Muscle aches
- Sleep disturbances
What are some cognitive warning signs of acute stress?
- Anxiety
- Denial
- Fear
- Survivor guilt
- Depression
- Grief
What are some emotional warning signs of acute stress?
- Change in activity
- Withdrawal
- Change in interactions with others
- Increase or decrease in food intake
What are some behavioral warning signs of acute stress?
- Chest pain
- Dyspnea
- Hypertension
- Dizziness
- Bloody stools
What are distress signs that require immediate assistance?
- Decreased alertness to surroundings
- Panic reactions
- Significant change in speech patterns
- Antisocial acts (violence, extremely angry outbursts)
What is Critical Incident Stress Debriefing (CISD)?
A 7 step psychological and emotional process for people with normal reactions to an abnormal situation
What is the main goal of Critical Incident Stress Defusing?
To offer information, support, initial ventilation of feelings and set up or establish a need for a full debriefing
What is the role of a CISD facilitator?
The team leader who guides the debriefing process
What is the ideal timing for a debriefing after an incident?
Preferably 24-72 hours after the incident
What is the average duration of a debriefing?
About 3 hours
What are the types of help available for critical incident stress?
- Informal help (friends, family, co-workers)
- Formal help (physician, psychologist, EAP, CISD)
What should be avoided during the defusing process?
Management should not be involved; they may require their own defusing
What are some key components of the defusing process?
- Introduction of the incident
- Sharing perspectives
- Ventilation of feelings
- Education on expected reactions
What training is recommended for managing critical incident stress?
- CISM - BASIC
- CISM - PEER SUPPORT
- CISM - ADVANCED
