Critical Incidents
First responders encounter many stressful and potentially traumatic events in the course of their careers. Being able to effectively cope with critical incidents is important for functioning well on the job and at home. Critical incidents include working at scenes of violent crimes against children, motor vehicle accidents with severe injury or loss of life, line-of-duty deaths, and officer-involved shootings. Reactions often include the “fight-flight” response, with racing heart, rapid breathing, dry mouth, feelings of intense fear and the urge to escape. These situations can feel overwhelming. Although traumatic events are distressing to even the most seasoned first responders, some ways of coping with these events are much more adaptive than others. These will be reviewed in more detail below.
Factors that Affect Critical Incident Severity
Many factors can influence the severity of critical incidents for first responders, including:
Factors relating to the nature of the event itself (such as whether it involved actual or threatened loss of life or injuries, whether it involved unusual or unpredictable aspects, whether it involved horrific sensory experiences, whether the events occurred suddenly or were prolonged in nature, and the manner in which the events unfolded).
Aspects relating to the roles of first responders, dispatchers, and others involved with the event, their proximity to the event, and their behaviors during and following the event.
Characteristics of prior experiences of first responders, dispatchers, and others involved with the event (including the nature of any past critical incidents or traumatic experiences).
The extent to which the critical incident may be associated with prior critical incidents or traumatic events, either directly or indirectly.
The quality and extent of support offered following the event to those involved, as well as any stressors that manifest following the event (such as social isolation, negative media exposure, or legal stressors).
Any other factors affecting the resiliency, psychological preparedness, or vulnerability of those involved or otherwise affected.
Critical incidents are especially difficult to cope with if they are unexpected, and if there is a sense of having no control over the outcome. Situations that involve danger but can be planned for and that progress under the planned movements of the first responders tend to be less distressing than sudden, chaotic situations where it is unclear what to do next.
Personnel exposed to situations involving a sense of helplessness are more likely to blame themselves or criticize themselves. They may have thoughts like, “I’m not cut out for this”, or “I couldn’t handle myself when things got tough.” These beliefs may be completely inaccurate—the first responder may have responded the same way most others would have responded in the same situation—but this way of thinking can drain confidence, and can distract from clear, quick, and effective thinking while on duty.
Looking for Symptoms of Critical Incident Stress
In the days and weeks after a critical incident, some people experience changes that can become problematic if left unchecked. These include avoidance behaviors, such as calling in sick at work, backing out of social activities or family events, and not talking about the event with others. Other changes include increased use of alcohol or other substances, either for their calming effects, to get to sleep, or to distract away from distressing thoughts about the event. This can quickly develop into a serious problem. If you find yourself, or a colleague, using alcohol much more after a critical incident, right now is the time to take steps to be back in charge of alcohol use, and to find more effective ways of coping.
Self-blame is also common after critical incidents, based on the belief that something could have been done differently to prevent or lessen the critical incident. It involves the belief that if only you had done this instead of that, or if only you had reacted more quickly, you could have stopped the terrible event. Although it is very common to think of things you might have done differently in a situation, it is useful to remember that most situations involve many different factors, and it may be impossible to know with certainty the best thing to do in a dangerous, unpredictable situation.
Watch also for recurring thoughts such as doubts about your abilities, your courage, or your resilience. Although nearly everyone feels fear and has strong physical reactions when in danger, those who are less affected by critical incidents are those who accept these responses as normal, and do not judge themselves for having these responses. If you find yourself thinking, “I cracked under pressure,” because you felt fear and your heart raced and you hesitated in a crisis situation, it is worth examining these ideas more closely. Negative self-talk can become a distraction. If you find yourself having recurrent negative thoughts, consider contacting your agency’s Employee Assistance Program (EAP) or scheduling an appointment with a behavioral health provider to get a clearer picture of these thoughts, and how you might be able to modify your thinking to keep you at your best.
SUPPORT FOLLOWING A CRITICAL INCIDENT
It is very important that those negatively affected by critical incidents be offered support.
Caring for Your Fellow First Responders Following a Critical Incident
When a first responder has been involved in a traumatic incident, support should be provided as soon as possible. As a fellow first responder, there are things you can do to help that do not require specialized training (these suggestions are adapted from a book entitled Preparing for the Unimaginable: How Chiefs Can Safeguard Officer Mental Health Before and After Mass Casualty Events).
Safety First: Ensure that the first responder is safe, that medical attention is provided if circumstances allow, and that reassurances of safety are communicated.
Practical Help: Ask what you can do to help. For example, they may be hungry, thirsty, or require assistance contacting their loved ones. Your genuine concern is important.
Do You Want to Talk?: Offer to talk, if they wish, but don’t insist on talking if they don’t wish to engage with you.
Listen Closely: If the first responder you’re assisting wishes to talk with you, listen attentively. You don’t need to feel pressured to ask detailed questions or solve problems; simply listening may be enough.
Provide Reassurance: If the first responder appears upset or distressed, provide reassurance that they are having a normal reaction to an abnormal circumstance.
Follow Through: Help ensure that your fellow first responder makes it home safely and and has access to necessary support resources.
Caring for Yourself Following a Critical Incident
There are also many positive things that individuals can do tho care for themselves following critical incidents. Below are helpful strategies for self-care following a critical incident:
- Avoid drugs and alcohol
- Be open to receiving support from those you trust
- Reach out to trusted family, friends, and co-workers who support you
- As much as possible, maintain a normal and active routine|
- Exercise regularly|
- Get plenty of sleep and rest
- Maintain a nourishing diet comprised of regularly scheduled healthy meals
- Consider writing down your thoughts and emotions to help organize your internal experience (it is recommended that you shred the writing if you wish to ensure your privacy)
- Avoid major life decisions that you may later regret (e.g., deciding whether or not to get married or buy a new house)|
- Make many inconsequential decisions (e.g., selecting what to eat for lunch or what time to go for a run) to help reestablish a sense of control
- Understand that having strong feelings (including anxiety, anger, worry and fear) following a traumatic event is normal, and the “normal” range of personal responses following a traumatic incident varies widely from person to person
- Focus on what you can influence while letting go of what you cannot control
- Give yourself permission to feel however it is that you feel, while not imposing upon yourself any sense of obligation to maintain or preserve negative emotions
- Understand that emotional states are temporary and most people “bounce back” sooner or later following a traumatic event
- Keep in mind that you are only human, we are all prone to error, and even people who are the best in the world at what they do routinely make mistakes
- Be aware of “red flags” that signal you need help (e.g., frequent crying, excessive worry, anxiety, fearfulness, sadness, confusion, anger, sleep disturbance, or increased use of alcohol or other substances), and seek out support
- Consider reaching out to others who may be having difficulties; reassuring and helping others can be one of the most effective ways to recover as a team
- Communicate your needs to others in a clear and unambiguous manner
- Be patient and compassionate with yourself and others who may also be experiencing stress
© 2017 Cordico LLC. All Rights Reserved.
