Critical Incident Stress Debriefing

People involved with, or exposed to, modern-day traumas can experience a range of emotional responses. Concern for victims of workplace and disaster-related trauma has led to increased popularity of early intervention and prevention strategies.

Critical incident stress debriefing (CISD) is one such strategy.  CISD was originally developed by Dr. Jeffrey Mitchell to ease the acute stress responses of emergency workers.A critical incident is any event faced by emergency service personnel that may cause strong emotional reactions that could interfere with their ability to function.  CISD hopes that immediate intervention following a traumatic event will eliminate or at least reduce delayed stress reactions.

CISD is an intervention conducted by trained mental health professionals, in either group or individual format. CISD encourages traumatized individuals to share their thoughts and feelings about the critical incident, with the goal of making sense of the trauma.Aside from the reassurance and support provided by the health care professional, resources and information regarding practical coping skills are also offered.

Debriefing typically occurs two to three days following the traumatic event and can last three to five hours.  Debriefing responses are now recommended as standard practice in many schools, workplaces and government organizations. For example, people witnessing or experiencing workplace- or school-based violence will often receive a debriefing intervention.

When it comes to the job of a paramedic CISD is important.  Most medics feel that they can “take it” because they see the same tragedy day in and day out.  It is true.  We start to become desensitized.  Think about the jokes we tell.  Your fellow medics burst out laughing at jokes that would have the general public horrified.

This is not a bad thing.  It is another coping mechanism.  Without a release valve of some sort the stress will continue to pile up until the paramedic can’t take one more call.

Because we deal with tragedy on such a frequent basis and are strong enough to not only finish our shift but show up the very next day for more is even more reason that we need to take CISD so seriously.  What does not seem to bother us so much right now is just one more brick that we carry.

Quite often it is hard for people to genuinely open up and share what is bothering them or talk about “that call”.  We all have to be sensitive to this and do our best to look out for our fellow medics.  Simply asking them how they are doing shows that you are willing to listen.  Maybe they really are fine or they are just not ready to talk about it but they will know that you are there when they need someone.

While formal CISD sessions play an important role in coping with stress on the job there are countless calls that fall through the cracks.  It is up to all of us to make sure we fill as many of these cracks as we can.