CISM
	Tri-County Critical Incident Stress Management
	Caring for the community and each other

ON CALL 24 HOURS	776-2180	Steuben County Dispatch
	937-7200	Corning Hospital
	737-4100	Arnot Ogden Medical Center
	733-6541	St. Joseph's Hospital
	292-3941	Schuyler County
	737-5600	Chemung County EMS
"Our team keeps your team on the job"

CRITICAL INCIDENT STRESS MANAGEMENT FOR EMERGENCY SERVICE PERSONNEL
What is a Critical Incident?
Normal Responses to Critical Incident Stress
If You Experience Symptoms of Stress
For Immediate Assistance in the Tri-County Area
Critical Incident Debriefings

What is a Critical Incident?Any incident faced by service personnel that causes them to experience unusually strong emotional involvement.

For example:
-Serious injury of an emergency service worker at an incident or en route.
-Mass Casualty Incidents.
-Suicide of a crew member.
-Serious injury or death of a civilian resulting from emergency service operations, i.e., auto accident, etc.
-Death of a child, or violence to a child.
-Loss of life of a patient following extraordinary and prolonged expenditure of physical and emotional energy during rescue efforts by emergency service personnel.
-Incidents that attract extremely unusual or critical news media coverage.
-Any incident that is charged with profound emotion.
-An incident in which the circumstances were so unusual or the sights and sounds so distressing as to produce a level of immediate or delayed reaction.

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Some Normal Responses to Critical Incident Stress:Everyone is unique and everyone responds uniquely to critical incidents. Some people experience stress reactions, while others have no stress reactions or symptoms.

Kinds of Stress:
Community marketplace Acute - within 24 hours after the event
Delayed - days or months after the event
Burnout - accumulated stress from the job

Acute Stress Reactions

Difficulty thinking
Memory losses
Inability to name familiar objects
Difficulty making decisions
Difficulty solving problems
Confusing trivial with major problems
Concentration problems
Loss of attention span
Difficulty adding, subtracting, etc.

Physical Signs & Symptoms

Fatigue
Nausea
Muscle tremors
Twitches
Shock symptoms
Profuse sweating
Chills
Dizziness
Gastro-intestinal upset

Emotional Symptoms

Anxiety
Fear
Grief
Depression
Hopelessness
Irritability
Anger
Feeling overwhelmed
Identification with victims

Delayed Stress Responses:

Intrusive images - visual, sound, taste, smell
Dreams
Fear of repetition

Cumulative Stress Reactions (burnout)
A state of fatigue or frustrations resulting from disappointment and excessive exposure to stress over time. It is a problem born of good intentions, unrealistic expectations, and excessive striving.

Burnout Behaviors

Giving Up
Derogatory labels
Social withdrawal
Sick humor
Patient abuse
Omnipotence Creating bureaucratic rules
Rationalizing failure
Poor performance
Absences from work
Increased use of drugs, alcohol
Unacceptable behaviors

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Some Things To Do If You Experience Symptoms of Stress

Air it out - don't hold the problem within. Talk is cheap (cheaper than a breakdown). Confide in someone you trust (friend, spouse, doctor, clergyperson). You will find that talking relieves strain. Many times others can help you to see what you can do about a problem because they are not involved emotionally as you are.

Avoid drugs and alcohol to relieve your symptoms. These substances will slow your recovery.

Take care of your body - get plenty of exercise, sleep, and good nutrition.

Know that your symptoms are normal reactions, by a normal person, to an abnormal strain.

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For Immediate Assistance in the Tri-County Area

Contact the county dispatcher and request an immediate announcement on F-1 for any members of the Tri-County Critical Incident Stress Debriefing Team to contact the county dispatcher immediately. Give your name and telephone number. Responding team members will be give information for immediate contact. Other numbers:
     937-7200 Corning Hospital
     737-5600 Chemung County EMS
     737-4100 Arnot Ogden Medical Center
     733-6541 St. Joseph's Hospital
     292-3941 Schuyler County

"Our team keeps your team on the job"

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Critical Incident Debriefings

What: Critical Incident debriefings are beneficial when a single or multiple incident causes stress to Emergency Service Providers. They are not critiques!

Why: Critical incidents may cause Emergency Service personnel to experience intense stress which, if unresolved, could cause physical or emotional symptoms that interfere with their work and personal lives. These efforts may result in "burnout" and a desire to leave the Emergency Services. Examples include multiple deaths or injuries, youthful victim, peer death or injury, police shootings, busy ERs, etc.

Who: The Tri-County CISM Team is a dedicated and trained peer group of Emergency Services providers and mental health professionals who have volunteered to help YOU in a relaxed and confidential setting.

Where: They will meet with you in a place near your agency for quiet, confidential meetings.

When: Preferably 24-72 hours after an incident. Very major incidents can be addressed in progress.

Fee: None.