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Emotional wellness of the First Responder
JENNIFER RIEKER ADVANCED PRACTICE PARAMEDICCHRISTIAN HOSPITAL MIH
• 15 years in EMS
• Community Paramedic
• Course Coordinator
Community Paramedic class
Let’s talk about trauma!
Trauma
What’s going on??
Compensating
Post traumatic stress Disorder (PTSD)
PTSD Recognized as a mental disorder in 1980 Thought to be combat veterans who were unable to
face their battlefield experiences Those with PTSD were labeled “weak”, they faced
rejection and were discharged from the military 8 million adults a year 10/100 women 4 /100 men Military
Varies by service area
• Combat exposure
• Childhood physical
abuse
• Sexual violence
• Physical assault
• Being threatened with
a weapon
• An accident
PTSD symptoms Physical pain
Dizziness, fatigue, chest pain, migraines, digestive issues
Nightmares or Flashbacks Awake or asleep, sleeping difficulties,
anxiety
Depression Anxiety Withdrawing Risky behavior
Drug/alcohol abuse, thrill seeking
Avoidance Triggers
Repression Blocking or removal
Emotional numbing “Jumpy”
Hyper-arousal, aggressive, agitated
Irritability lack of concentration, sleeplessness,
Indecisive
Guilt or Shame Blaming themselves, constant relive
event
PTSD and EMS 2012 “Work related stress and
Posttraumatic stress in EMS” Elizabeth Donnelly
Ontario, Canada
1600 EMS professionals
100% reported exposure to traumatic events
Chronic stress vs Critical Incident Stress
Chronic stress in EMS Decision making
Fast moving environment
Strong emotional reactions
Life or death decisions
Lack of support
Competitive environment
Conflict with supervisors
Low pay
Lack of sleep
Long hours Chronic Stress
Relatively enduring problems, conflicts and threats that many people face in their daily lives
Critical Incident Stress
Patient care- any situation faced by EMS personnel that causes them to experience strong emotional reactions, which have the potential to interfere with their ability to function either at the scene or later
“”
The stress resulting from helping or wanting to help a traumatized or suffering person
CHARLES FIGLEY
AUTHOR OF “COMPASSION FATIGUE”
Compassion Fatigue
Compassion FatigueSigns Individual Isolating from others
Unusual amount of complaints
Excessive complaining
Seeming preoccupied
Substance abuse
Bottled up emotions
Compulsive behaviors such as overspending, overeating, gambling, sexual addictions
Poor hygiene and /or appearance
Blaming others
Frequent physical ailments- colds, GI problems, etc.
Difficulty with concentration
Exhaustion- mental and physical
Organization Co-workers not working well together
Lack of confidence with management
An increase in absenteeism
Willingness to break department rules
A feeling that “things will never change”
Sudden aggressive behavior among team
Not completing assignments and tasks
Missing deadlines
Decreased flexibility
Objection to change
No direction or vision for the future
Secondary Trauma
“”
Trauma resulting from caring for, hearing about or witnessing the intense suffering of others. Over time the build-up can result in an internalization of trauma, leading to compassion fatigue or burnout
PSYCHOTHERAPY-CENTER.COM
Secondary Trauma
Secondary Trauma
Who is at risk?
Medical professionals
Therapists
Those who work with traumatized children and adults
First responders
Signs Hopelessness
Social withdrawal
Guilt
Avoidance
Anger
Chronic exhaustion
Poor boundaries
Insensitivity to Violence
Emotional trauma
Traumatic Event
“An event in which we experience a threat (actual or perceived) of death or serious injury to self or others , with a response of “intense fear, helplessness or horror.”
DSM-IV definition
How does this effect me?
Response to trauma
There is a normal and expected response
Physical and psychological
Anxiety, irritability, fatigue, feeling overwhelmed ……
Acute stress disorder vs Post Traumatic Stress Disorder (PTSD)
Have an impact on important areas of function
Social and/or occupational impacts
Acute Stress Disorder: occur within a month of event and last for at least 2 days
PTSD- symptoms begin or last longer than a month after event
YES!!!!
Why are some people susceptible to a response from trauma and others are not?
It’s not just the actual event that can cause distress, it is the meaning it has for that person
Prior trauma Childhood trauma
Previous experience EMS, Fire, Police
Connection to another event
Previous exposure
What can we do?
Self Care Hobbies, exercise, get enough sleep, healthy diet, leisure time, spend time with
friends and family, using relaxation techniques
Seek support from co-workers and other first responders Seek further education Therapy or counselor
EAP, department counselor or seek out your own
Watch out for each other
Ems and Coping
National First Responder Lifeline Program
1-888-731-FIRE(3473)
• Confidential • Counselors will connect you to right
resources • First Responder Counselors
Safe Call Now – 1-206-459-3020A 24/7 help line staffed by first responders for first responders and their family members. They can assist with treatment options for responders who are suffering from mental health, substance abuse and other personal issues.Share The Load – 1-888-731-3473Also known as The Fire/EMS Helpline. A program run by the National Volunteer Fire Council. They have a help line, and have also collected a list of many good resources for people looking for help and support.National Suicide Prevention Lifeline – 1-800-273-8255The national (USA) suicide hotline. Not first responder specific, but they can and will talk to anyone who needs help. We’ve been told by one of their founders they have a large number of first responders and veterans who volunteer.Kristin Brooks Hopeline – 1-800-442-4673Another national (USA) hotline for people suffering from mental health issues.Veterans Crisis Line (Veterans only)- 1-800-273-8255 & press 1, or text 838255A crisis line specifically for veterans of the US armed forces.Copline (Law Enforcement Only) – 1-800-267-5463A confidential helpline for members of US law enforcement. Their website also has additional information on help and resources.Crisis Text LineA service that allows people in crisis to speak with a trained crisis counselor by texting 741741.Suicide.org list of local helplines for all 50 statesThis list includes thousands of local call numbers for every state in the US. Calling a local number can help put you in contact with nearby resources like counselors or psychiatrists faster than calling a national line.