Critical Incident Stress Debriefing (CISD) for Emergency Personnel
Reiko Homma True, PhD
San Francisco Community Mental Health Services, San Francisco, California USA

The goal of this presentation will be: 1) to acquaint the emergency medical personnel about the potentials for experiencing stress reactions while engaged in frequent emergency or disaster-assistance activities; and 2) to provide a brief overview of the critical incident stress debriefing frequently utilized in preventing the development of post traumatic stress disorders (PTSD).

The presentation will include:

1) Types of critical incidents or disasters:
a) natural disasters, e.g., earthquakes, floods, fire
b) man-made disasters, e.g., chemical spill, terrorist attack, war, plane crash, car wreck, murder, accidents;

2) Types of stress reactions:
a) Physiological, e.g., increased heart beat, blood pressure, nausea, upset stomach, diarrhea, trouble breathing, headaches;
b) Cognitive, e.g., memory problems, disorientation, confusion;
c) Psychological, e.g., anxiety, fear, excessive worry, depression;
d) Behavioral, e.g., outbursts of anger, increased use of alcohol and/or drugs, frequent arguments, marital problems, violence;

3) Critical Incident Stress Debriefing: Historical background and relationship to emergency personnel;

4) Phases of Critical Incident Stress Debriefing:

Phase 1: Introduction and explanation of rules
Phase 2: Fact Phase - What was your job? What happened?
Phase 3: Thought Phase -What were your first thoughts?
Phase 4: Reaction Phase - What was the worst thing about this for you?
Phase 5: Symptoms - What symptoms did you experience at the scene? Next few days? Left over now?
Phase 6: Teaching Phase - What to expect; coping strategies; and
Phase 7: Re-entry Phase - Transition back to work

5) When to refer to professional experts (both medical and psychiatric)?

Keywords: critical incident stress debriefing (CISD);disasters; debriefing; emergency personnel; post-traumatic stress disorder (PTSD); referrals; stress reactions
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