See Something? Say Something! A Word on Critical Incidents

Given the recent attack in Paris that left dozens dead or wounded, I thought it would be an appropriate time to talk about mental health. Many EMS services (and the public safety industry in general) have taken positive steps over the last decade in taking care of their clinicians’ mental health… but other services are still behind the 8-ball.

Responding to an incident like that which occurred in Paris this week would affect most of us very deeply; it is the epitome of what we imagine when the specialists talk about the dreaded “critical incident.” So what is a critical incident? In the simplest terms, a critical incident is one in which the suddenness, the magnitude, or the particulars of the event overwhelm the coping skills of a responder. While medics like to think of ourselves as invincible at times, unfortunately… we are not.

What defines a critical incident for one responder, however, will not be constant across the board. Your personal life, work history, and general life experience will all play into what events become critical incidents. If you have children, maybe it is the sick or injured child that gets you; if you are or were involved with law enforcement, maybe it will be the officer-involved shooting that presses the reset button on your mental defenses. It is hard to say what it will be until that time comes.

Hopefully, you are working for a company or municipality that takes mental health services seriously and has the pieces in place for you to get help.  This could be in the form of an employee assistance program, a therapist on staff, or a critical incident stress management program. The resources you have available to you will largely depend on the size or funding of your agency.

So when do you need to look for help? Remember that these events can affect you both physiologically and psychologically. In the days and weeks following a critical incident (whatever that looks like for you), make sure to be especially aware of yourself.

  • How are you eating?
  • How are you sleeping? Do you have to have a couple strong cocktails to help you get to sleep? (we call that one a clue).
  • Are you playing back the events in your head, over and over, even if you aren’t feeling particularly sorrowful about it? Maybe you are having recurring dreams about the incident.
  • If you run a call with a similar setting do you find yourself getting anxious?

All of the above could be signs that you need to look to your agency for what resources are available to you.

In my career thus far I have experienced several calls that I would file into the critical incident category. I am fortunate in that I have worked for several very good agencies that have really stepped up to the plate when these sort of things happened. The two most recent were both in the last three years and both times I attended a critical incident stress debriefing.

The CISD in both cases took place about 48 hours after the incident and consisted of a group session that included every responder who had a meaningful role at the scene, from the call-taker in dispatch all the way through to the police, medics, and firefighters who responded. We sat and talked through what each of our roles were, what we did, and how it had been affecting us in the hours since.

Going in, I was rather skeptical about the whole deal as I am not one to share my feelings, especially in a public setting. But, having been through the experience since then I can say I am glad I did it. While it certainly won’t be for everyone, it definitely helped me.

So folks, that was my spiel. When it comes down to it, we have to take care of ourselves before we can take care of anyone else. If you, or someone you know, is having difficulty after a tough call, speak up! Get help!

-Tom