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.