Critical Incident Response, Consultation, and Training

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Critical Incidents

What To Look For

Critical Incident Stress:

I am often asked, "How do we know if we have had a critical incident?" The general answer is actually quite simple. You have had a critical incident if one or more person’s ability to function has been compromised. That is often enough to initiate a crisis intervention response so that impacted persons can be returned to their normal level of functioning as soon as possible.

You can identify various signs of exposure to a critical incident because you and/or those around you are experiencing particularly strong physical, cognitive, emotional, and behavioral signs and symptoms that are impacting your ability to function. This is due to an elevated state of neurological arousal in response to the incident.

Human and Financial Costs of Unmanaged Critical Incident Stress:

If critical incident stress is not managed and resolved appropriately, either by oneself or with assistance, previous experience demonstrates clearly that these exposures may lead to several psychological disorders that can impact an individual or an entire organization. They include but are not limited to:

  • Increased absenteeism
  • Increased use and misuse of sick days
  • Increases in healthcare costs
  • Diminished productivity
  • Increased injury rates at work and at home
  • Increased conflicts within your organization
  • Poor decision making
  • Premature resignation of staff
  • Higher than normal and expected turn-over rate
  • Increased worker’s compensation claims
  • Decreased morale
  • Increased fear and agitation
  • Insubordination
  • Memory dysfunction
  • Increased distractibility
  • Increased risk of clinical errors
  • Operational, manufacturing, and other production errors
  • Withdrawal and depression
  • Increase in anti-social behaviors
  • Chronic fatigue
  • Increased susceptibility to substance abuse of alcohol, prescription, and non-prescription medications
  • Abuse of street drugs
  • Child abuse
  • Elder Abuse
  • Spousal abuse
  • Increased marital separations and divorce
  • Post-traumatic stress disorders/chronic

Common Signs and Symptoms:

Here are some typical signs and symptoms that may indicate the presence of critical incident stress during and after exposure.

Physical:
  • chills
  • thirst
  • fatigue
  • nausea
  • vomiting
  • twitches
  • dizziness
  • weakness
  • feeling faint
  • chest pain
  • headaches
  • elevated blood pressure
  • tachycardia – rapid heart rate
  • muscle tremors
  • shock symptoms
  • grinding of teeth
  • clenched jaw
  • visual difficulties
  • difficulty breathing

Cognitive:
  • confusion
  • uncertainty
  • hypervigilance
  • suspiciousness
  • persistent intrusive images
  • inappropriate blaming of someone
  • poor problem solving
  • poor abstract thinking
  • poor attention/decisions
  • poor concentration/memory impairment
  • disorientation of time, place, or person
  • difficulty identifying familiar object or people
  • heightened or lower levels of alertness
  • increased or decreased awareness of surroundings
  • disturbances in sleep including insomnia, difficulty falling asleep, nightmares, night terrors, prolonged inability to sleep, excessive sleep

Emotional:
  • fear
  • grief
  • guilt
  • panic
  • denial
  • anxiety
  • sadness
  • crying
  • depression
  • agitation
  • irritation
  • intense angry outbursts
  • apprehension
  • emotional shock
  • feeling overwhelmed
  • loss of emotional control
  • inappropriate emotional responses

Behavioral:
  • withdrawal
  • anti-social acts
  • abuse of self and others
  • inability to rest
  • intensified pacing
  • erratic movements
  • changes in social activity
  • changes in speech patterns
  • loss or increase of appetite
  • hyper alert to environment
  • increased susceptibility to self-medication through alcohol and/or drugs
  • changes in usual pattern of communications

IMPORTANT NOTE: SOME OF THE ABOVE SYMPTOMS MAY INDICATE THE NEED FOR MEDICAL ATTENTION. IF SOMEONE APPEARS TO BE IMPAIRED MEDICALLY, IMMEDIATELY CONTACT A PHYSICIAN.