Critical Incidents

helicopter near edge of high rise building

Basic Description

A critical incident is defined as the psychological distress that is sometimes associated with exposure to a traumatic event. This acute response to a traumatic event becomes a crisis when:

  1. One or more people experience significant and increased levels of stress;

  2. When one’s usual coping mechanisms have failed; and

  3. As a result of the Critical Incident, there is evidence of significant distress and impairment to the extent that people’s ability to function has been compromised.

We know that there has been a Critical Incident when one or more people may have become so impacted that they are having difficulty functioning in their day-to-day life either at home, at work, at school, or in any other social aspect of their lives.

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 objects 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

What to Look For

To determine if a situation qualifies as a critical incident, the key indicator is a noticeable impact on an individual’s or group’s ability to function normally. This disruption is often a direct consequence of experiencing a highly stressful or traumatic event.

It’s not the event itself, but the reaction to it that defines a critical incident. Typically, if even one person’s functional capacity is significantly compromised, it can be considered a critical incident, warranting attention and potential intervention.

Signs to look out for include marked changes in physical, cognitive, emotional, or behavioral states. These changes are often due to heightened neurological arousal in response to the incident.

Symptoms might range from severe anxiety, difficulty concentrating, and mood swings to physical symptoms like fatigue or insomnia. Recognizing these symptoms early is crucial for initiating timely and effective crisis intervention, aiming to restore normal functioning as quickly as possible.

Common Signs & Symptoms

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

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 the 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.

Human and Financial Costs of Unmanaged Critical Incident Stress

If critical incident stress isn't adequately addressed, either individually or with professional help, past experiences show that it can lead to various psychological disorders. These disorders can affect not only the individual involved but can also significantly impact the 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 home

  • Increased conflicts within your organization

  • Poor decision making

  • Premature resignation of staff

  • Higher than expected turnover 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