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Critical Incidents

Critical Incidents. A Normal Reaction to an Abnormal Situation. CRITICAL INCIDENT Definition:. An incident that exposes you to actual or threatened death, serious injury or other threats to your physical integrity or that of others. TYPICAL CRITICAL INCIDENTS.

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Critical Incidents

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  1. Critical Incidents A Normal Reaction to an Abnormal Situation

  2. CRITICAL INCIDENTDefinition: • An incident that exposes you to actual or threatened death, serious injury or other threats to your physical integrity or that of others.

  3. TYPICAL CRITICAL INCIDENTS • Serious injury or death of a fellow employee at work. • Serious injury or death of a non-employee resulting from Railroad operations. (“Trespasser”) • Requirement for employees to administer first aid for serious illness or injury (e.g. CPR or traumatic amputation.)

  4. TYPICAL CRITICAL INCIDENTS(continued) • Requirement for employees to remove bodies or parts of bodies. • Requirement for employees to wait with seriously ill or injured victims for the arrival of Emergency Services.

  5. Nightmares Flashbacks Memory disturbances Persistent intrusive recollections of the incident Guilt Withdrawal from family and loved ones Difficulty Concentrating Depressed mood Eating problems Heightened awareness COMMON TRAUMATIC STRESS SYMPTOMS

  6. Anger or hostility which is difficult to control Feeling “numb”or detached Exaggerated startle response Sleep problems Inability to experience pleasure Excessive Drinking or drug use Crying spells COMMON TRAUMATIC STRESS SYMPTOMS (Cont.)

  7. CRITICALINCIDENTDEBRIEFING

  8. “A VISIT TO THE SHRINK” PSYCHOTHERAPY CRITIQUE PART OF ANY INVESTIGATION JUDGEMENTAL PUBLIC MEETING PART OF ANY PERSONNEL OR MEDICAL RECORD WHAT IT ISN’T!!!

  9. What It Is!!! • 1 to 2 hour meeting led by a Masters Level mental health professional, trained in crisis intervention, stress and the “CID” process. • Usually conducted within 72 hours of the incident. • Structured discussion of the event to reduce its impact on you. • A confidential opportunity to provideand receive group support.

  10. WHY A “C.I.D.”? • Protectsyou from Post Traumatic Stress Disorder! • Helps you identify and understand intense feelings! • Helpsyou predict and prepare for possible emotional after effects! • Helpsyou identify supports and resources!

  11. “C.I.D.”GOALS • MINIMIZE THE IMPACT OF A CATASTROPHIC EVENT. • ACCELERATE NORMAL RECOVERY PROCESSES IN NORMAL PEOPLE WHO ARE EXPERIENCING NORMAL REACTIONS TO ABNORMAL EVENTS!

  12. WHAT WILL IT COST ME? • Only your time! • You will be paid for time you spend traveling to and from your reporting point, and for time spent at the debriefing.

  13. WILL I GET TIME OFF? If you attend a debriefing you will be given an excused absence of two days with pay directly following the incident if you want or need it.

  14. WHAT HAPPENS IN A CRITICAL INCIDENT DEBRIEFING?

  15. STAGE #1 INTRODUCTION • Introduce participants • Explain the process • Set and agree to ground rules

  16. STAGE #2 FACTS Participant describes: • The incident. • Their activities at the scene. • What they did, heard, saw, smelled, etc. (“Just the facts”)

  17. STAGE#3 THOUGHTS Participants describe cognitive reactions: • Thoughts on arrival, during, and shortly after the incident.

  18. STAGE#4 REACTION Participants: • Identify the most traumatic aspects of the event . • Identify emotional (feeling) reactions.

  19. STAGE#5 SYMPTOMS Participants: • Identify and discuss symptoms experienced during and following the incident

  20. STAGE#6 TEACHING • Educate regarding the stress response • Normal reactions to abnormal situations • Practical suggestions to assist in recovery

  21. STAGE#7 RE-ENTRY • Answer any remaining questions • List of do’s and don’ts • Arrangements for follow-up • Re-enforce group support through exchange of phone numbers

  22. WHAT YOU HAVE SAID ABOUT DEBRIEFINGS!!! • “The fatality shook me up more than I wanted to admit. The debriefing helped me see that I would get through this OK.” • “Within a few hours of the debriefing, I was no longer seeing the body whenever I closed my eyes.”

  23. MORE OF WHAT YOU SAID!!! • “When I lost my keys , I just sat down and laughed. I couldn't believe it! In the debriefing they told us to expect this type of memory loss. Before I finished laughing I remembered where I put the keys.” • “I was afraid I was going crazy, until I went to the debriefing and found out that my symptoms were a normal reaction.”

  24. “WHEN BAD THINGS HAPPEN TO GOOD PEOPLE WE CAN HELP!” MTA Metro-North Railroad EAP (212) 340-2792

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