CISM Flashcards
What are the 6 stages in the Defusing process?
1) Make contact - acknowledge and contract
2) Get the story - the facts, just the facts
3) Find the impact - emotions
4) How are they doing - safety
5) Educate - handout
6) Ending - follow up
What are 6 key helpful things to mention to someone post-critical incident stress?
1) CIS does not mean you are mentally ill.
2) You are having normal / expected reactions to abnormal situation
3) Your family is involved - let them be a part of your recovery
4) Get help if your symptoms persist
5) Counselling will lessen your CIS
6) Find someone you trust and talk about it
What are 8 things to suggest people DON’T do following critical incident stress?
1) Drink excessive alcohol
2) Use substances to numb post-trauma consequences
3) Withdraw from family and friends
4) Don’t stay away from work necessarily (normal routine will help you feel normal)
5) Don’t fall back on easy answers, blame for incident
6) Don’t think that you are crazy
7) Don’t think you alone were affected
8) Don’t be unrealistic in your expectations for recovery
What are 8 things to suggest people DO do following critical incident stress?
1) Expect the incident will bother you
2) Maintain diet and cut down on sugar, caffeine, stimulants
3) Exercise
4) Take time for leisure
5) Remind yourself that post-trauma consequences are expected / normal
6) Learn as much as you can about stress response
7) Spend time with family, friends, and co-workers
8) Get extra help if you need it
What is stress?
The body’s response to demanding situations.
What are the terms for positive and negative stress?
Eustress and Distress
What consequenses lie at the ends of the stress continuum?
Burnout and boredom
What is an analogy for a healthy level of stress in life?
Violin string. If it’s too tight, it will break, if it’s not tight enough, it won’t sing.
What are the three major components to a critical incident?
1) The distressed state resulting from memories of trauma (experience which shatters sense of invulnerability to harm)
2) Any situation where one is overwealmed by sense of vulnerability or lack of control
3) Any situation faced by emerg services resulting in strong emotional reactions which may interfere with ability to function
What is traumatic stress? How is it different from a critical incident.
Any stress resulting from trauma. Traumatic stress is not necessarily critical incident stress. Death of a sibling may be traumatic, but may not be critical incident, for eg., if death were expected.
What are the four general typical responses to stress?
Acute (in the moment)
Delated (comes back to bite you)
Secondary (compassion fatigue, vicarious trauma)
Cumulative (burnout, several acute situations)
What are the 7 stages of a critical incident?
Alarm (e.g., a pager, phone call, there’s been an accident)
Impact (Rote training kicks in; feel overwealmed)
Inventory (confusion, frustration, disorientation)
Rescue (elated, purposefulness, euphoria, fearfulness, sadness)
Stress management (demobilizations, defusings, debriefing)
Empowerment (achieving mastery)
Loss accommodation (resolution, continuance)
What are the five main categories of critical incident reactions, and an example for each?
Physical (shaking, autonomic nervous system)
Emotional (fear, anger)
Cognitive (confusion)
Behavioural (aggression, blaming)
Spiritual (look for meaning, question beliefs)
Where does critical incident stress sit in relation to PTSD in terms of normal/abnormal reactions?
CIS is involves normal reactions, that will either resolve or possibly develop into abnormal reactions like Acute Stress Disorder or PTSD.
What are the 8 categories of diagnostic criteria for PTSD?
Traumatic event (s) Exposure to actual or threatened death, serious injury, or sexual violence
Intrusion symptoms associated with traumatic event
Persistent avoidance of stimuli associated with traumatic event(s)
Negative alterations in cognitions and mood associated with traumatic event
Arousal and reactivity, marked alterations of.
Duration is more than 1 month
Impairment or Distress is clinically significant
Not attributable to substance or another condition
What are the PTSD diagnostic specifications?
1) With dissociate symptoms (depersonalization, derealization
2) Delayed expression (full criteria are not met until at least 6mo following traumatic event.
PTSD diagnosis: What are the 4 different ways one could be exposed to traumatic event?
1) Direct experience
2) Witnessing it happen to someone else
3) Learning that it happened to family or friend
4) Repeated or extreme exposure to aversive details of traumatic event
PTSD diagnosis: What are the 5 categories of intrusion symptoms and how many are required for PTSD diagnosis?
One or more of following required:
Distressing memories
Distressing dreams related to trauma
Dissociative reactions (flashbacks)
Intense or prolonged psychological distress at exposure to cues (triggers, reminders)
Marked physiological reactions to cues (triggers, reminders)
PTSD diagnosis: What are the 2 categories of avoidance stimuli and how many required for diagnosis?
At least one:
Effort to avoid thoughts memories or feelings related to trauma
Effort to avoid external reminders, like people, places, things, closely associated to trauma
PTSD diagnosis: What are the 7 categories of negative alterations of mood/cognitions, and how many required for diagnosis?
At least 2 of following:
Inability to remember important aspect of traumatic event
Negative beliefs about oneself (I am bad, I can’t trust anyone)
Distorted cognitions of blame or consequences related to trauma
Persistent neg emotions like fear, horror, anger, guilt, shame)
Marked diminished interest in significant activities
Feeling detached, estranged from others
Unable to experience positive emotions like happiness, satisfaction, love)
PTSD diagnosis: What are the 6 categories of arousal and reactivity and how many are required for diagnosis?
At least two of following req’d Irritable and angry outbursts with little provocation Reckless, self-destructive behaviour Hypervigilance Exaggerated startle response Problems with concentration Sleep disturbance
What is the main difference between acute stress disorder and PTSD?
Duration. ASD is 3 days to 1 month following trauma exposure. Symptoms begin very soon after trauma and persist for at least 3 days.
