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Critical Incident Stress Intervention After Loss of an Air Ambulance: Two-year Follow Up

Published online by Cambridge University Press:  28 June 2012

Andrew J. Macnab ,
James A. Russell ,
John P. Lowe  and
Faith Gagnon
Andrew J. Macnab*
Affiliation:
Paediatric Transport Program, Division of Intensive Care, British Columbia Children's Hospital, Vancouver, Canada
James A. Russell
Affiliation:
Paediatric Transport Program, Division of Intensive Care, British Columbia Children's Hospital, Vancouver, Canada
John P. Lowe
Affiliation:
Paediatric Transport Program, Division of Intensive Care, British Columbia Children's Hospital, Vancouver, Canada
Faith Gagnon
Affiliation:
Paediatric Transport Program, Division of Intensive Care, British Columbia Children's Hospital, Vancouver, Canada
*
Intensive Care Unit, British Columbia Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, Canada V6H 3V4
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Abstract

Objective:

Following an air ambulance crash with five fatalities, critical incident stress debriefing (CISD) was provided for involved paramedics, physicians, and nurses. A study was conducted to evaluate the long-term effects of a critical incident with critical incident stress debriefing according to the Mitchell model.

Methods:

Six months following the incident, empirically designed questionnaires were mailed to all transport paramedics and directly involved medical staff, and a random sample of both nurses from the dispatch/receiving institution and paramedics from around the province. Twenty-four months post-incident, all members of the transport paramedics completed the Impact of Events Scale and the General Health Questionnaires.

Results:

There were no differences between groups on any scores, except for disturbed sleep patterns, bad dreams, and the need for personal counseling being greater among transport paramedics at one day. There was no correlation between how well the deceased individuals were known, amount of debriefing, and symptom severity. A trend was seen for those with pre-existing stress management routines to have less severe symptoms at six months (p = 0.07). At two years, 16% of transport paramedics still had significant abnormal behavior.

Conclusion:

CISD did not appear to affect the severity of stress symptoms, whereas having pre-existing stress management strategies may. These findings give justification for proceeding to a randomized, controlled trial of different levels of critical incident stress intervention.

Keywords

critical incident stressdebriefingdefusingdepressionGeneral Health QuestionnaireImpact of Events Scalepost-traumatic stress disorder
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 14 , Issue 1 , March 1999 , pp. 15 - 19
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1999

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References

1. Mitchell, J: Emergency Services Stress, Guidelines for Preserving the Health and Careers of Emergency Services Personnel. Brady Publishing: Englewood Cliffs, New Jersey. 1990.Google Scholar
2. Dillman, D: Mail and Telephone Surveys: The Total Design Method. John Wiley and Sons: New York. 1978.Google Scholar
3. Horowitz, M, Wilner, N, Alvarez, W: Impact of Events Scale: A measure of subjective stress. Psychosomatic Medicine 1979;41:209–218.CrossRefGoogle Scholar
4. Goldberg, DP, Hillier, VF: A scaled version of the General Health Questionnaire. Psychol Med 1979;9:139–145.CrossRefGoogle ScholarPubMed
5. Boudreaux, E, Mandry, C: Sources of stress among emergency medical technicians (Part I): What does the research say? Prehospital and Disaster Medicine 1996;11:296–301.CrossRefGoogle ScholarPubMed
6. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (3rd ed) (DSM-III). Washington, DC. APA. 1980.Google Scholar
7. Koopman, C, Classen, C, Spiegel, D: Predictors of post-traumatic stress symptoms among survivors of the Oakland/Berkeley, Calif., firestorm. Am J Psychiatry 1994;151:888–894.Google ScholarPubMed
8. Mitchell, J: Stress: The history, status and future of critical incident stress debriefings. Journal of Emergency Medical Services 1988 (Nov);47–52.Google Scholar
9. Deahl, MP, Gillham, AB, Thomas, J, Searle, MM, Srinivasan, M: Psychological sequelae following the Gulf War: Factors associated with subsequent morbidity and the effectiveness of psychological debriefing. Br J Psychiatry 1994;165:60–65.CrossRefGoogle ScholarPubMed
10. Fontana, A, Rosenheck, R: Effectiveness and cost of the inpatient treatment of post-traumatic stress disorder: Comparison of three models of treatment. Am J Psychiatry 1997;154–156.CrossRefGoogle Scholar
11. Bisson, JI, Deahl, MP: Psychological debriefing and prevention of post-traumatic stress. More research is needed. Br J Psychiatry 1994;165:717–720.CrossRefGoogle ScholarPubMed
12. Raphael, B, Meldrum, L: Does debriefing after psychological trauma work? Br Med J 1995;310:1479–1480.CrossRefGoogle ScholarPubMed
13. Boudreaux, E, Mandry, C: Effects of stressors on emergency medical technicians (Part II): A critical review of the literature, and a call for further research. Prehospital and Disaster Medicine 1996;11:303–308.CrossRefGoogle Scholar
14. Alexander, DA, Wells, A: Reactions of police officers to body-handling after a major disaster. A before-and-after comparison. Br J Psychiatry 1991;159:547–555.CrossRefGoogle ScholarPubMed
15. Helzer, JE, Robins, LN, McEvoy, L: Post-traumatic stress disorder in the general population. N Engl J Med 1987;317:1630–1634.CrossRefGoogle ScholarPubMed
16. Barrett, DH, Green, ML, Morris, R, Giles, WH, Croft, JB: Cognitive functioning and posttraumatic stress disorder. Am J Psychiatry 1996;153:1492–1494.Google ScholarPubMed
17. Everly, GS Jr, Rosenfield, R: The Nature and Treatment of the Stress Response: A Practical Guide for Clinicians. Plenum Press: New York, 1981.CrossRefGoogle Scholar
18. Gillham, AB: Psychological debriefing (Letter). Br J Psychiatry 1995;167:407–414.CrossRefGoogle Scholar
19. Jones, L: Debriefing after psychological trauma.Response to stress is not necessarily pathological. Br Med J 1995;311:509–510. Letter; commentCrossRefGoogle Scholar
20. Summerfield, D: Debriefing after psychological trauma. Inappropriate exporting of Western culture may cause additional harm. Br Med J 1995;311:509. Letter; comment.CrossRefGoogle ScholarPubMed
21. Busuttil, A, Busuttil, W: Psychological debriefing. British Journal of Psychiatry 1995;166;676–681. Letter.CrossRefGoogle ScholarPubMed
22. Palmer, IP: Debriefing after psychological trauma. Response to treatment varies. Br Med J 1995;311:510. Letter; comment.CrossRefGoogle ScholarPubMed