SURREY FIRE SERVICE

CRITICAL INCIDENT STRESS MANAGEMENT TEAM

CISM
DEFUSING/
DEBRIEFING

“HANDOUTS”
 SURREY FIRE SERVICE
CRITICAL INCIDENT STRESS MANAGEMENT TEAM

Common Signs and Symptoms During a CIS Event

You have experienced a traumatic event, or a critical incident. Even though
the event may be over, you may now be experiencing, or may experience later, some
strong reactions to it. It is very common, in fact quite normal, for people to
experience emotional aftershocks when they have passed through a horrible event.

Sometimes the stress reactions appear immediately after the traumatic

event, or they may appear a few hours or days later. In some cases, weeks or
months may pass before the stress reactions appear.

The signs and symptoms of a stress reaction may last a few days, weeks,
months, or even longer. With the understanding and support of loved ones the
stress reactions usually pass more quickly. Occasionally, a traumatic event is so
painful that professional assistance from a counsellor may be necessary. This only
indicates that the traumatic event was just too powerful for the person to manage
by themselves.

Stress reactions can affect a person physically, emotionally, behaviourally,

or cognitively (how your mind works). Some very common signs and symptoms of a
stress reaction are:
Cognitive
Physical Impaired thinking/decision making
Nausea, Upset stomach, sweating Poor concentration/memory
Heart rate and blood pressure increase Difficulty with abstract thoughts
Muscle soreness, fatigue Flashbacks/poor attention span
Hyperventilation, chest pains Time distortion/perception alteration
Twitches, thirst, headaches Blaming someone
Dizziness, fainting Difficulty identifying people/objects
Chills, profuse sweating Nightmares/intrusive images
Grinding of teeth Disturbed thinking

Emotional Behavioural
Anxiety, guilt and fear Withdrawal
Grief/depression Change in activity, speech or patterns
Emotional Numbing Emotional outbursts
Feeling lost, abandoned, helpless Suspiciousness
Withdrawal/anger Loss/Increase in appetite
Feeling numb/shocked, over whelmed Alcohol consumption
Denial, uncertainty, apprehensive Startle reflex intensified
Irritability, agitation Inability to rest
 SURREY FIRE SERVICE
CRITICAL INCIDENT STRESS MANAGEMENT TEAM

Delayed Stress Response Syndrome

Sometimes a stress response can be delayed, and the victim may

not think it is associated with the traumatic event. Common signs and
symptoms include:

™ Increased feelings of depression, anxiety and irritability

™ Sleep disturbances
™ Changes in eating habits
™ Loss of emotional control
™ Feeling of isolation
™ Lowering sexual drive
™ Menstrual cycle changes
™ Lowered interest in loved ones
™ Marital conflict

If the condition becomes more acute, the victim may experience:

¾ Intrusive memories
¾ Fear of repetition of the event

After experiencing a traumatic event, be aware of any PHYSICAL,

BEHAVIOURAL, COGNITIVE, OR EMOTIONAL changes.
 SURREY FIRE SERVICE
CRITICAL INCIDENT STRESS MANAGEMENT TEAM

FACTORS THAT MAY AFFECT THE SEVERITY

OF A REACTION TO A TRAUMATIC EVENT
™ Severity and nature of event

™ Role of worker

™ Level of responsibility associated with the incident (the greater

the responsibility, the greater the potential for impact)

™ Knowing the victim

™ Victim is similar to someone known to worker

™ Worker is experiencing stress in life already (divorce, death in

family, etc…)

™ Workers’ previous experience with personal crisis - could help

through desensitization, or hinder through cumulative stress

™ Media involvement/interference

™ Behaviour of others at the incident (effective, ineffective)

™ Preparedness for the incident (details known enroute, training

updated and maintained, etc)

™ Knowledge and awareness of CIS Management

™ Availability of appropriate support services (MFAP, peer

defusers, management support)

™ Support or ostracism by co-workers, family, or general public

 SURREY FIRE SERVICE
CRITICAL INCIDENT STRESS MANAGEMENT TEAM

“DO’S AND DON’TS”

For the Survivor of a Traumatic Incident

These examples of coping skills may assist recovery

DO: DON’T:

TALK ABOUT THE INCIDENT Drink alcohol

Expect the incident to bother you Use legal or illegal substances to numb

Maintain a good diet and exercise, Withdraw from family, friends, and co-
alternating with rest workers

Take time for leisure activities, and Automatically stay away from work or other
get plenty of rest obligations

Remind yourself that post-traumatic Use off-duty time for training immediately
reactions are normal after the incident

Learn as much as possible about Look for easy answers to explain the reason
Critical Incident Stress for the incident

Spend time with family, friends and co- Think you are “crazy”
workers

Get extra help, if necessary Have unrealistic expectations for recovery

Structure your time – keep busy Make big life changes

Reach out – people do care Fight any reoccurring thoughts , dreams or

flashbacks – they will decrease over time
Give yourself permission to feel rotten and become less painful

Keep a journal – write your way through

those sleepless hours

Help co-workers by sharing your feelings,

and checking to see how they are doing
 SURREY FIRE SERVICE
CRITICAL INCIDENT STRESS MANAGEMENT TEAM

Advice for the Family, Friends and Co-Workers of Survivors of

Critical Incident Stress.

1. Encourage them to talk to you about how they are feeling about
the incident.
2. Tell them how you feel, that you are sorry that they have been
hurt, had to go through this experience, that it must have been
hard for them, etc.
3. It is OK to remind them that confusing feelings are a
common/normal reaction.
4. Don’t attempt to reassure them that everything is OK. IT IS
NOT! (Don’t try to fix it for them)
5. Don’t attempt to impose your explanation on why this has
happened to them.
6. Don’t tell them that you know how they feel. You don’t. Often
such attempts are really aimed at relieving your own anxiety
about how you feel about the incident.
7. BE WILLING TO SAY NOTHING. JUST BEING THERE IS
OFTEN THE BIGGEST HELP FOR THESE SURVIVORS.
8. Don’t be afraid to ask how someone is doing. This provides the
opportunity for them to tell you as much or as little as they need
to (or that they want to share). You call them, as often it will be
much harder for the survivor to call you.
9. Don’t be afraid to encourage them to get post-trauma
counseling from a specially trained professional counselor (mental
health professional).

Remember that as a person who cares for the survivor of a

traumatic event, you are a CO-SURVIVOR. You must also expect
that you will experience post-trauma consequences.
 SURREY FIRE SERVICE
CRITICAL INCIDENT STRESS MANAGEMENT TEAM

“DO’S AND DON’TS”

For Family and Friends of a Traumatic Incident Survivor
Stress reactions are a natural result of experiencing a traumatic event, and it takes
time and effort to recover. Family, friends and co-workers can be more effective when
helping the griever if they know what helps and what doesn’t.
These examples of coping skills may assist your loved ones’ recovery

DO: DON’T:

Tell them that you are sorry for their pain Suggest that they have grieved long
enough

Give practical assistance at home (meals, Discourage crying

cleaning, kids to school, etc)

Allow the griever to talk and express Change the subject when they talk about it
feelings

Encourage good eating and exercise habits Suggest they are doing well by not
showing their emotions

Be aware that eating and sleeping Exclude them from social activities
patterns may change

Reach out to the griever, as it is difficult Be afraid to talk about the

for them to reach out to you incident/deceased

Remind them that the stress reactions Tell them everything is OK. IT IS NOT
are normal

Be willing to say nothing. Just being there Attempt to explain why this has happened
is often the biggest help for them to them

Encourage them to get post-trauma Tell them that you know how they feel.
counseling from a trained professional You don’t

Ask how they are doing

 SURREY FIRE SERVICE
CRITICAL INCIDENT STRESS MANAGEMENT TEAM

Critical Incident Stress Personal Report Form

Instructions for filling out this form:

1. As soon as possible after the CISM Defusing, fill out the summary form. When
necessary use the back of the form if more space is required. Keep in mind that the notes
are your own personal thoughts about the incident. The form will be stored in your union
file in the union office in a sealed envelope. It will only be used in the event of a future
psychological disability claim.
2. Place completed form in the envelope and seal it.
3. Send the sealed envelope to a Union Executive member.

Incident number ______________________

Date of Defusing _____________________
Time of Defusing _____________________

Summary:

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

™ This form is to be used as possible documentation for Post Traumatic Stress

Disorder claims.
™ This form should be kept on file with your personal documents and records
in the union office.