By Allison G. S. Knox
Contributor, EDM Digest
In the last six months, there have been a number of mass casualty incidents that have forced emergency management professionals to contemplate how to handle mass casualty incidents in the future.
For first responders such as emergency medical technicians and paramedics, it can be difficult to triage people, knowing that some individuals might have been saved if only there had been enough appropriate and available resources. First responders also find it hard to shake the horrific sights they witness during these events, because mass casualty events can be particularly violent and traumatic.
Many psychologists advocate the importance of critical incident stress debriefings. They argue that it is important for first responders who have worked a mass casualty event to talk through the horror of the event with trained professionals who are ready to help guide them away from the trauma of Post-Traumatic Stress Disorder (PTSD).
While these debriefings appear advantageous for first responders, some psychologists argue that stress debriefing sessions are detrimental. This begs the question: How should emergency managers handle the psychological effects of mass casualty incidents on their staff, if critical incident stress debriefings are a controversial treatment?
Briefings after Mass Casualty Events are Critical for First Responders’ Mental Health
After a significant mass casualty event (one that can be considered traumatic in nature), it is important for the professionals who worked the event to discuss what they saw in a supportive fashion. In a 2000 study published in the International Journal of Emergency Medical Health, Maryland professors George Everly, Jr. and Jeffrey T. Mitchell define a critical incident as an “event which is outside the usual range of experience and challenges one’s ability to cope.”
Everly and Mitchell say, “The critical incident has the potential to lead to a crisis condition by overwhelming one’s usual psychological defenses and coping mechanisms.” They add that critical incident stress debriefings are needed to help stabilize individuals after a traumatic incident.
The debriefings keep first responders’ feelings from worsening. They also help to establish “independent functioning” and to “mitigate acute signs of distress.” In these respects, critical incident stress debriefings are important for the individuals involved in a serious mass casualty incident.
Can Critical Incident Stress Briefings Be Detrimental to First Responders?
Everly and Mitchell cite several studies on critical incident stress debriefings that show that some individuals who were debriefed after an event had more trouble with post-traumatic stress disorder. They also reported finding numerous problems with how the studies were constructed and their subsequent findings.
Everly and Mitchell said some of their findings might suggest that critical incident stress debriefings are not particularly helpful in managing acute stress following a major incident. They add, however, that the word “debriefing” doesn’t really indicate what is taking place; the word “intervention” is a better term.
Emergency Managers Should Work with Psychologists
Since Everly and Mitchell’s 2000 study, there has been more research into critical incident stress debriefings’ numerous positive and negative attributes. Nevertheless, psychologists Grant Devilly, Richard Gist and Peter Cotton write in a 2006 American Psychological Association study that critical incident stress debriefings are still considered the “standard of care.”
Taking into account just how traumatic mass casualty incidents are for many first responders, it becomes increasingly important for emergency managers to work closely with psychologists and other experts who must keep abreast of current research into the most psychologically sensitive manner to help first responders cope with traumatic events.
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