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

  • Andrew J. Macnab (a1), James A. Russell (a1), John P. Lowe (a1) and Faith Gagnon (a1)

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.

Copyright

Corresponding author

Intensive Care Unit, British Columbia Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, Canada V6H 3V4

References

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1. Mitchell, J: Emergency Services Stress, Guidelines for Preserving the Health and Careers of Emergency Services Personnel. Brady Publishing: Englewood Cliffs, New Jersey. 1990.
2. Dillman, D: Mail and Telephone Surveys: The Total Design Method. John Wiley and Sons: New York. 1978.
3. Horowitz, M, Wilner, N, Alvarez, W: Impact of Events Scale: A measure of subjective stress. Psychosomatic Medicine 1979;41:209218.
4. Goldberg, DP, Hillier, VF: A scaled version of the General Health Questionnaire. Psychol Med 1979;9:139145.
5. Boudreaux, E, Mandry, C: Sources of stress among emergency medical technicians (Part I): What does the research say? Prehospital and Disaster Medicine 1996;11:296301.
6. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (3rd ed) (DSM-III). Washington, DC. APA. 1980.
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;151:888894.
8. Mitchell, J: Stress: The history, status and future of critical incident stress debriefings. Journal of Emergency Medical Services 1988 (Nov);4752.
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;165:6065.
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;154156.
11. Bisson, JI, Deahl, MP: Psychological debriefing and prevention of post-traumatic stress. More research is needed. Br J Psychiatry 1994;165:717720.
12. Raphael, B, Meldrum, L: Does debriefing after psychological trauma work? Br Med J 1995;310:14791480.
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;11:303308.
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;159:547555.
15. Helzer, JE, Robins, LN, McEvoy, L: Post-traumatic stress disorder in the general population. N Engl J Med 1987;317:16301634.
16. Barrett, DH, Green, ML, Morris, R, Giles, WH, Croft, JB: Cognitive functioning and posttraumatic stress disorder. Am J Psychiatry 1996;153:14921494.
17. Everly, GS Jr, Rosenfield, R: The Nature and Treatment of the Stress Response: A Practical Guide for Clinicians. Plenum Press: New York, 1981.
18. Gillham, AB: Psychological debriefing (Letter). Br J Psychiatry 1995;167:407414.
19. Jones, L: Debriefing after psychological trauma.Response to stress is not necessarily pathological. Br Med J 1995;311:509510. Letter; comment
20. Summerfield, D: Debriefing after psychological trauma. Inappropriate exporting of Western culture may cause additional harm. Br Med J 1995;311:509. Letter; comment.
21. Busuttil, A, Busuttil, W: Psychological debriefing. British Journal of Psychiatry 1995;166;676681. Letter.
22. Palmer, IP: Debriefing after psychological trauma. Response to treatment varies. Br Med J 1995;311:510. Letter; comment.

Keywords

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

  • Andrew J. Macnab (a1), James A. Russell (a1), John P. Lowe (a1) and Faith Gagnon (a1)

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