A critical incident stress reaction is normal. What you do next matters.
A critical incident is any event that causes emergency service personnel to experience unusually strong emotional reactions — a critical incident stress reaction that can interfere with your ability to function at the scene or later. This page is the PCCISM pamphlet, online.
Emotional aftershocks
Even though the event is over, your body may not know it yet.
It is very common — in fact, quite normal — for people to experience emotional aftershocks after passing through a horrible event. Sometimes the critical incident stress reaction appears immediately. At other times it appears a few hours or a few days later, and in some cases weeks or months may pass before it surfaces.
The signs and symptoms of a stress reaction may last a few days, a few weeks, a few months — and occasionally longer, depending on the severity of the event. With understanding and the support of loved ones, however, they usually pass more quickly. Occasionally the event is so painful that professional assistance from a counselor is necessary. This does not imply craziness or weakness. Rather, it simply means that the particular event was too powerful for one person to manage alone.
Signs & signals
Common signs of a critical incident stress reaction
Any of the physical symptoms may indicate the need for medical evaluation. Above all, don’t wait on chest pain or difficulty breathing — get checked.
Physical
Cognitive
Emotional
Behavioral
Spiritual
Ways for you to respond
Responding to a critical incident stress reaction in the first 24–48 hours
- First, periods of appropriate physical exercise, alternated with relaxation, will alleviate some of the physical reactions.
- Structure your time and keep busy. You’re normal and having normal reactions, so don’t label yourself crazy.
- Talk to people, because talk is the most healing medicine.
- Beware of numbing the pain with overuse of drugs or alcohol. After all, you don’t need to complicate this with a substance problem.
- Reach out — people do care.
- Maintain as normal a schedule as possible and, likewise, spend time with others.
- Help your co-workers as much as possible by sharing feelings and checking on how they are doing.
- Give yourself permission to feel rotten and share your feelings with others.
- Keep a journal, so that you can write your way through those sleepless hours.
- Do things that feel good to you. At the same time, realize that those around you are under stress too.
- Don’t make any big life changes. Instead, make as many daily decisions as possible, because it gives you a feeling of control. For example, if someone asks what you want to eat, answer them even if you aren’t sure.
- Get plenty of rest. Also, eat well-balanced, regular meals, even if you don’t feel like it.
- Finally, recurring thoughts, dreams or flashbacks are normal, so don’t try to fight them. They’ll decrease over time and become less painful.
For family members & friends
- First, listen carefully.
- Spend time with the traumatized person.
- Offer your assistance and a listening ear, even if they haven’t asked.
- Reassure them that they are safe.
- Also, help with everyday tasks — cleaning, cooking, caring for the family, minding children.
- Then give them some private time.
- Don’t take their anger or other feelings personally.
- Above all, don’t tell them they are “lucky it wasn’t worse,” because traumatized people are not consoled by those statements. Instead, tell them you are sorry such an event occurred and you want to understand and help.
Request assistance
A critical incident stress reaction is not yours to carry alone. Call a peer.
One conversation with a peer who gets it. No report, no record, no judgment. And if we’re not the right fit, we’ll connect you with someone who is.
24 hours a day · 7 days a week · Peer-to-peer