# Presentation: 108591

## Unit Objectives

- Describe the disaster and post-disaster emotional environment.
- Describe the steps that rescuers can take to relieve their own stress and those of disaster survivors.

## Vicarious Trauma

- The process of changes in the rescuer resulting from empathic engagement with survivors

## Possible Psychological Symptoms

- Irritability, anger
- Self-blame, blaming others
- Isolation, withdrawal
- Fear of recurrence
- Feeling stunned, numb, or overwhelmed
- Feeling helpless
- Mood swings
- Sadness, depression, grief
- Denial
- Concentration, memory problems
- Relationship conflicts/marital discord

## Possible Physiological Symptoms

- Loss of appetite
- Headaches, chest pain
- Diarrhea, stomach pain, nausea
- Hyperactivity
- Increase in alcohol or drug consumption
- Nightmares
- Inability to sleep
- Fatigue, low energy

## Team Well-Being

- CERT team leaders should:
- Provide pre-disaster stress management training.
- Brief personnel before response.
- Emphasize teamwork.
- Encourage breaks.
- Provide for proper nutrition.
- Rotate.
- Phase out workers gradually.
- Conduct a brief discussion.
- Arrange for a post-event debriefing.

## Reducing Stress

- Get enough sleep.
- Exercise.
- Eat a balanced diet.
- Balance work, play, and rest.
- Allow yourself to receive as well as give.  Remember that your identity is broader than that of a helper.
- Connect with others.
- Use spiritual resources.

## Critical Incident Stress Debriefing

- Six phases:
- Introduction and a description
- Review of the factual material
- Sharing of initial thoughts/feelings
- Sharing of emotional reactions to the incident
- Instruction about normal stress reactions
- Review of the symptoms
- Closing and further needs assessment

## Phases of a Crisis

- Impact
- Inventory
- Rescue
- Recovery

## Traumatic Crisis

- An event in which people experience or witness:
- Actual or potential death or injury to self or others.
- Serious injury.
- Destruction of homes, neighborhood, or valued possessions.
- Loss of contact with family/close relationships.

## Traumatic Stress

- Traumatic stress may affect:
- Cognitive functioning.
- Physical health.
- Interpersonal reactions.

## Mediating Factors 

- Prior experience with a similar event
- The intensity of the disruption in the survivors’ lives
- Individual feelings that there is no escape, which sets the stage for panic
- The emotional strength of the individual
- The length of time that has elapsed between the event occurrence and the present

## Stabilizing Individual

- Assess the survivors for injury and shock.
- Get uninjured people involved in helping.
- Provide support by:
- Listening.
- Empathizing.
- Help survivors connect with natural support systems.

## Avoid Saying . . .

- “I understand.”
- “Don’t feel bad.”
- “You’re strong/You’ll get through this.”
- “Don’t cry.”
- “It’s God’s will.”
- “It could be worse” or “At least you still have . . .”

## Managing the Death Scene

- Cover the body; treat it with respect.
- Have one family member look at the body and decide if the rest of the family should see it.
- Allow family members to hold or spend time with the deceased.
- Let the family grieve.

## Informing Family of a Death

- _Separate the family members_ from others in a quiet, private place.
- _Have the person(s) sit down_, if possible.
- _Make eye contact_ and use a calm, kind voice.
- Use the following words to _tell the family members_ about the death:  “I’m sorry, but your family member has died.  I am so sorry.”