Helping The Helpers In A Disaster

Heavy workloads, long hours and the pressure to accomplish difficult tasks quickly are inherent in emergency and disaster work. Occupational stresses can arise from:

  • Time pressures – especially in rescue and  emergency medical situations in which a time limit exists in the victim’s chance for  survival.
  • Responsibility overload – especially for  those with supervisory or command responsibility, a multitude of tasks, all with high priority, may need to be done simultaneously with no one to whom they can be delegated.
  • Physical demands – rescue work requires  physical exertion, strength, stamina and  endurance where hours are long and work conditions adverse.
  • Mental demands – the work requires good  judgement, clarity of thinking, and the ability to make decisions in chaotic  situations.
  • Emotional demands – workers are exposed  to traumatic stimuli and victims under stress. They must keep their emotions  under control in order to function.  They must make painful, life-or-death decisions and  work in the presence of  anger or fear.
  • Work area – this can range from low- pressure, such as a staging area, to high pressure, such as a triage area or morgue.
  • Limited resources – lack of personnel,
    equipment, funding.
  • High expectations – from the public and  from rescue response personnel
  • Environmental stress ­ extreme weather  conditions, environmental hazards  (e.g. toxic fumes).

Minimizing Stress Effects During A Disaster

The following guidelines are suggested for minimizing stress effects among emergency response workers and maximizing performance during a
disaster operation:

  • Staff location – Limit worker’s time in high- stress assignments such as body removal or  morgue work to two hours at a time. Workers involved in providing grief  support to loved ones at a morgue or hospital or who  are assigned to telephone  help lines should be limited to four hours  of work at a time.
  • Rest periods – Provide 15 to 30 minutes  rest periods every two hours. Breaks from  the action will help decrease the possibility  of injury, fatigue and emotional strain.
  • Comfort and care – On breaks, try to  provide workers with the following: A  place to sit or lie down away from the scene; warm food, high protein snacks and  beverages, preferably fruit juice; shelter   from weather; dry clothes; an opportunity  to talk about their feelings with co-workers  or a chaplain.

Critical Incident Stress Debriefing

Critical Incident Stress is defined as ‘Any situation faced by emergency service personnel that causes them to experience usually strong emotional reactions which have the potential to interfere  with their ability at the scene or later.’

A Critical Incident Stress Debriefing (CISD) is a structured meeting of emergency response personnel involved in a critical incident and facilitated by a trained (CISD) team. The purpose of the  debriefing is to:

  • Lessen the impact of major events on emergency service personnel.
  • Accelerate normal recovery in normal  people who are experiencing normal stress  after experiencing highly abnormal events  or incidents.

The format for the meeting, in general, deals with what happened to the individuals during the event, how they felt at the scene, and what their reactions were afterwards. In addition to providing a  supportive environment that allows emergency workers to deal with stress reaction, the debriefing provides education about acute stress and its normal effects; the participants learn specific stress management techniques for  coping with their responses.

CISD meetings should optimally occur within 72 hours of the incident but can be done any time after the event. However, the greater the delay
between the incident and the debriefing, the greater the likelihood of delayed or prolonged stress  reactions.