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Critical Incident Stress Information Sheet 

You have experienced a traumatic event or a critical incident (any incident that causes emergency service personnel to experience unusually strong emotional reactions, which have the potential to interfere with their ability to function either at the scene or later). Even though the event may be over, you may now be experiencing or may experience later, some strong emotional or physical reactions. It is very common, in fact quite normal, for people to experience emotional aftershocks, when they have passed through a horrible event.

Sometimes the emotional aftershocks (or stress reactions) appear immediately after the traumatic event. Sometimes they may appear a few hours or a few days later. And, in some cases, weeks or months may pass before the stress reactions appear.

The signs and symptoms of a stress reaction may last a few days, a few weeks or a few months, and occasionally longer depending on the severity of the traumatic event. With understanding and the support of loved ones the stress reactions usually pass more quickly. Occasionally, the traumatic event is so painful that professional assistance from a counselor may be necessary. This does not imply craziness or weakness. It simply indicates that the particular event was just too powerful for the person to manage by himself or herself.

Here are some very common signs and signals of a stress reaction:

Muscle tremors
Chest pain*
Difficulty breathing*
Elevated BP
Rapid heart rate
Thirst headaches
Visual difficulties
Grinding of teeth
Profuse sweating
Shock symptoms*
Blaming someone
Poor attention
Poor decisions
Heightened or lowered alertness
Poor concentration
Memory problems
Difficulty identifying familiar objects or people
Increased or decreased awareness of surroundings
Poor problem solving
Poor abstract thinking
Loss of time, place or person orientation
Disturbed thinking
Intrusive images
Severe panic (rare)
Emotional shock
Loss of emotional control
Inappropriate emotional response
Feeling overwhelmed
Intense anger
Change in activity
Change in speech patterns
Emotional outburst
Change in usual communications
Loss or increase of appetite
Alcohol consumption
Inability to rest
Antisocial acts
Nonspecific bodily complaints
Hyper alert to environment
Startle reflex intensified
Erratic movements
Change in sexual functioning

* Definite indication of the need for medical evaluation.

UW-Eau Claire Counseling Service
105 Garfield Avenue, P.O. Box 4004
Eau Claire, WI 54702-4004
(715) 836-5521

Used with permission from Chippewa Valley Emergency Support Service

Things to try:

  • WITHIN THE FIRST 24 - 48 HOURS periods of strenuous physical exercise, alternated with relaxation, will alleviate some of the physical reactions.
  • Structure your time - keep busy.
  • You're normal and having normal reaction - don't label yourself crazy.
  • Talk to people - talk is the most healing medicine.
  • Be aware of numbing the pain with overuse of drugs or alcohol, you don't need to complicate this with a substance abuse problem.
  • Reach out - people do care.
  • Maintain as normal a schedule as possible.
  • Spend time with others.
  • Help your co-workers as much as possible by sharing feelings and checking out how they are doing.
  • Give yourself permission to feel rotten and share your feelings with others.
  • Keep a journal; write your way through those sleepless hours.
  • Do things that feel good to you.
  • Realize those around you are under stress.
  • Don't make any big life changes.
  • Do make as many daily decisions as possible, which will give you a feeling of control over your life, i.e., if someone asks you what you want to eat - answer him or her even if you're not sure.
  • Get plenty of rest.
  • Reoccurring thoughts, dreams or flashbacks are normal - don't try to fight them - they'll decrease over time and become less painful.
  • Eat well-balanced and regular meals (even if you don't feel like it).

For Family Members & Friends

  • Listen carefully.
  • Spend time with the traumatized person.
  • Offer your assistance and a listening ear if they have not asked for help.
  • Reassure them that they are safe.
  • Help them with everyday tasks like cleaning, cooking, caring for the family, minding children.
  • Give them some private time.
  • Don't take their anger or other feelings personally.
  • Don't tell them that they are "lucky it wasn't worse" - these statements do not console traumatized people. Instead, tell them that you are sorry such an event has occurred and you want to understand and assist them.

Information provided by:
Jeffrey T. Mitchell, Ph.D.
International Critical Incident
Stress Foundation, Inc.
(A non-profit foundation)
5018 Dorsey Hall Drive, Suite 104
Ellicott City, MD 21042
(410) 730-4311 (410) 730-4313 - Fax Line