2.4 - Emotion and Stress

General adaptation syndrome

Typical bodily response to stress; stage 1: alarm, stage 2: resistance, stage 3: exhaustion

Three common types of stress reactions

Acute stress reactions, delayed stress reactions, cumulative stress reactions

Acute stress reaction

-Linked to catastrophes

-S/Sx develop simultaneously or soon after incident

-Involve physical, cognitive, emotional, and/or behavioral function

When does an acute stress response require immediate intervention?

When the stress shows up as an acute medical problem (chest pain, trouble breathing, abnormal heart rhythms) or an acute psychological problem (uncontrollable crying, inappropriate behavior, irrational thinking)

Delayed stress reaction

-Also known as posttraumatic stress disorder

-Triggered by an incident, but s/sx develop days/months/years later

-S/sx: Flashbacks, nightmares, feelings of detachment, irritability, sleep difficulties, self harm, difficulty concentrating

-Requires professional intervention

Cumulative stress reaction

-Also known as burnout

-Not triggered by a single incident, rather sustained low-level stressors

-Early s/sx: Anxiety, boredom, apathy, exhaustion

-Later s/sx: Headaches, stomach ailments, significant sleep disturbance, irritability, lack of emotional control, isolation, depression

Some likely causes of stress in EMS

-Multiple-casualty incidents

-Calls involving infants and children

-Severe injuries

-Abuse and neglect

-Death of a coworker

Two types of stress

Eustress and distress

S/sx of stress

-Irritability with family, friends, and coworkers

-Inability to concentrate

-Changes in daily activities, like difficulty sleeping or nightmares

-Loss of appetite

-Loss of sex drive

-Anxiety

-Indecisiveness

-Guilt

-Isolation

-Loss of interest in work

Lifestyle changes for dealing with stress

-Healthier diet

-Exercise

-Devote time to relax.

eSCAPe (dealing with posttraumatic stress)

every patient

Social support

Choice and control

Anticipate

Plan and organize

every time

Critical incident stress management

System including education and resources to prevent and deal with stress

Critical incident stress debriefing (CISD)

-Counselors meet with those involved in a major accident 24-72 hours after.

-Not used frequently anymore

Stages of grief

-Denial (“not me”)

-Anger (“why me”)

-Bargaining (“Ok, but first let me…”

-Depression (“Ok, but I haven’t…)

-Acceptance (“Ok, I’m not afraid.”

Dealing with patient or family confronted with death

-Recognize patient’s needs

-Be tolerant of angry reactions from the patient or family

-Listen empathetically

-Do not falsely reassure

-Offer as much comfort as you can