When I read this article from the Ventura County Star, I felt strongly that I had to share it with all of you. Each of us in EMS has our "nightmares", those cases that hit us especially hard. And yes, I have a few that strike me hard when I think of them even today. Some come back to haunt me when I have a similar case, or when we all talk about something. Personally, I have been a part of 3 CISD (Critical Incident Stress Debriefing) events, and one "Defusing" (A chance to just openly vent). All of these will remain confidential with all of us that participated. I can share with you that even the most hardened firefighter, policeman, and medic can break down at these very important meetings of all involved.
The last paragraph especially points out that we EMS folk are human. Keep in mind, when I first became an EMT, "suck it up" (AKA "deal with it yourself") was the common method of dealing with the unthinkable. We have learned a lot over the years; this attitude resulted in burnout and suicide among EMS, police, and fire personnel.
Saving lives sometimes trigger crises
First responders' roles to lessen suffering and save lives sometimes trigger their own crises
By Cynthia Overweg
Correspondent
Wednesday, October 3, 2007
When paramedic Brian Williams got the emergency call, he knew he was about to encounter a tragic scene.
Along with police, firefighters and others, Williams was on his way to one of the most notorious crime scenes in Ventura County history.
When his ambulance crew arrived at an apartment building in Newbury Park in August, they found 6-year-old Sev'n Molina had been brutally killed with a meat cleaver.
The first responders were not only confronted with the mutilated body of a child, but also with the boy's critically wounded mother, a seriously injured neighbor who had managed to stop the attack, and a violent suspect, who had to be restrained with a police Taser.
While first responders are specifically trained and equipped for the difficult jobs they do, the strain of repeated calls to scenes of human anguish can take an emotional, psychological and physical toll.
"The violent death of a child is the hardest call there is. There is nothing that can train you to deal with that," said Williams, who pronounced Sev'n Molina dead at the scene.
He also stabilized Sandra Ruiz, the boy's mother, who had near-fatal stab wounds, and rushed her by ambulance to Los Robles Hospital and Medical Center for emergency surgery. A second ambulance crew attended to the injuries of Diane Cox, the woman who intervened in the attack, and took her to the same hospital.
When they arrive at the site of heartbreak and danger, whether a man-made tragedy or a natural disaster, emergency responders — firefighters, police, paramedics, chaplains, and crisis intervention workers — work to alleviate suffering and save lives, sometimes at great personal risk. But their vital role as public servants can sometimes trigger a private crisis within.
"When you're on the call, there's no time to think and reflect. It's only later, sometimes much later, that incidents like these get to you," said Williams, who lives in Newbury Park and has been a paramedic for 20 years.
Senior chaplain and certified trauma responder Larry Modugno, who works for the county Fire Department, also went to the apartment where Sev'n died and said it was one of the most traumatic things he's ever seen.
"As chaplains, we make ourselves available to anyone who needs us. Often, all that is needed is a hand on the shoulder or a few words of encouragement, but more was required in this case," Modugno said. He said he stayed as long as necessary and then went to the hospital to be with the two surviving victims.
Team assists after incident
To help first responders deal with the inevitable stress created by the work they do, a critical incident stress management, or CISM, team is assembled after a traumatic incident.
CISM is a volunteer, peer-driven support network, chartered in Ventura County under the International Critical Incident Stress Foundation based in Maryland, regarded by many as the nation's leading crisis intervention program.
A CISM team consists of emergency responders, chaplains and mental health professionals who specialize in stress-related disorders. Within 48 hours of a traumatic event, emergency responders have the option to attend a "debriefing," a meeting where they discuss what happened, have the opportunity to express their feelings in a supportive setting, and get further assistance if needed.
Not inclined to seek help
"First responders deal with the trauma and grief of others every day. In so doing, they can become traumatized themselves," said Scott Barash, a licensed clinical social worker with the County of Ventura and a CISM team member.
Barash said the personality traits that make emergency responders good at their jobs can also make them less inclined to ask for help.
"These are very resilient and compassionate people who need to be able to lighten up and not carry the stress around," Barash said.
The slaying of Sev'n Molina caused a tremendous amount of sadness among responders, said Capt. Jerry Hernandez, spokesman for the sheriff's department.
"He was chased down and struck repeatedly with a meat cleaver. Along with other deputies, I saw the body of that poor child. We were all traumatized by it," said Hernandez, who added that just repeating the details of what happened can be uncomfortable.
"These are normal reactions to a very abnormal event," said Stephanie Huhn, emergency medical services coordinator for the Oxnard Fire Department and a CISM team member involved in the debriefing of responders. "Because of the horrible nature of the crime, I felt some dread prior to the debriefing, and that's normal, too. It's not easy to see co-workers in distress, but I'm there to validate how they feel because I've been in similar situations myself," said Huhn, who was an emergency room nurse for 23 years.
"We see things in our daily jobs most people never see in their entire lives, unless they've been in a war," said Capt. Barry Parker, spokesman for the county Fire Department.
He said one event that stands out in his mind involved a traffic collision on Highway 101 in Camarillo. He was first on the scene to find a man and a woman trapped in the front seat of their van.
"The woman was screaming for her baby, but I didn't see one. Then I noticed a car seat on the highway. I went over to get it and found a dead infant with massive head trauma. Images like that get glued into your brain," said Parker. He said sometimes a traumatic memory can be re-triggered by a similar event or by passing the spot on a road where something terrible happened.
"We talk about these things at the firehouse, and we help each other," Parker said.
Disturbing images or nightmares eventually go away, said Barash, but when they don't, it's a signal to ask for help.
"Emergency responders are better prepared to handle a traumatic event because of their experience and training, but they're not super-human. Like the rest of us, they can be overwhelmed and need reassurance and support," he said.
Labels: EMS, Fire, Misc Rants
