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Common reactions to critical incident stress

Physical Thinking Emotional Spiritual

Adrenalin rush (as “In a fog, “like a All stirred up Loss of innocence,
if you drank 1,000 nightmare,” “Things will never
cups of coffee) slowed thinking be quite the same”

Rapid breathing Indecision Numb Loss of meaning

Tremors (hands Memory loss Anxiety/fear Loss of direction

and lips),

Upset stomach, Difficulty Sadness, Thoughts of

nausea, diarrhea concentrating, depression mortality
poor attention

Sweating/chills Confusion Embarrassed Emptiness, doubt,


Cardiac Difficulty problem- Isolated, Cynicism,

symptoms: rapid solving, alienated, wanting unforgiving
heart beat, calculating to hide
increased BP,
chest pain (check
out at hospital)

Head and muscle Distressing Guilt Feelings that you

aches dreams don’t belong

Dizziness Images you can’t “Shoulda, coulda, Casting blame

get out of your woulda”

Sleep disturbance Disorientation Anger, irritability Feeling


Sexual Hyper-vigilance Hopelessness Loss of faith


These signs and symptoms usually disappear within a few days. Less often, such incidents
may cause a more prolonged stress reaction. Following are some things you can do to help
minimize the symptoms.

Ways to address stress reactions

1. Handle the adrenaline rush symptoms:

 Exercise to the point where you sweat.

 Drink plenty of water. This helps flush out the chemicals that pour into your body after a
critical incident.

 Let yourself cry. Tears are an emotional release.

 Make a conscious effort to breathe deeply.

 Eat small meals high in protein.

 Avoid excessive amounts of sugar, caffeine or alcohol. These will make your symptoms
worse. Alcohol will worsen any feelings of depression you are having.

2. Return to your routine schedule as soon as you are able to do so. A familiar routine helps
anchor you while your thoughts and emotions settling down.

3. Rest. It is common to have difficulty sleeping after a traumatic event.

 If you have trouble getting to sleep or staying asleep (and you previously did not have
trouble) think about your favorite vacation spot or another positive image. This helps to
minimize the images of the traumatic event that come to mind.

 If you can’t sleep after 15 minutes, get out of bed and do something quiet and boring
until you are sleepy.

 If sleep disruption remains a problem four weeks after the incident or it worsens, seek
professional help.

4. Talk to family, friends, a chaplain, a minister or coworkers that you trust. Talking actually
changes brain chemistry. The more you talk about the incident, the sooner it will be over in
your mind and body. Take advantage of mental health resources available through your
employer. Contact your manager for information about employee assistance.

A few additional notes:

 Reoccurring thoughts, dreams or flashbacks are not necessarily abnormal. They can be
your brain’s way of incorporating what has happened. Allow yourself to feel more
comfortable through them and let them pass without fighting them. They should
decrease over several weeks. If not, seek help from a mental health professional.

 If you were feeling stressed or had difficult worries before the incident, your feelings and
attempts to cope with them may worsen with the effects of the incident. Now would be a
good time to talk to someone about these stresses.

Tips for recovery from a critical incident can be outlined using the acronym of ‘NEW

 Nutrition (↑ Protein, vegetables ↓ Excessive carbs, sugar, caffeine)

 Exercise (Aerobic activity is helpful)
 Water (Staying hydrated helps physical recovery from stress)
 Sunlight (Be aware of your sleep cycle)
 Temperance (Avoid alcohol and other chemicals)
 Air (Consciously breathe deeply)
 Rest (Intentionally relax your muscles; try to rest)
 Trust (Tend to your faith/spirituality)

+ Talk to trusted family, friends, a chaplain, minister or co-workers.

The more you talk about the incident, the sooner it will be over in your mind and body.


 Your supervisor or manager.

 Chaplain at your site, if available.
 Employee Assistance Program (EAP).
 Your area Critical Incident Stress Management team (CISM).
 Community clergy or other local support resources.