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Critical Incident Stress Intervention After Loss of an Air Ambulance: Two-year Follow Up

Published online by Cambridge University Press:  28 June 2012

Andrew J. Macnab ,
James A. Russell ,
John P. Lowe  and
Faith Gagnon
Andrew J. Macnab*
Affiliation:
Paediatric Transport Program, Division of Intensive Care, British Columbia Children's Hospital, Vancouver, Canada
James A. Russell
Affiliation:
Paediatric Transport Program, Division of Intensive Care, British Columbia Children's Hospital, Vancouver, Canada
John P. Lowe
Affiliation:
Paediatric Transport Program, Division of Intensive Care, British Columbia Children's Hospital, Vancouver, Canada
Faith Gagnon
Affiliation:
Paediatric Transport Program, Division of Intensive Care, British Columbia Children's Hospital, Vancouver, Canada
*
Intensive Care Unit, British Columbia Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, Canada V6H 3V4
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Abstract

Objective:

Following an air ambulance crash with five fatalities, critical incident stress debriefing (CISD) was provided for involved paramedics, physicians, and nurses. A study was conducted to evaluate the long-term effects of a critical incident with critical incident stress debriefing according to the Mitchell model.

Methods:

Six months following the incident, empirically designed questionnaires were mailed to all transport paramedics and directly involved medical staff, and a random sample of both nurses from the dispatch/receiving institution and paramedics from around the province. Twenty-four months post-incident, all members of the transport paramedics completed the Impact of Events Scale and the General Health Questionnaires.

Results:

There were no differences between groups on any scores, except for disturbed sleep patterns, bad dreams, and the need for personal counseling being greater among transport paramedics at one day. There was no correlation between how well the deceased individuals were known, amount of debriefing, and symptom severity. A trend was seen for those with pre-existing stress management routines to have less severe symptoms at six months (p = 0.07). At two years, 16% of transport paramedics still had significant abnormal behavior.

Conclusion:

CISD did not appear to affect the severity of stress symptoms, whereas having pre-existing stress management strategies may. These findings give justification for proceeding to a randomized, controlled trial of different levels of critical incident stress intervention.

Keywords

critical incident stressdebriefingdefusingdepressionGeneral Health QuestionnaireImpact of Events Scalepost-traumatic stress disorder
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 14 , Issue 1 , March 1999 , pp. 15 - 19
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1999

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