SAR Fundamentals/Stress

Authors
(Chris Jorgensen or Brian Sundberg probably created this)

Scope

 * SAR Fundamentals Manual: Ch.16 "Stress in SAR"
 * Basic SAR Skills Manual: F-3

Objectives
At the conclusion of this lesson the participants:
 * 1) will be able to ...

Time Plan
Total Time: 60 minutes
 * 2013-02: 58 min

Shock the students, by not providing any introduction. Don't allow any discussion or comment.

Play "Floating Stone" video -- without comment


 * Allow people to stew over it for some time

Talk them down by getting them to reflect
 * What are you feeling in your body?
 * Look around at your fellow students. How do they look?

Let students discuss incident.

Answer questions and provide background as they ask.

Floating Stone Lake Provincial Park is 42 km NW of St. Paul. http://www1.travelalberta.com/en-ca/index.cfm?pageid=4&Search=Details&ID=58901 http://www.floatingstonelake.com/

Happened in 1999? http://www.naarsdiveteam.org/callout.html

Darcy, the person who drowned had the key to the Seadoo so person who made it to it couldn't start it. Alcohol was not involved. The video was distributed to SAR by the family to help in training.

No PFDs.

Introduce topic title

Introduce Instructor

Present Objectives

Objective - to recognize the different types of stress and understand how they affect people. This includes symptoms and different coping methods

Why do we study stress?


 * You will see and do things that will stress you ... Finding a body ... Assisting with a removal ... Witnessing others' pain and loss


 * QUESTION: How does it make you feel?
 * QUESTION: Did you want to talk about it ... why?


 * Comfort Zone - everyone has a comfort zone unique to them
 * E.g. An undertaker, after dealing with 5 dead bodies in one moring may be thing ... Lunch Time
 * A SAR worker would not normally want to see 5 dead bodies in a career
 * What is your comfort zone ... do you know?


 * Types of Stress - (Thinking and Emotions Overhead [BASIC SAR 727])
 * GOOD STRESS (Eustress): person performs at a level not normally experienced. E.g. mom lifting a car off her child.  A stage of "hyper-alert" or getting into the game of sports
 * BAD STRESS (Distress): instead of lift the car of her child, mom steps in front of traffic. Often results in alcohol abuse and other problems such as FEAR (chap. 5)


 * OVERHEAD - Four Stages of Fear or Distress [Slide 25]
 * 1. Alarm - A state of alertness as a result of some stimulus. Anxiety appears as a natural reaction to what could happen
 * 2. Reaction - The body physically gears up for reaction
 * Muscles tighten
 * Sweat glands close down
 * Sugar is released for energy
 * Adrenaline is produced
 * Heart rate increases
 * If allowed to progress, anxiety can turn to OVERT FEAR. At this point TRAINING AND EXPERIENCE (your comfort zone) come into play.
 * "You will NOT rise to the level of your expectations, but fall to the level of your TRAINING"
 * 3. Response and Options [Slide 26]
 * Fight or Flight kicks in
 * Adrenaline rush occurs
 * Methodical approach to the problem with a parn and precise moves... OR
 * Scatterbrained thinking with no plan and refusal to believe the situation is really as bad as it appears (DENIAL)
 * Complete panic with frozen limbs & mind (crying, trembling, naseau, vomiting)
 * depends on your level of training
 * Rest
 * Sharp emotional letdown after intense situation
 * This will come whether wanted or not
 * Often a complete emotional and physical drain
 * Chances of shock is real
 * ALARM > REACTION > FIGHT or FLIGHT > REST


 * Stress is only a problem with it overwhelms your coping mechanism


 * STRESS TYPES
 * Acute Stress / Delayed - single event or past event
 * Cumulative Stress - burnout after extended time (can be weeks or years)
 * EMT's / Paramedics in large centres generally have a care expectancy of approx. 15 years at which point they "burn out"


 * QUESTION - What causes stress?
 * Have class give examples
 * Are they Acute or Cumulative?
 * Biogenic - caffeine, nicotine, amphetamine
 * Environmental - noise, light, dust, extreme temps, confined zpace (comfort zone)
 * Psychological - relationships, conflicts, lack of appreciation, abuse
 * Personality - need for love, guilt, fatigue, pain, sensitivity to criticism


 * OVERHEAD - Signs and Symptoms of an ACUTE Stress Reaction [SLIDE]


 * Cognitive
 * Blaming somenone
 * Confusion
 * Memory problems
 * Poor attention span*
 * Difficulties with decision making*
 * Heightened or lowered aletness
 * Difficulties with problem solving
 * Disorientation
 * Slowed thinking
 * Poor caculations
 * Poor concentration*
 * Difficulty naming familiar objects
 * Seeing event over and over


 * Physical
 * Nausea
 * Vomiting
 * Tremors (lips, hands)
 * Feeling uncoordinated
 * Profuse sweating
 * Chills
 * Diarrhea
 * Dizziness
 * Chest pains
 * Difficulty breathing
 * Shock symptoms
 * Rapid heard beat*
 * Rapid breathing
 * Excessively elevated blood pressure
 * Headaches*
 * Muscle aches
 * Fatigue


 * Emotional
 * Anxiety
 * Fear
 * Guilt
 * Grief
 * Anger
 * Depression
 * Sadness
 * Feeling lost
 * Feeling abandoned
 * Feeling isolated
 * Worrying about others
 * Wanting to hide
 * Wanting to limit contact with others
 * Irritibility
 * Feeling numb
 * Startled
 * Shocked


 * Behavioural
 * Change in anxiety
 * Change in speech
 * Withdrawal
 * Angry outbursts
 * Suspiciousness
 * Change in communications
 * Change in interactions with others
 * Increased or decreased food consumption
 * Increased alcohol consumption
 * Intense fatigue
 * Antisocial acts
 * Hyper-alert


 * OVERHEAD - Signs and Symptoms of a CUMULATIVE Stress Reaction [Slide]


 * Stage 1: The Early Warning Signs
 * Vague anxiety (feeling of impending doom)
 * Excessive and constant fatigue
 * Feeling of depression
 * Boredom with one's job or home life
 * Apathy


 * Stage 2: Mild cumulative stress reaction
 * Lowered emotional control
 * Increased anxiety
 * Sleep disturbances
 * Headaches
 * Irritability
 * Muscle aches and pains
 * Loss of energy
 * Depression
 * Hyperactivity and restlessness
 * Excessive fatigue
 * The beginnings of withdrawal from friends, family and coworkers
 * Nausea
 * Increased


 * Stage 3: Moderate cumulative stress reaction
 * Skin rashes
 * Generalized physical weakness
 * Strong feeling of depression
 * Increased alcohol abuse
 * Increased smoking
 * High blood pressure
 * Migraine headaches
 * Loss of appetite
 * Angry outbursts
 * Marital conflict
 * Loss of sexual appetite
 * Ulcers
 * Severe withdrawal from friends, family and coworkers
 * Constantly feeling angry
 * Crying spells
 * Serious depression
 * Serious anxiety
 * Problems with clear thinking and decision making
 * Problems with memory
 * Rigid thinking patterns


 * Stage 4: Cumulative stress reaction
 * Severe depression
 * Severe anxiety
 * Low self-confidence
 * Inability to appropriately manage one's job or personal affairs
 * Severe withdrawal
 * Excessive alcohol abuse
 * Uncontrolled emotions
 * Suicidal thoughts
 * Muscle tremors
 * Feeling desperate and out of control
 * Severe fatigue
 * Overreaction to minor events
 * Agitation
 * Constant tension
 * Hostile feelings
 * Homicidal thoughts
 * Chronic state of anger
 * Accident prone
 * Carelessness
 * Development of moderate to severe thought disturbance
 * Hallucinations
 * Sleep disturbance


 * Defense Mechanisms
 * Repression - don't talk about it "just leave it alone"
 * Denial - deny that you have any symptoms of stress
 * Rationalization - explain away poor performance
 * Humour - not always used properly


 * Critical Stress Debriefing / Defusing
 * Professional services are available
 * Its most effective if you simply talk about things, and soon
 * Get help for your team, and yourself
 * Stress is not a weakness
 * If you had bad vision, you would get it fixed
 * EMS has the system in place, they use it, and SAR fell through the cracks
 * Don't underestimate its effects

Aids

 * (Floating Stone Video)


 * non publishable material

Question bank
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Frequently Asked Questions
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Reference Material

 * CISM