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== Subject ==
{{prompt|What is this lesson plan about?}}

== Authors ==	
{{prompt|List who wrote this lesson plan.}}
(Chris Jorgensen or Brian Sundberg probably created this)

== Scope ==
{{prompt|What is included in this lesson, what's not and why.}}
: SAR Fundamentals Manual: Ch.16 "Stress in SAR"
: Basic SAR Skills Manual: F-3

== Objectives ==
At the conclusion of this lesson the participants:
# will be able to ...
== Time Plan ==
Total Time: 60 minutes
* 2013-02: 58 min

See {{nbw|2016|10|26}}
{{lesson slides start}}
{{lesson slide|00:00|3 min}}
''Shock the students, by not providing any introduction.''
''Don't allow any discussion or comment.''

''Play "Floating Stone" video -- without comment''

{{lesson slide||}}
* ''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?

{{lesson slide||}}
''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.
{{lesson slide||}}
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

{{lesson slide||}}
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'''

{{lesson slide||}}
* QUESTION: How does it make you feel?
* QUESTION: Did you want to talk about it ... why?

{{lesson slide||}}
* '''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?'''

{{lesson slide||}}
* '''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)'''

{{lesson slide||}}
* '''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'''

{{lesson slide||}}
* Stress is only a problem with it overwhelms your coping mechanism

{{lesson slide||}}
* '''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"

{{lesson slide||}}
* '''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

{{lesson slide||}}
* '''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

{{lesson slide||}}
* '''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

{{lesson slide||}}
* '''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

{{lesson slide||}}
* '''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 ==
{{prompt|What materials are needed or useful in presenting this lesson.}}
: (Floating Stone Video)

* [[/Restricted|non publishable material]]
* info sheet see {{nbw|2016|11|19}}

== Question bank ==
{{prompt|List of questions suitable for an review/exam of this section.}}
See {{subpage|Question bank}}

== Frequently Asked Questions ==
{{prompt|What are some of the questions that students typically ask.  Include the answers.}}

What time of year was the incident?

== Feedback ==
{{prompt|When has this lesson been presented.  What was the feedback.}}

== License ==
{{prompt|What can others do with this lesson?}}

Recommended license below.  Fill in the year and the author's name(s):

Copyright © YEAR, Author.  
This work is licensed under a 
Creative Commons Attribution-NonCommercial 2.5 Canada License.
To view a copy of this license, visit 
http://creativecommons.org/licenses/by-nc/2.5/ca/
or send a letter to Creative Commons, 559 Nathan Abbott Way, Stanford, California 94305, USA.

== Reference Material ==
{{prompt|If you need to cite sources, do so here.}}

* [[CISM]]

== Notes ==
{{prompt|Any additional notes, etc.}}

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@@ Line 22: / Line 22: @@
 See {{nbw|2016|10|26}}
 {{lesson slides start}}
-{{lesson slide|00:00|6 min}}
+{{lesson slide|00:00|3 min}}
 ''Shock the students, by not providing any introduction.''
 ''Don't allow any discussion or comment.''
-''Play "Floating Stone" video (4 min) -- without comment''
+''Play "Floating Stone" video -- without comment''
+{{lesson slide||}}
 * ''Allow people to stew over it for some time''
-{{lesson slide|00:06|}}
+''Talk them down by getting them to reflect''
-''Bring them down by allowing the students to discuss incident.
+* What are you feeling in your body?
+* Look around at your fellow students.  How do they look?
-How would you sum up what you saw?
+{{lesson slide||}}
+''Let students discuss incident.''
-''Answer questions and provide backgronud as they ask.
+''Answer questions and provide background as they ask.''
 Floating Stone Lake Provincial Park is 42 km NW of St. Paul.
@@ Line 47: / Line 51: @@
 No PFDs.
-{{lesson slide|00:11|4 min}}
+{{lesson slide||}}
-''Talk them down by getting them to reflect
-* What have you been feeling in your body?
-* What emotions were you feeling+
-* Were you watching your fellow students?  How do they look?
-{{lesson slide|00:15|2 min}}
 Introduce topic title
@@ Line 59: / Line 58: @@
 Present Objectives
-'''Objective'''
+'''Objective''' - to recognize
-# to recognize the different types of stress
+the different types of stress and understand how they affect people.
-# understand how they affect people
+This includes symptoms and different coping methods
-# understand different coping methods
-{{lesson slide|00:17|2 min}}
+{{lesson slide||}}
 Why do we study stress?
@@ Line 70: / Line 69: @@
-{{lesson slide|00:19|2 min}}
+{{lesson slide||}}
 * QUESTION: How does it make you feel?
 * QUESTION: Did you want to talk about it ... why?
-{{lesson slide|00:21|2 min}}
+{{lesson slide||}}
 * '''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
@@ Line 81: / Line 80: @@
 ** '''What is your comfort zone ... do you know?'''
-{{lesson slide|00:23|2 min}}
+{{lesson slide||}}
 * '''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)'''
-{{lesson slide|00:25|5 min}}
+{{lesson slide||}}
 * '''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
@@ Line 111: / Line 110: @@
 ** '''ALARM > REACTION > FIGHT or FLIGHT > REST'''
-{{lesson slide|00:30|1 min}}
+{{lesson slide||}}
 * Stress is only a problem with it overwhelms your coping mechanism
-{{lesson slide|00:31|1 min}}
+{{lesson slide||}}
-* '''Stress Duration Types'''
+* '''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"
-{{lesson slide|00:32|5 min}}
+{{lesson slide||}}
 * '''QUESTION''' - What causes stress?
 ** ''Have class give examples''
@@ Line 129: / Line 128: @@
 ** '''Personality''' - need for love, guilt, fatigue, pain, sensitivity to criticism
-{{lesson slide|00:37|5 min}}
+{{lesson slide||}}
 * '''OVERHEAD''' - ''Signs and Symptoms of an ACUTE Stress Reaction [SLIDE]''
@@ Line 199: / Line 198: @@
 ** Hyper-alert
-{{lesson slide|00:42|5 min}}
+{{lesson slide||}}
 * '''OVERHEAD''' - ''Signs and Symptoms of a CUMULATIVE Stress Reaction [Slide]''
@@ Line 270: / Line 269: @@
 ** Sleep disturbance
-{{lesson slide|00:47|2 min}}
+{{lesson slide||}}
-* '''Poor Defense Mechanisms'''
+* '''Defense Mechanisms'''
 ** Repression - don't talk about it "just leave it alone"
 ** Denial - deny that you have any symptoms of stress
@@ Line 277: / Line 276: @@
 ** Humour - not always used properly
-{{lesson slide|00:49|2 min}}
+{{lesson slide||}}
-''Strong Defense Mechanisms
-* talking
-* exercise
-* eating healthy
-* keeping to routine
-* peer group
-{{lesson slide|00:51|8 min}}
 * '''Critical Stress Debriefing / Defusing'''
 ** Professional services are available
@@ Line 295: / Line 286: @@
 ** Don't underestimate its effects
-{{lesson slide|00:59|1 min}}
-Questions
 {{lesson slides end}}