SAR Fundamentals/Stress

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Contents

Material covered

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

Time

0.75 hr

Aids

(Floating Stone Video)

Lesson plan

(Chris Jorgensen or Brian Sundberg probably created this)

Shock value introduction

  • Play "Floating Stone" video -- without comment
    • Do not allow any dicussion or comment
  • Allow people to stew over it for some time
  • QUESTION: How does it make you feel?
  • QUESTION: Did you want to talk about it ... why?
  • You will see and do things that will streess you ... Finding a body ... Assisting with a removal ... Witnessing others' pain and loss

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

  • 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)
    • 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
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