Trauma Counselling and first responders / paramedics

Trauma Counselling and first responders / paramedicsWith the daily carnage on the roads of South Africa, it is not only the victims of road crashes that are exposed to trauma. Our first responders to these road crashes such as paramedics and members of the police are exposed to the trauma of horrific crashes and it is important that the long-term effects of this trauma be addressed with the utmost efficiency and professionalism!

We decided to inquire from emergency medical response service provider ER24 how we are dealing with trauma counselling for our first responders:

Are we at risk of focussing on the trauma experienced by road crash and other victims - and often neglecting those who respond to the scenes – i.e., first responders such as paramedics, police etc.?

The first and foremost concern regarding a traumatic experience is that of the patients/victims themselves (they are the ones that went through the ordeal themselves and experienced everything first hand ) and yes, often the first responder aren’t always considered.

We need to keep in consideration that the first responders are performing a duty to the victims and/or patients and by doing so, are putting their own safety and concern on the line. Often, dealing with stressful situations proves to be an extremely difficult task as an uncontrolled environment need to be controlled.

Are there different “levels of trauma” experienced by paramedics/ first responders?

Yes. According to international guidelines, trauma and medical patients are categorised on basis of the mechanism and severity of the incident (motor vehicle collision; fall from a height; twisting an ankle) and on basis of vital signs recorded by an emergency practitioner.

A patient will then fall under certain criteria that will describe the overall condition of a patient from the ‘walking wounded’ ( stable patient with minor injuries ); serious but stable; serious and in need of urgent medical attention; critical/life-threatening injuries/condition. Taking these categories into consideration, the level of stress and intensity also varies.

Would there be a difference to the trauma experienced from regular prolonged exposure to trauma from i.e. road crashes as compared to the trauma from one major traumatic event?

Would there be a difference to the trauma experienced from regular prolonged exposure to trauma from i.e. road crashes as compared to the trauma from one major traumatic event?

Yes, there would be in the sense that paramedics often prepare themselves to deal with road accidents and are exposed to them each and every day. However, when a major traumatic event happens, no one can prepare for the impact of that. We have found that major traumatic events have an impact on everyone involved no matter what the experience levels.

What are the major threats if a first responder in need of trauma counselling does not undergo treatment - threats to family, colleagues and victims of trauma?

It can negatively impact his work performance for one in the sense of a threat; the responder can freeze or start experiencing forgetfulness whilst working with patients on a scene. Colleagues can be put at risk when the person that needs counselling is not helped in the sense that they can neglect to help their colleagues or not respond when help is needed.

A threat to their family lives can manifest in many ways such as absenteeism’s mentally, the person can take out their feelings and frustrations on the family causing further harm or substance abuse can start that has a negative impact on every aspect of the person’s life.

Does ER24 screen employees from time to time to establish whether someone is in need of trauma counselling? Does this happen from time to time or after specifics traumatic events?

ER24 need to adhere to the guidelines specified by the HPCSA regarding counselling and these guidelines stipulate that employees cannot be screened without their permission and consent. We do offer screening and counselling to all of our employees and they have the option at any time to speak to a counsellor confidentially and free of charge. Therefore, employees are not forced but encouraged to go for screening or counselling, but they have the option to refuse.

 

Do paramedics come to the counsellors out of own free will or will you receive notification from colleagues/friends or family that the person may be in need of counselling?

Do paramedics come to the counsellors out of own free will or will you receive notification from colleagues/friends or family that the person may be in need of counselling?

Our counsellors experience this both ways.

The availability of counselling to our paramedics is well known among staff although many ‘leads’ are being received through colleagues who notices a problem. The employee then receives a phone call from the counsellor asking whether they need assistance and then the employee has a choice.

What are the warning signs that might tell colleagues and relatives that the first responder may be in need of counselling?

The general signs are:

  • Mood changes (out of ordinary from the usual behaviour)
  • Having trouble sleeping
  • Change in appetite
  • Irritability
  • Cannot focus on work duties
  • Forgetfulness
  • Changing of personality

Is there a need to be more attentive to the novice paramedic as compared to the experienced paramedic in terms of how he responds to trauma and the need for counselling?

Yes, absolutely.

The novice paramedic might not have been exposed to certain conditions/emergency situations.

Many of the paramedical courses offer practical training that offers exposure to these conditions.

The BAA (Basic Ambulance Assistant) program, however, does not contain a practical phase and practical experience is limited as these practitioners fall under ‘supervised practice’.

It does, however, differ from person to person.

 

Is it only the paramedics that are in need of trauma counselling or do you also need to look at the emotional and psychological health of the call centre operators taking the emergency calls?

Is it only the paramedics that are in need of trauma counselling or do you also need to look at the emotional and psychological health of the call centre operators taking the emergency calls?

The first point of contact in an emergency situation is that of the call takers, where a call is logged and all the details of the emergency are obtained.

Often, these individuals have to deal with panicked/stressed callers that prove to be an emotional encounter for both parties.

What is the process required for trauma counselling of first responders, in terms of questionnaires, eye to eye consultation, feedback etc?

The first responder simply has to state that they need counselling and the branch manager can arrange face to face session with the counsellor or the first responder can call the counsellor on their own.

The counselling is confidential therefore the only feedback that can be given to the branch managers is how to help the employee during the trauma recovery process.

How long does it generally take before a first responder/ paramedics are deemed fit to be exposed to trauma again?

It is handled on an individual basis seeing that every person is unique in personality and history. Therefore each case is handled individually and there is no set amount of time.

What would ER24 recommend in terms of trauma counselling for first responders, crash victims etc – who can they contact when they believe there is a need for counselling?

ER24 has their own in-house counsellors that are assigned not only to contracted clients but to the employees of ER24. These counsellors can be contacted anytime by employees for trauma counselling or support.

How long does it generally take before a first responder paramedics are deemed fit to be exposed to trauma again

Also view:

Trauma Counselling and Road Safety

Emergency Response Time

Crash types and types of injuries in road crashes

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