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  • CrisisSituationsManifestationsIntervention strategies

  • Crisis

    What does the term crisis mean for you?

  • CrisisState of emotional turmoilSerious interruption in equilibriumEmotion overcomes thoughtsEmotional pressure becomes too great Can happen to anyone, at any stage of life

    Brady: Emergency Response to Crisis Mitchell/Resnik pp3

  • Wikipedia on Crisiscrises are "specific, unexpected, and non-routine events or series of events that [create] high levels of uncertainty and threat or perceived threat to a persons or organization's high priority goals."

  • Delicate BalanceMost of the time we live in a steady state.We fluctuate between thoughts and emotions. One normally fluctuates around the baseline of equilibrium. When ones own balancing system fails and ones equilibrium disrupted, Crisis can occur. When that equilibrium is shifted far enough or rapidly enough a problem occurs.

  • The breaking pointEveryone has a breaking pointWe are all unique, therefore our breaking point is unique and differentRemember; anyone can reach the breaking point even you!A person in crisis is a person who has reached their breaking point

  • OMAHA, Neb.The gunman who killed eight people in a mall shooting "just snapped," he wrote in a suicide note that combines love for his friends and family with contempt for his random victims.Toronto Star, Dec. 8/07, Sophia Tareen, Associated Press

  • Four Characteristics of crisisCrisis is suddenNormal coping mechanisms failCrisis short in durationResult in dangerous, unacceptable or self destructive behaviour

    Brady: Emergency Response to Crisis Mitchell/Resnik

  • 1. Crisis is suddenThe breakdown in equilibrium is an isolated incident, not a usual pattern of lifeIt is unforeseen and unexpected

  • 2. Normal coping methods have failedThe person tries to cope but is unsuccessfulThe person is unable to draw on his emotional resources, his self motivation, his internal strengths or outside support

  • 3. The crisis is short in durationA true crisis rarely lasts more then six weeksMost are resolved in 36 hoursWhy? People find it unbearable to be in a crisis state for very longA person will do something to end the pain and suffering

  • 4. Crisis may result in dangerous, unacceptable or self destructive behaviourCrisis can bring with it feelings of panic or defeatIf not resolved, may lead to suicide or homicide

  • From a different perspectiveCrisis has four defining characteristics. 1. event is unexpected (i.e., a surprise)2. creates uncertainty3. is seen as a threat to important goals. "crisis is a process of transformation where the old system can no longer be maintained." 4. There is a need for change, if change is not needed, the event could more accurately be described as a failure. Seeger, Sellnow and Ulmer Communication organization and crisis

  • Three classifications of crisistypes of crisisPredictable

    2. Maturational

    3. Unpredictable

  • 1. PredictablePart of the natural order of lifeResult from normal and expected life experiencesAny change can be stressful (positively or negatively) and may lead to a crisis

  • 2. MaturationalPubertyAdolescenceOld age

  • 3. UnpredictableSuddenCompletely unexpected

  • Stages of crisisImpactCrisisResolutionReconstruction

  • 1. ImpactThe occurrence of the crisis /stressful event Equilibrium is destroyedBody prepares for the traditional fight or flightAll of the persons energy is concentrated on the present and on the stressful eventPerson may be disoriented and distracted or may be full of energy why?

  • 2. CrisisCrisis occurs within minutes to hours of the eventYou are concerned with the persons reaction to the eventThere may be a range of emotions from hostility to uncertainty and detachment

  • 3. ResolutionAs the crisis period passes, the period of resolution or adjustment beginsThe person regains control and begins to think more clearly, explores alternatives, makes plans and sets goalsMotivated to make changeMay take weeks to months

  • 4. Reconstruction/Post crisisOnce the resolution is complete, the person resumes normal activityThere may be some lasting effects, however, most of the signs and effects of the crisis are over and may even be forgottenSome suffer permanent emotional injury

  • Recognizing a person in crisisRemember; each person is uniqueThere is no checklist for psychological crisisBUT do not underestimate your roleAssistance provided by EMS has deep and lasting effects upon victims

  • Consider the following when trying to determine if a person is in crisisThe person may have lost some or all contact with realityMay not be acting normally When talking to them, you may feel you are talking to a brick wallUnable to work at a normal level

  • MoreMay seem withdrawnAvoid sensory overloadExtraordinary fear and/or angerExtreme anxietyConfusionDepressionMay become impulsiveOverly dependent on othersMay reject offers of help

    YOU MAY SEE ALL, SOME OR NONE OF THESE SYMPTOMS

  • When things were out of whack how have you felt?

    What was your response to the crisis ?

  • Emotional reactions to crisis

    As we explore the following behaviour consider what kinds of calls would elicit the response

  • 1. Emotional shockhigh anxietyMay be hysterical or stunnedCombativePanicAgitated, out of controlTend to act irrationallyCan be dangerous

  • 2. DenialThe person is trying to protect themselvesTrying to limit what is happening to them, so they deny the crisis is happeningManagement?

  • 3. AngerOnce the person has passed through the denial stage and admits that the crisis is happening they will often become angryMay direct the anger inappropriately often at you!Management?

  • 4. RemorseMay become overwhelmed with guilt and sorrowTwist events out of proportionPlace the burden of events onto them selfif only statementManagement ??

  • 5. GriefBegins the first stage of healingUsually happens much later not generally seen by paramedics

  • 6. ReconciliationThe person passed through the crisisResumes his normal lifestyleNo longer preoccupied by the crisis

  • *

    Intervene in the Crisis Could be at any of the aforementioned stages Earmarked by narrow goals of short durationAimed at helping a person regain equilibrium and return to normal functioningTo be continuedOur Role

    *The problem is too greatThe problem has special significance that makes it overwhelmingThe problem occurs at a time of special vulnerabilityThe problem is a new one, so appropriate coping mechanisms havent been developed.The usual network of social support fails

    *Sudden event that causes flood of emotionsNormal routine shatteredNo longer able to rationalize the eventCoping mechanisms failCrisis is a serious interruption in equilibrium. It is a state of emotional turmoil, a state in which emotions overcome thoughts. It is a state in which the delicate balance breaks down under stress, a state in which emotional pressure simply becomes too great for the individual to cope with. Crisis is that state of disruption,it can happen to anyoneCrisis has four defining characteristics. Seeger, Sellnow and Ulmer[1] explain that a crises are "specific, unexpected, and non-routine events or series of events that [create] high levels of uncertainty and threat or perceived threat to an organization's high priority goals." Thus the first three characteristics are that the event is 1. unexpected (i.e., a surprise), 2. creates uncertainty, and 3. is seen as a threat to important goals. Venette[2] argues that "crisis is a process of transformation where the old system can no longer be maintained." Therefore the fourth defining quality is the need for change. If change is not needed, the event could more accurately be described as a failure.*Most of the time people are in a steady state a state of balanceYou may fluctuate slightly but stay around a state of equilibriumWhen the balancing system fails and equilibrium is disrupted crisis can occurPotential for crisis depends on how completely the state of equilibrium has been upset

    *What makes my breaking point different from yours? Past experiences Training Cultural Support**Crisis has four defining characteristics. Seeger, Sellnow and Ulmer[1] explain that a crises are "specific, unexpected, and non-routine events or series of events that [create] high levels of uncertainty and threat or perceived threat to an organization's high priority goals." Thus the first three characteristics are that the event is 1. unexpected (i.e., a surprise), 2. creates uncertainty, and 3. is seen as a threat to important goals. Venette[2] argues that "crisis is a process of transformation where the old system can no longer be maintained." Therefore the fourth defining quality is the need for change. If change is not needed, the event could more accurately be described as a failure.*Pilot flies same route between Toronto and Montreal every week.Engine fails and he is forced to land* Pilot tries to restart the engine He has not experienced this He is a rookie has no radio or co-pilot

    *4. Withdraw psychologically catatonia Use drugs/alcohol*Many reported incidents of murder-suicide**Trying to get pregnant If I dont study for this test, I will fail my year. Conflict within a family Lottery win*Puberty: change of life, worries about pregnancyAdolescence: Peer pressure, authorityOld age: loss of independence, health decline, money*Broadsided while drivingTornado, heart attack, stroke, house burns down**5. Our pilot may have practiced this scenario on a simulator and is confident he can handle the emergency land

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