Seeing a bad crash and Critical Incident Stress Management (Debriefing)

[KMG_365]

I just thought I'd post this as I'm not sure it's been talked about before here in this way.

 

I just had a great chat with a good friend regarding a horrific motorcyclist accident he happened upon this afternoon. I know we don't ever expect to roll up on something like this and yet a certain percentage of us are bound to. It is the other reason I teach the First Responder for Motorcyclists courses for those riders for whom we still can make a difference. But for those of us who have witnessed this sort of psychological trauma first hand--especially for the first time-- there exists a methodology to handle and sort out the feelings that inevitably come up. It's called Critical Incident Stress Management (link) and we in the Fire Service use it more and more now a days as we've learned that these ghosts don't go away on their own without some light being shed on them and in so doing taking away their power over our subconscious selves. We've realized that if we don't address the issues that arise from experiencing these sorts of traumas, the stress will express itself in other usually much more sinister ways down the road.

 

While there is no way to deaden the profound impact of such horrific experiences (other than seeing enough of them to the point where they become more familiar, like a coroner who isn't freaked out by dead bodies anymore) one way of reducing the trauma on the would-be First Responder is at least knowing what to do in such a situation to at least feel like they were able to do what they could for the victim(s) and the rest is up to fate.

 

There is an organization called Accident Scene Management Inc. (link) which teaches a course called "A Crash Course for the Motorcyclist". This course is very similar to the one I teach and our own "Woodie" is one of their instructors in the North East Crew. I had the pleasure of attending one of his classes this last Spring and for those who have never had any sort of motorcycle specific First-Aid training I can't recommend it highly enough. The ASMI classes are still few and far between but they are growing. I'm sure if you contact them they might be able to put you in touch with an instructor in your area or point you towards other valuable resources.

 

Coincidentally, I also had a nice chat with a member in Texas earlier today and he's fired up about hosting a First Responder for Motorcyclists class in the Dallas, TX area sometime soon.

 

 

For the rest of you who might have experienced a recent motorcycle scene related trauma, please feel free to PM me for a phone number (I type way too slowly! ) and I'd be happy to chat with you about ideas and/or options. I'm not a trained headshrinker, but I've attended my share of final rides and also many CISD's and I'd be happy to chat with you about your feelings about the experience if it's still haunting you.

 

I hope--like your insurance policy--that you never need to use it, but sometimes it's comforting just knowing it's there.

[chrisd]

Thanks, Jamie, for again sharing what you know. Always interesting and useful stuff.

[Mike05]

 

Coincidentally, I also had a nice chat with a member in Texas earlier today and he's fired up about hosting a First Responder for Motorcyclists class in the Dallas, TX area sometime soon.

 

That would be me.

 

I'm in my 6th. day of rehab/bedrest after (partial) right knee replacement surgery. All is well but with time on my hands, decided to line up some "projects" for the return to the world.

 

One of them is to get Red Cross First Aid Training re-certification. My original motivation was driven by the extreme amount of "activity" time our granddaughters (ages 4 & 7; also our next door neighbors ) spend with Joyce & I. That brought me to riding motorcycles & First Aid training and wondering about applying first aid in the middle of nowhere on a downed ridier.

 

Searched the 'net, discovered it is a real issue & called Jamie...

 

who in the first few minutes of our phone call shared more about the topic then I gleamed in my few hours research! He, together with a few other Board members, actually teach this!!

 

WE have "Tech Daze" for the Bikes, why not for the Riders??

 

Would anyone be interested in attending a class on First Aid use/application as it relates to motorcycle accidents?

 

Figure some minimal cost ($20) per attendee for airfare to lure Jamie or some other like-qualified person to teach it. Food/drinks included.

 

What do you think? If you're interested pls. send me a PM and/or comment here.

 

I'd sure like us to do this!! Yet another reason to get together!

[tobyzusa]

I think it's in your best interest to pay my tuition .

 

 

...and then again, I'd better pay yours.

 

Of course I'm in.

[upflying]

Criticial Incident Stress Debriefing with a psychologist is standard operating procedure in LEO agencies in Cali. Any time an OIS or some major incident occurs, attendance in the CISD is manadatory for all the role players. Much it has to do with preventing or reducing disability retirements that often occur after such aftermaths.

[Laura]

Thanks for posting this. I'm definitely going to read all of your links. This is no joke; one can't imagine how you will react when see something devasting like this.

 

Back in 1983 I was first upon a horrific two car accident (drunk kids hit a car in the shoulder changing a flat tire). The fellow who was getting the tire out of his trunk died while I was trying to comfort him. His wife and sister sat on the guardrail in total shock; his car was upside down in the middle of the Garden State Parkway. I cried everyday for months. It took me years to get over it and I can remember it today like it happened yesterday.

 

I wish someone had offered to counsel me or I knew enough to get some help dealing with it. To this day I refuse to pull over on the shoulder of a road.....if I'm in someone else's car and they I actually start shaking and go into a total panic attack.

[Rocket_Cowboy]

Would anyone be interested in attending a class on First Aid use/application as it relates to motorcycle accidents?

 

Count me as interested!

[Jeff98362]

+1. Used CISM since 1991 in numerous public safety jobs. Highly recommended.

[K2R1150RS]

Thanks, Jamie, for putting yourself out there to help.

I too have been to my share of "bad" calls and been through the CISD follow-up. I would like to make one small addition: CISD gives you an opportunity to talk about how the event affected you, what the common aftereffects are, and may even help "reframe" a particularly bad incident, helping put it back in perspective for you. If you truly need help after an incident because the effects are staying with you, you might need more than a one time intervention.

Dr. Richard Gist, the department psychologist for the Kansas City FD, once told me that what happens to you is not as important as what you do about what happens to you. In other words, you can use choice about what direction you go after the event. That has been the most useful information about "bad" calls I have ever gotten.

[AZKomet]

Outstanding post KMG.....and even though I am out of the business now I have lingering thoughts each time I passs a particular intersection, house, field you name it.....

 

My very first incident (that still bothers me to this day) was a 4 year old that had been thrown from the back of a truck with others. She was shaking her mother (dead) and asking her to wake up when I arrived. There were several other deaths on scene (to include the father)due to a stop sign violation. Each time I pass that intersection (now 29 years later) I get that hair on my neck standing up feeling.

 

And most people don't realize the horrors as they are safe in bed or they lead a sanitized life. It is not until one lives with this each and everyday that CSIM comes in handy. If I sat down and looked back I'd more than likely go screaming in the night.....I vote for everyone to visit the sites listed they are truly a blessing in disguise.

 

Regards, Dave

[JTWright]

I asked the BMWMOA to consider developing first aid training for motorcyclists in some form like DVD/CD ROM or on their website.

Lots of us have had Red Cross First Aid, and I agree that it is very good basic course.

It would be nice to have something dealing with the unique issues related to biking, such as, when and how to remove a helmet, steps to be taken at an accident scene, etc.

I've been in a couple of accidents and stopped to render aid at a couple, and feel less than properly prepared to render aid.

 

Jim

[Ben_Ricci]

Excellent post. I'll read the links. Thanks.

[Lawman]

Jamie,

I've noticed that people respond to critical incidents in a very wide range of ways..I'm not seriously bothered anymore by most death scenes but more so at scenes where someone is critically injured, conscious and in shock or in severe pain especially if limbs have been severed..No matter how many of those I see I just don't become numb to them as I do death scenes, no matter how gruesome...

Do I need professional help?

[Whip]

Do I need professional help?

 

Let me count the ways.

 

[KMG_365]

K2:

Dr. Richard Gist, the department psychologist for the Kansas City FD, once told me that what happens to you is not as important as what you do about what happens to you. In other words, you can use choice about what direction you go after the event.

This idea is a very powerful concept and can put you back in the driver's seat pretty quickly and keep the monstrous storm surge from battering you to death against the rocks. This concept as well as another related one can serve any of us incredibly well in our daily lives (but especially when dealing with difficult emotions and/or disappointments): try, whenever you can, to discover the clear distinction between "what actually happened" and "what YOU made it mean" (usually about you, your failings, your worthiness, etc.). Try this one on for size and see if that doesn't take a few hundred pounds off your shoulders.

 

Jim:

I asked the BMWMOA to consider developing first aid training for motorcyclists in some form like DVD/CD ROM or on their website.

Lots of us have had Red Cross First Aid, and I agree that it is very good basic course.

It would be nice to have something dealing with the unique issues related to biking, such as, when and how to remove a helmet, steps to be taken at an accident scene, etc.

I've been in a couple of accidents and stopped to render aid at a couple, and feel less than properly prepared to render aid.

This last part is precisely why I started teaching my courses. WHO of us without medical training would feel confident that they knew what their priorities should be and how to do the greatest good for the greatest number when they suddenly see a few bikes in front of them hit a patch of winnebago snot and go sliding over the side, or hit a deer, or get taken out by an oncoming car crossing over the line, etc.?

 

The problem with a large corporation is that they're concerned about the liability. Your suggestion gets forwarded to their legal department and it doesn't even stop sliding on their desk before they kick it back. That's why I teach them as a private entity. Sure someone may try to take me to court for something they got wrong from one of my classes, but they can't get blood from a turnip. Besides, I may have saved a few more people some serious suffering and when I've shuffled off this mortal coil I'll take my chances with that "Great Karmic Balance Sheet in the Sky"!

 

 

Billy:

I've noticed that people respond to critical incidents in a very wide range of ways..I'm not seriously bothered anymore by most death scenes but more so at scenes where someone is critically injured, conscious and in shock or in severe pain especially if limbs have been severed..No matter how many of those I see I just don't become numb to them as I do death scenes, no matter how gruesome...

Do I need professional help?

First, we ALL need professional help! Second, anyone who rides a motorcycle really needs professional help. And third anyone who gets paid to have other people shoot at them really, REALLY needs professional help!

 

But you're exactly right: everyone is different and we react in vastly different ways to the same conditions. We are not merely a product of our genes and our upbringing, but our life experiences, our judgments, our prejudices/biases, our fears, etc. Most of us wander through life unaware of how these factors "filter" how we perceive reality, but exercises like the one in my response to K2 can shed light on these and give us power to see more clearly, make more informed decisions and take care of what we want our life to be like.

 

The fact that you don't become numb to those "horrific" scenes just means that you're still human (and don't let Whip convince you otherwise! ) [edit: I typed the previous sentence before I even saw Whip's response! ].

 

Death scenes are much easier for our brains to make unreal as there is no emotion coming from the scene (just from family/bystanders and of course what we bring to it, see above again). But it is/can be more of a static tableau that often bears little to no resemblance to reality. But again, you're right: the worst scenes are the ones with the critically injured people, crying out in pain, people severely maimed, and it is multiplied even more when the victims are young children. For your average 11-44 (Coroner's Case) where the patient was in their 80's and lived a full life it is easier to rationalize that at least they lived a full life and it was their time--when the deceased is a kid who had his whole life ahead of him this becomes a MUCH bigger challenge. Responding to these calls is what sends many professional rescuers out the door early.

 

But for the bystander/First Responder ANY critical scene (like the one Laura described above) can shake you to your core. I could list a dozen or so myself that I still have a hard time describing without my voice cracking and my eyes watering up even though I've been on a hundred 11-44's and these dozen were all years ago--you can imagine the impact on the average bystander who's never seen a dead body before even well preserved in an open casket funeral--let alone freshly scattered all over the road.

 

The main lesson is: do NOT be shy to seek out professional help, both proactively to train yourself to be mentally prepared for the eventuality (even a regular First-Aid or CPR course is GREAT for this!) and reactively after you've experienced a critical incident. It is best to seek counseling help in a timely fashion, but if you are still haunted by critical events or the after-images thereof, it's never too late to deal with those feelings, learn any valuable lessons to be had from the experience and exorcise those demons, loosen their grip and finally put them to their rest--in the past--where they belong, so you can move forward with your life as YOU want to.

[K2R1150RS]

Nicely put, Jaime!!

[Woodie]

Jamie, Jamie, Jamie.

 

I swear, some days you're like my brother from another mother.

 

I've got two ASMI classes coming up in late February, sponsored by Cliff's BMW, of Danbury, CT. Anyone interested, make sure you're on their mailing list, as they will be small classes (limited class-room size in their new facility).

 

CISD: I was one of the founding members of the Connecticut CISD team, sometime back in the late 80s? Several of us met by accident at a conference down in Baltimore, MD. The line I still remember the most: "While them other folks tell you to eat normally, don't get all hopped up on coffee or sugar, I gotta tell you, Chocolate relieves a lot of stress for me!"

 

Good stuff that CISD stuff...and it's not just for the big departments or towns. CISD pops right up in the small-towns too-- scraping up a neighbor, or their kid, is a really memorable event. DAMHIK

[L Rider]

Thank you for this very thoughtful post. The insight and links much appreciated.

 

Cheers..........Rod

[Ken H.]

Would anyone be interested in attending a class on First Aid use/application as it relates to motorcycle accidents?

I just updated my First Aid / CPR cert., but depending upon the when and where specifics, I'd be interested.

[Trinity]

I would definitely be interested in attending and would wager that others from the local Dallas and Ft. Worth clubs would also be interested. Once dates/time are set, let me know and I'll make sure info gets out to the locals.

 

Thanks for the initiative!

[KTsRidin]

As always Jamie, you are right on the mark!

 

I've been a member of the National Park Service (NPS) CISM team since 1995. I had the honor of serving as the national team leader who assisted USFS and other federal agencies who had staff dealing with the after affects of Hurricane Katrina. One might wonder why the NPS would have certified peer support of this nature... well, let me just say my last three call-out dealt with deaths (employees, public, murders...). We also respond to a variety of other traumatic incidents. Like another poster pointed out, we all respond differently to situations.

 

The depth, caring and experience of the folks on this board is just staggering. Although my schedule keeps me from being as active as I'd like, there's not one time I don't open this forum and find something compelling, new, insightful, or freakin' funny!

 

Thanks to you all!

Kirsten