Accidents can happen in any field within the public or private sector. While some industries face more risk than others, it is important for any organization responsible for the well-being of its employees to anticipate potential risks and develop a plan to mitigate negative effects on its staff.

Even the FBI has a team dedicated to anticipating, training for, and managing dangerous events within their organization. Their motto is Proventus Per Adparatus – Success Through Readiness – and many other industries would do well to follow their commitment to preparation.

What Is A Critical Incident?

A critical incident is an unexpected event that occurs outside of the realm of everyday experiences and overwhelms a person’s sympathetic nervous system in such a way that it threatens their capacity to cope with psychological stress.

Common examples include neglect, physical or sexual assault, serious injuries or medical emergencies, exploitation or human rights violations, natural disasters, accidents, suicide attempts, or witnessing death. Even an encounter with law enforcement for a traffic stop can trigger a critical incident, depending on a person’s history.

Less frequent, but equally disturbing incidences include involvement in hostage or kidnapping situations, active shooter or lockdown scenarios, armed assaults or terrorist attacks, riots or violence occurring within large crowds, incidences involving explosives or bomb threats, and warfare. 

What Is A Normal Response During A Critical Incident?

Critical incidents can have both physical and emotional ramifications – what matters is the intensity of sensory and perceptual experiences in the moment of a critical incident. In these moments, the sympathetic nervous system (SNS) goes on alert in what is often referred to as the “fight or flight response.” 

When the SNS enters fight or flight mode, one may experience a steep increase in heart rate and/or blood pressure, flushed skin as a result of redirected blood flow, dilated pupils, memory alterations, muscle twitches or tremors, involuntary bladder or bowel movements, or an overall feeling of being on edge. Other normal body processes like digestion, hormone production, and tissue repair are stalled while the body focuses all of its energy on survival.

Who Is Most At Risk Of Experiencing A Critical Incident?

Persons of all ages, genders, abilities, and ranges of experiences can be confronted with intense feelings in the midst of and immediately following a critical incident. Typical emotions include fear, terror, loss of control, helplessness, shock, and despair. Emotions can be exceptionally heightened when a threat to life or a physical or emotional loss is perceived.

While anyone can experience a critical incident, emergency service staff are more likely, as a group, to be affected by critical incidents by nature of their career; in fact, up to 87% of emergency personnel may endure physical injuries or acute stress reactions that are often associated with critical incidents. 

Emergency personnel includes frontline workers who work in law enforcement, the military, security roles, the healthcare industry, and rescue teams, although there are many industries in the private and corporate sector that are at higher risk and more frequently exposed to potential stressors in their line of work. 

It is important that leaders and managers of organizations that face higher exposure to critical incidents anticipate risks, develop a protocol, provide training to staff, and offer support services in the event of a critical incident.

What Is A Critical Incident Response Team?

There is a crucial period in the immediate aftermath of a critical incident when the risk of developing traumatic stress is extremely high. On the one hand, there are factors that can mitigate the stress response in these moments, while on the other hand, certain factors can worsen a person’s response.

Supervisors of the occupational groups that face physical or psychological risks should have a fully-developed plan of interventions, at various levels, to help minimize the risk of psychological injury in the hours, days, and weeks following a critical incident. A critical incident response team is a great strategy to implement the decided-upon protocols.

Who Makes Up The Critical Incident Response Team?

Anyone within an organization can make up a critical incident response team – the key is ensuring that each member is aware of their responsibilities, effective in communicating efficiently and calmly during stressful or dangerous situations, and fully trained to carry out their responsibilities in the instance of a critical incident. 

Within certain industries, obvious members of the critical incident response team might include case managers, social workers, and emergency medical technicians. In other contexts, especially within smaller groups, anyone who is a member of the team or a witness to a critical incident might be required to step in. 

In a public school, for example, members of a critical incident response team might include the principal, assistant principal(s), school nurse(s), school resource officer, school psychologist, and any classroom teacher who witnesses a critical incident (like a violent fight, threat, accident, or use of a weapon).

What Are The Key Roles Within A Critical Incident Response Team?

The overall purpose of a critical incident response team is to mitigate the impact of traumatic events and assist those affected in their coping so that they may return to a normal level of functioning. In a protocol where every team member knows their responsibilities, there are several roles to play:

• Help those affected to make a course of action by breaking down overwhelming goals into smaller, more manageable tasks

• Offer access to resources, like information, transportation, communication devices, a debrief of the critical incident, and professional counseling services

• Provide security by containing the incident and preventing additional people from experiencing harm or intrusiveness by way of onlookers, media representatives, brusque or oblivious colleagues, or emergency staff

• Follow up with claims regarding workers’ compensation, paperwork filing, or other administrative or human resources procedures

• Comfort those who are distressed and help the affected navigate the stress and psychological ramifications of the experience by listening attentively

• Seek the assistance of a first responder or other relevant personnel

• Oversee an evacuation process, if necessary

• Ensure that customer service continues with minimal disruptions

• Encourage staff members who, though not harmed, are witnesses or invested in the experience and wellbeing of their colleagues

• Boost team morale in the days and weeks following a critical incident

It is highly unlikely that one person can effectively carry out all of the necessary protocols mentioned above. The more qualified people there are involved in a critical incident response team, the higher likelihood an organization has of mitigating the stress response on their team members and providing adequate support in the aftermath.

What Kind Of Interventions Might A Critical Incident Response Team Anticipate And Implement?

It is helpful to categorize interventions into three tiers: primary interventions, secondary interventions, and tertiary interventions. Primary interventions are developed prior to or launched at the source of a critical incident. Secondary interventions happen in the days following a critical incident. Tertiary interventions take place in the weeks after a critical incident has occurred. 

Primary interventions

Primary interventions involve developing a strategic plan, assigning members to a critical incident response team, providing training to those colleagues, and even going through drills to prepare team members for a real scenario.

Many hospitals, airports, and schools may go through active shooter drills, earthquake drills, and hostage negotiation drills. The goal is to acclimate team members to the tense environment of a real-time scenario and review protocol until it is committed to muscle memory.

Some protocols might involve engaging in mindfulness, measured breathing, or relaxation techniques that help to restore the body’s sympathetic nervous system to equilibrium. A swift, composed response is essential when handling critical incidents.

Secondary Interventions

Secondary interventions are generally incident-specific. In the moments immediately after a critical incident, people may experience intense emotions or a state of shock.

It is important to assess and monitor how the stress of the critical incident affects employees and to provide support for those exposed in order to reduce the gravity of the psychological impact.

It may be appropriate to offer large- or small-group sessions in some situations, while other instances warrant one-on-one conversations.

Tertiary Interventions

Tertiary interventions are ongoing and strive to enable rehabilitation and a safe return to work.

The focus pivots to analyzing the team’s response, determining how the response could have been improved, focusing on preventative measures for the future, and making referrals to local agencies or insurance providers. 

How Can Leaders Support Critical Incident Stress Management?

Sometimes, the stress that follows a critical incident can have a greater negative impact than the critical incident itself. Similar to the three-tiered system of intervening in critical incidents, there is a three-phase response for assisting the affected in managing stress.

Phase 1

In the initial phase, most affected persons are managing extreme sensory or perceptual load and/or their fight or flight response. They may experience physical symptoms like crying, loss of breath, a lump in the throat, or a stomach ache. Mentally, they might fixate on what is happening, lose the sense of time, experience distorted sensations or disturbances, pass out, or suffer from tremors. 

To aid in stress management, members of the critical incident response team should encourage the affected to process their emotions, which are normal. It might help to provide proximity in some cases and distance in others. Regardless, they should encourage the affected to seek the comfort of their trusted peers or loved ones.

Phase 2

In the next phase, different physical and emotional reactions manifest in the first few days following a critical incident. The affected may feel heart palpitations, heartburn, disruption in bowel cycles, muscle soreness, difficulty sleeping, decrease in sex drive, or stomach aches.

Emotionally, they may develop feelings of numbness, irritability, tension, difficulty focusing, lapses in memory, sleep loss, preoccupation with the incident, high levels of sensitivity, or a feeling like they are functioning on “autopilot.” 

To help the affected manage their stress in the days following a critical incident, team members should encourage adequate sleep and exercise as a means to rid the body of stress hormones. They should also discourage the affected from making any major decisions before they have had sufficient time to rebalance their nervous systems.

Phase 3

In the final and lengthiest phase – occurring 3-7 days after a critical incident – team members may notice fewer physical responses and an escalation or persistence of psychological responses.

Physically, the affected may develop insomnia, wake up throughout the night due to flashbacks or nightmares, have sexual difficulties, or decide to cope with alcohol or illegal substances.

Their psychological symptoms might be considered abnormal outside of the context of the critical incident, and it is in this phase that the affected person’s stress response may have negative effects on friends or family members.

Emotionally, the affected might be grappling with anger, guilt, blame, avoidance, anxiety, depression, fear, withdrawal, and alienation.

It is easy for a traumatized person to “start to spiral,” but when caring members of their circle are attentive and checking in, the affected person may be less likely to lose control.

Members of the critical incident response team should encourage the affected to spend time with their close friends and family members. In some cases, it is appropriate to encourage them to tell the story of what happened, either in oral or written form, to strangers or loved ones. In other cases, the affected might not be ready to do so.

Resuming a routine is optimal, and involves eating regular meals, going to bed at a normal bedtime, and exercising when possible. It is important that team members discourage the use of illicit substances, nicotine, caffeine, or alcohol, as these can depress the nervous system. Engaging in mindfulness techniques and therapy is usually beneficial, as well.