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PTS(D)/TBI-A GUIDE FOR FIRST RESPONDERS. The Silver Star Families of America.
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PTS(D)/TBI-A GUIDE FOR FIRST RESPONDERS The Silver Star Families of America
The Silver Star Families of America has been a leading advocate for those wounded in the mind by PTS(D). In fact we do not call it a disorder so you will see us refer to it here as simply PTS. We are not physicians or mental health experts but we do have some expertise in dealing with those wounded by PTS and we do have some experience with first responders.This suggested class outline for police, fire and other first responders came from antidotal cases of PTS and FR contacts and is offered as a general, but not all inclusive, guide. The Silver Star Families of America offers this as a guide only and cannot be held liable for any consequence that may or may not arise. Disclaimer
PTS and the Military If you are in the military, you may have seen combat. You may have been on missions that exposed you to horrible and life-threatening experiences. You may have been shot at, seen a buddy shot, or seen death. These are types of events that can lead to PTS. Experts think PTS occurs: · In about 30% of Vietnam veterans, or about 30 out of 100 Vietnam veterans. · In as many as 10% of Gulf War (Desert Storm) veterans, or in 10 veterans out of 100. · In about 6% to 11% of veterans of the Afghanistan war (Enduring Freedom), or in 6 to 11 veterans out of 100. · In about 12% to 20% of veterans of the Iraq war (Iraqi Freedom), or in 12 to 20 veterans out of 100. Statistics
Other factors in a combat situation can add more stress to an already stressful situation and may contribute to PTS and other mental health problems. These factors include what you do in the war, the politics around the war, where it's fought, and the type of enemy you face. Another cause of PTS in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to men and women and can occur during peacetime, training, or war. Among veterans using VA health care, about: · 23 out of 100 women (23%) reported sexual assault when in the military · 55 out of 100 women (55%) and 38 out of 100 men (38%) have experienced sexual harassment when in the military Even though military sexual trauma is far more common in women, over half of all veterans with military sexual trauma are men. Statistics
http://www.va.gov/ http://www.ncptsd.va.gov/ncmain/information/ Resources
By Nancy Spoerke How do Americans celebrate the day That our nation with fireworks does display How can I be a part of all of this now When my mind takes me back to the war somehow The sound of the sky rockets that cause all the glee It sounds like mortar rounds to me To all that smile at the beautiful sights in the sky They look like tracer rounds through my eyes So how can others not see all of this Why can't they see my fears and paralysis How much more need I take How far can I go before I break Am I a rock so solid and strong NO, you make it so hard for me to go on I love our country beyond belief But I can't handle this, I need relief How strong can I be, please let me be strong Sometimes I have the feeling I can't go on How strong do you think I can be When the shots of hell are still inside of me as I cower from the beautiful sights This 4th celebration, sometimes night after night Please remember I so want to be free I love my country, my flag, . . . Remember I gave my mind for thee. How do Americans Celebrate the Day
A GUIDE FOR FIRST RESPONDERSA PROJECT OF THE SILVER STAR FAMILIES OF AMERICASECTION 1Understanding PTS and TBISECTION 2Why this is important to you and the Wounded?SECTION 3Suggested responses for dealing with the WoundedSECTION 4Delivering Psychological First Aid A GUIDE FOR FIRST RESPONDERS
*The SSFOA highly recommends the Crisis Intervention Team program started by the Memphis Police Department in 1988 who joined in partnership with the Memphis Chapter of the National Alliance on Mental Illness (NAMI), mental health providers, and two local universities (the University of Memphis and the University of Tennessee) in organizing, training, and implementing a specialized unit. This unique and creative alliance was established for the purpose of developing a more intelligent, understandable, and safe approach to mental crisis events.This program trains officers to recognize mental issues and teaches de-escalation techniques. While the SSFOA does not consider PTS a disorder or illness, many of the techniques used are applicable to those wounded with PTS. Recommendation
UNDERSTANDING PTS/TBIMany of the same symptoms can be displayed for both wounds, PTS and TBI. This is often the reason why the diagnoses are found with one and then later the other. PTS(D) is nothing to be ashamed of, embarrassed by,feel guilty about or laughed at.PTS(D) -- Post Traumatic Stressknown as PTSD or Post Traumatic Stress Disorder. SSFOA feels that PTS(D) is not a disorder but is awound that affects thousands of service members and their families. We believe PTS(D) sufferers should be treated with the same respect, care and honor as all wounds and illness receive. Section 1
Basically, Post Traumatic Stress is unconscious, automatic physical, emotional reaction(s) brought on by a delayed reaction to severe physical and psychological experiences that are outside the normal human range of emotions. Veterans of combat are the most publicized group of sufferers.But law enforcement officers; emergency medical personnel; firefighters; survivors of life threatening accidents, fire, flood or natural disasters; victims of violent crime; and victims of domestic, child or sexual abuse can and do suffer from PTS(D). ANYBODY can be affected by PTS(D). Even family members and friends of those who have PTS(D) can suffer from what is called Secondary Traumatic Stress Disorder (STSD). It is believed that 7-8% of the population have PTS(D) at some point in their lives. Cont.
The following behavior/reactions are contributed to the affects of PTS(D) (not a complete list, each person reacts differently and aperson's reaction is different due to the source of the trauma):- Flashbacks, or reliving the traumatic event(s) for minutes or even hours- Feelings of shame or guilt- Having upsetting dreams about the event(s)- Trying to avoid thinking or talking about the event(s)- Feeling emotionally numb- Irritability or anger- Poor relationships- Self destructive behavior - use of drugs or drinking too much- Feeling hopeless about the future- Having trouble sleeping- Memory problems- Trouble concentrating- Being easily startled or frightened- Not enjoying activities that once were enjoyed- Hearing or seeing things that aren't there Cont.
Signs and symptoms of PTS(D) usually show up within 3 months of a traumatic event. However, for some, PTS(D) signs may not occur until years afterwards. Symptoms can come and go.Usually more symptoms become apparent during times of higher stress or when experiencing symbolic reminders of the event(s). These reminders might be something remembered, something seen, something heard or even something smelled.There is no one cause of PTS(D) and research is ongoing in this area. As with any mental health issue, the individual's biology and genetics, life experiences, temperament and changes in the natural chemicals of their brains all play a part.To help those with PTS(D) everyone is encouraged to do the following - general:- Become aware of what PTS(D) is- Offer understanding and support to those (along with their family members and friends) who are living with this condition Cont.
What is Traumatic Brain Injury?Traumatic brain injury (TBI), also called acquired brain injury or simply head injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking. A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation. TRAMACTIC BRAIN INJURY*
WHY IS THIS IMPORTANT TO YOU AS A FIRST RESPONDER?Your personal safety and the safety of by standers is your prime responsibility. Refer to your training. However taking a few simple steps can protect you and the person wounded with PTS.Remember that the person with combat PTS has fought for his country and if you can defuse a situation without harm to anyone you have served your country as well. Section 2
SUGGESTED RESPONSES IN DEALING WITH PTS WOUNDEDThe following is information that may be helpful when dealing with someone with combat related PTS(D) These recommendations come directly from combat veterans.When in contact with someone who has combat related PTS(D) or you think has it:- Be calm- Keep the number of people involved to a minimum- Do away with unnecessary noise, bright lights- Do not move quickly toward them- Be patient- Speak slowly with frequent pauses- Avoid interruptions when they are speaking, as they may forget what they are trying to sayCrowds, loud noise, bright lights, fast movement, yelling are all things reminiscent of combat and can trigger a flashback or intensify the situation if the individual is currently experiencing a flashback.Anything that can be done to keep the conditions affecting the personwith PTS(D) as non-threatening as possible will go a long way in defusing a potential confrontation.If possible remove sunglasses. Being able to see someone's eyes helps build trust Section 3
Delivering Psychological First Aid*Professional Behavior Introduce themselves and give their job title.....police, EMT, paramedic, etc. Model healthy responses; be calm, courteous, organized, and helpful.Be visible and available.Maintain confidentiality as appropriate.Remain within the scope of your expertise and your designated role.Make appropriate referrals when additional expertise is needed or requested by the survivor.Be knowledgeable and sensitive to issues of culture and diversity.Pay attention to your own emotional and physical reactions, and practice self-care. Section 4
Guidelines for Delivering Psychological First AidPolitely observe first, don't intrude. Then ask simple respectful questions to determine how you may help. Ask if they know where they are.Often, the best way to make contact is to provide practical assistance (food, water, blankets).Initiate contact only after you have observed the situation and the person or family, and have determined that contact is not likely to be intrusive or disruptive.Be prepared that they will either avoid you or flood you with contact.Speak calmly. Be patient, responsive, and sensitive.Speak slowly, in simple concrete terms; don't use acronyms or jargon.If the wounded want to talk, be prepared to listen. When you listen, focus on hearing what they want to tell you, and how you can be of help.Give information that directly addresses the wounded immediate goals and clarify answers repeatedly as needed.Give information that is accurate.Remember that the goal of Psychological First Aid is to reduce distress, assist with current needs, and promote adaptive functioning, not to elicit details of traumatic experiences and losses. Cont.
Some Behaviors to AvoidDo not make assumptions about what wounded are experiencing or what they have been through.Do not pathologize. Most acute reactions are understandable and expectable given what the wounded have experienced. Do not label reactions as symptoms,or speak in terms of diagnoses,conditions,pathologies, or disorders. Cont.
The Silver Star Families of America also operate the Law Enforcement Equipment ProgramSpecial thanks to the National Center for PTSDhttp://www.ncptsd.va.gov/ncmain/index.jspNational Institute of Neurological Disorders and Strokehttp://www.ninds.nih.gov/http://www.memphispolice.org/crisis%20intervention.htm Credit
REMBERING, HONORING AND ASSISTING THE WOUNDED AND ILL OF THE ARMED FORCES STAY SAFE!
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