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Post-Traumatic Stress Disorder in Emergency Medical Personnel

2022/10/13


Areas Of Specialization

Innovate Durham EMS

Post By

Marcus King

Ratings


PTSD

Within the field of emergency medical services, exposure to trauma is often a daily occurrence on the job (Russ, 2022). As a result, many EMS workers experience trauma responses, which may escalate into Post-Traumatic Stress Disorder (PTSD) (Russ, 2022).

      Post-Traumatic Stress Disorder includes the following criterion:

  • Exposure to or learning about a traumatic event, such as death or serious injury
  • Intrusion symptoms such as distressing dreams, memories, or dissociative reactions, in which one loses awareness and connection with one’s present surroundings
  • Persistent avoidance of stimuli associated through traumatic events, which may show up as calling out of work or feeling disconnected through responses to traumatic calls
  • Negative thoughts and changes in mood that impact one’s daily life
  • Changes in arousal and reactivity that may show up as anger, self-destructive behavior, challenges with concentration or sleep, and exaggerated startle responses (American Psychiatric Association, 2013)

Within the general population, the estimated rate of PTSD is only 6.8%, but estimates of PTSD in emergency medical personnel are as high as 37% (Russ, 2022). In addition, emergency medical personnel consistently score higher on severity scores for PTSD (Russ, 2022).

High rates of PSTD, mental illness, and substance use amongst EMS personnel, accompanied by lack of early intervention and access to mental health services has created an epidemic of mental health crises (Russ, 2022). With proper intervention and access to coping resources, individuals can overcome trauma and work towards post-traumatic growth, in which one is able to incorporate traumatic experiences into one’s life story and expand personal agency and sense of purpose and meaning as a result (Russ, 2022). 

One devastating effect of PTSD amongst emergency medical personnel occurs as the prefrontal cortex is dysregulated and gives way to the hyperarousal of the more primitive limbic system, which is responsible for emotional responses and the fight-flight-freeze response (Spitzer, 2020). As this bodily response takes its toll on one’s mental and physical health, suicide risk increases dramatically. In fact, EMS responders are estimated to have approximately 10x the risk of suicide compared to the national average (Spitzer, 2020).

While mental health services under the care of a professional therapist or psychiatrist is the most recommended course of treatment, financial and personal barriers keep many people from receiving the services they need (Spitzer, 2020). 

In order to work towards improving mental health, coping resources can be drawn upon (Smith et al., 2021). Some of these coping resources require medical professionals, while others can be utilized to build a personal toolbox to cope with stressful emotions.

  • Cognitive behavioral therapy has been shown to draw upon goal-oriented and structured approaches to restructure thoughts and change maladaptive coping mechanisms (Smith et al., 2021).
  • Animal-assisted therapy can allow for the development of a trusted relationship with an animal companion, which promotes the release of key neurotransmitters associated with relaxation and pleasure (Spitzer, 2020).
  • Relaxation techniques such as yoga, deep breathing, and meditation calm the body’s physiological responses and turn the prefrontal cortex back online to reduce hyperarousal (Smith et al., 2021).  
  • Self-help options include challenging one’s sense of helplessness and building self-efficacy, which is belief in one’s ability to do something effectively.
  • Reaching out to build a supportive community can serve as a protective factor.

Engaging in a healthy lifestyle with limited alcohol or drugs is essential, as substance abuse may increase difficult emotions and traumatic memories (Smith et al, 2021).