gms | German Medical Science

Emergency personnel are constantly exposed to traumatic experiences in their work environment. “Emergency personnel” means any persons, paid or volunteer, who receive calls for dispatch of police, fire, or emergency medical service personnel, and includes law-enforcement officers, firefighters, including special forest wardens and emergency medical service personnel (Code of Virgina of the State of Virgina). These experiences cause a high risk for anxiety and other mental disorders.

Trauma is the response to a deeply distressing or disturbing event. It overwhelms an individual’s ability to cope, causes feelings of fear, isolation, helplessness and sadness, diminishes their sense of self and their ability to feel the full range of emotions and experiences. Life with trauma means living in the shadows. Common responses and symptoms of a trauma in an emotional, psychological and physiological view are hypervigilance, dissociation, depression, irritability, loss of interest, numbing, insomnia, decreased concentration, hopelessness, nightmares, flashback, instrusive memories, startle response, shame, selfhatred, panic attacks, loss of sense “who I am”, emotional overwhelm, chronic pain, headaches, eating disorders, substance abuse, self-destructive behaviour and little or no memories. There is a high rate of committing suicide.

What about best practice in dealing with traumatic stress? It’s important to remember that people react in different ways to trauma. There is no “right” or “wrong” way to react. There is to avoid obsessivly reliving the traumatic event, repetitious thinking or viewing horrific images. It could overwhelm the nervous system, making it harder to think clearly, looking for activities that keep your mind occupied. Post-traumatic stress disorder (PTSD) and coping depends on predictor variables, like social support, social comparison and cognitive appraisals. Moderator variable is the coping style. Outcome variables are decreased PTSD symptoms vs. increased PTSD symptoms. Decreased PTSD symptoms are depending on engagement, increasing PTSD symptoms are depending on disengagement. Stress in one’s life is inevitable, but coping is the key not letting it control one’s life:

• Problem-focused coping means to remove the impact of their stress through their own action.
• Emotion-focused coping means to change the way a person feels or emotionally reacts to a stressor.
• Mediation means to refocus attention and to achieve a trancelike state of conscious.
• Stress management skills are therapy, excercise, hobby, yoga, nature, music and time management.

With this research we compare the relevance of work environments to the increased risks. We review the current coping management protocols used and revise the protocols to establish coping management techniques specific for the need of emergency personnel. We will incorporate the following possibilities: health management and physiology, health psychology and health sociology. The countries we investigate in cooporation are Canada, China, Egypt, Ethopia, Germany, India, South Africa and other countries. It is an international research project in order to compare different social structures and their approach to the above mentioned issue and to analyze why some countries have better results with their current coping management protocols. These protocols can be modified and incorporated. Trauma experiences in developing countries means that health care has not traditionally focused on emergency medical care:

• The incorporation in the medical system is very important
• The incorporation in the medical system would decrease the high costs for injured people and long care needs
• The incorporation in the medical system would have a significant impact to live satisfaction to the people.

Priority would be to develop guidelines for emergency care in low-income and middle-income countries. It would save lives and reduce costs for the health system. The research about the risks of traumatic experiences for emercency personnel and coping management is a very important demand in international and transdisciplinary view: psychological, sociological, medical and especially in the view of emercency medicine, medical geography, public health and social medicine.