Psycological First Aid
- A guide for health care professionals
A brief guide to the treatment of persons exposed to violence, threats, accidents, catastrophes or other traumatic incidents.
The guide will be useful for health care professionals in assisting patients and their relatives as well as colleagues and others exposed to stressful incidents.
The following pages will offer advice on how to help a traumatized person in the first hours and days following the critical incident.
The main goal of psychological first aid is to re-establish normal stability and balance of thoughts, feelings, behaviour and bodily functions as soon as possible.
In any case ofbodily harm or signs of somatic illness, and in cases where the injured person does not respond to normal contact, the person always has to be referred to medical examination and treatment immediately.
It is recommended to read the guidelines in the stated order.
One or more of the following symptoms will often be found:
Acute stress reactions are comparable to what is normally referred to as serious crisis reactions.
The reactions may vary from person to person.
This guide focuses on the immediate reaction that will normally wear off within a few days. The reaction may be triggered by an extremely stressful incident, physical or psychological, as for instance violence, threats, death, war,bodily harm or an unexpected loss of close relations. In most cases the reaction can be described as a normal reaction and will normally wear off within a few hours or days. The reaction is characterized by anxiety symptoms and emotional outbursts.
The reaction can be expressed in a number of very different ways. It is here important to be aware of the variants where the victim becomes quiet, withdrawn or even numb. These victims may easily be ignored in chaotic situations.
If the symptoms have not decreased within 48 hours, professional medical or psychological treatment is required.
The first hours
Even though most stress reactions wear off with no or moderate help from others, a more structured assistance from health care professionals can be recommended.
1. Forming a general view of the situation, establishing a primary contact and clarifying the conditions
2. Care for somatic symptoms
Medical treatment of bodily harm and illnesses must always be prior to the treatment of the psychological condition.
A medical description of physical and somatic consequences of violence and accidents is normally a prerequisite for reporting to insurance companies. Be aware that an independent medical examination may be required.
3. Care for personal hygiene
After accidents, violence and other critical incidents the victim will often be dirty with torn clothes and a smeared and tearful face.
In cases of violence or rape it is important to contact medical care and police before cleaning and changing of clothes. This is to make sure that important evidence for possible legal procedures is collected.
4. Psychological care within the first hours
The main goal of psychological care is to re-establish harmony and balance of thoughts, feelings, behaviour and bodily functions.
As the victim is sometimes unknown to the helper, it may be necessary to try to establish what is considered a common “normal” and balanced condition.
5. Helpful Advice
The following advice may be given to the victim:
The next days
Most reactions to critical incidents wear off markedly without professional help from psychologists or psychiatrists.
6. Be aware of changes
However, be aware of possible changes of behaviour, mood and habits as for instance:
If the above mentioned changes of behaviour, mood and habits do not wear off and return to normal within a few days, it is strongly recommended that the victim is referred to a psychologist or a doctor specialized in psychotraumatology.
7. Check-up within a couple of weeks
If there is contact to the victim, and if it is appropriate, it is recommended to evaluate after a couple of weeks:
8. Preventing a new critical incident