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CISM - Critical Incident Stress Management

Teams work with individuals or groups of emergency medical services, fire and police personnel who may suffer from stress after being involved in a critical incident. Team members provide pre-incident education and post-incident defusing, demobilization and debriefing.


Examples of critical incidents are:

Bullet Suicides

Bullet Injury or death of an emergency worker

Bullet Prolonged events

Bullet Injury or death of children

Bullet Mass casualty incidents

Bullet Threats to emergency worker's safety

Bullet Natural disasters

The constant intake of stress or encountering a highly stressful event can cause the emergency service professional to suffer stress reaction symptoms. These symptoms may include:

Bullet Fatigue

Bullet Nausea

Bullet GI upsets

Bullet Memory loss

Bullet Concentration problems

Bullet Problem solving difficulties

Bullet Anxiety

Bullet Fears

Bullet Depression

Bullet Identification with the victims

Bullet Nightmares

Bullet Flashbacks

Bullet Fear of repetition of the stressful event

Bullet Mood swings and depression

Bullet Changes in sleep patterns

Bullet Changes in eating and work habits

Bullet Unusual actions or behaviors

A debriefing should be requested if stress symptoms continue beyond the first 48-72 hours of the incident. Overwhelming stress symptoms usually occur in the first 24-48 hours following a critical incident. If you or your agency is in need of CISM Team assistance, please contact your area's team. CISM brochures are available from the Office of EMS.


For more information on CISM contact Karen Owens, Emergency Operations Manager, at


Last Updated: 07-27-2016

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