DEALING WITH TRAUMA n n n n TRAUMA

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DEALING WITH TRAUMA n n n n TRAUMA IS TRANSFORMING IT IS LIKE A

DEALING WITH TRAUMA n n n n TRAUMA IS TRANSFORMING IT IS LIKE A SLOW HEALING SICKNESS IT ISOLATES US FROM OTHERS DEFENCE MECHANISMS ARE STRONG WE FEEL INSECURE IN THE WORLD ALL HAS BECOME UNSAFE WE FACE AND EXISTENTIAL CRISIS

TRAUMATOLOGY n SEMINAR NOTES FROM PRESENTATIONS DELIVERED IN 2004 n BY DR JOHN C

TRAUMATOLOGY n SEMINAR NOTES FROM PRESENTATIONS DELIVERED IN 2004 n BY DR JOHN C MCEWAN n ALL MATERIAL © DR JOHN C MCEWAN n 1 JANUARY 2004

DEFINITIONS n n n 1. FAILURE OF THE G. A. S. TO HANDLE OVERWHELMING

DEFINITIONS n n n 1. FAILURE OF THE G. A. S. TO HANDLE OVERWHELMING DEMANDS = THE HORMONAL SYSTEM COLLAPSES 2. TOO MUCH STIMULI OVERTAXING COPING ABILITY = NO PROCESSING 3. RESPONSE TO THREAT PARALYZES AS WE PERCEIVE WE ARE UNABLE TO COPE WITH THE DANGERS.

A WORKING DEFINITION n “TRAUMA IS WHERE OVERWHELMING DEMANDS ARE PLACED INTENSELY ON AN

A WORKING DEFINITION n “TRAUMA IS WHERE OVERWHELMING DEMANDS ARE PLACED INTENSELY ON AN INDIVIDUAL, SO THAT THEIR COPING RESOURCES ARE EXHAUSTED IN A VERY SHORT TIME. THE STRESS REACTION SWITCHES ON AND GOES INTO OVERDRIVE. IT INVOLVES MULTI FOCAL STRESSORS, HAS A HEAVY GRIEF COMPONENT, AND PROVOKES AN EXISTENTIAL CRISIS”.

WHAT IT DOES TO US n n 1. IT TAXES OUR RESOURCES FOR COPING.

WHAT IT DOES TO US n n 1. IT TAXES OUR RESOURCES FOR COPING. ASSESSMENT/APPRAISAL. 2. PERCEPTION=WE CANNOT MEET THIS THREAT! HARM AND LOSS! 3. CONSEQUENCES ARE FEARED. 4. THE SYSTEM TURNS ON ITSELF AND BY OVER-REVVING RUNS US DOWN

THE VARIABLES n n n n 1. 2. 3. 4. 5. 6. 7. 8.

THE VARIABLES n n n n 1. 2. 3. 4. 5. 6. 7. 8. THE TYPE OF DISASTER DURATION AND INTENSITY PERSONAL IMPACT/CONTROL FELT POTENTIAL FOR RECURRENCE CONTROL PERCEIVED 4 FUTURE PREVIOUS EXPERIENCES PERSONAL FITNESS/HEALTH AGE/STAGE LIFE TRANSITIONS

DEATH AS A STRESSOR n n n n 1. 2. 3. 4. 5. 6.

DEATH AS A STRESSOR n n n n 1. 2. 3. 4. 5. 6. 7. CLOSENESS AGE OF THE DEAD ACCEPTANCE, ATTITUDES SUPPORT STRUCTURES EXPRESSION OF EMOTION CHANGES THAT DEATH WILL MAKE NUMBER/MANNER OF DEATH

THE PRIMAL RESPONSE n n n n FOCUS SIGHT FEEL TEAM WORK FLEXIBILITY SUSTAINABLE

THE PRIMAL RESPONSE n n n n FOCUS SIGHT FEEL TEAM WORK FLEXIBILITY SUSTAINABLE ROUTINES TENACITY SMELL STRENGTH FOOD COMMUNICATION PLANNING DEBRIEFING AROUND THE FIRE SONGS, POEMS, ART, SPEACHES

TRAUMA COPING “VIRTUES” n n ANCESTRAL VIRTUES HAD COPING VALUE AFTER PRIMAL CONFRONTATIONS WITH

TRAUMA COPING “VIRTUES” n n ANCESTRAL VIRTUES HAD COPING VALUE AFTER PRIMAL CONFRONTATIONS WITH DEATH! CHARACTER SURVIVAL AIDS n n TENACITY COURAGE JUSTICE TEAM WORK STRENGTH LOYALTY HONESTY INDEPENDENCE

COMPLICATORS n n n n 1. 2. 3. 4. 5. 6. 7. PHYSICAL ENVIRONMENT

COMPLICATORS n n n n 1. 2. 3. 4. 5. 6. 7. PHYSICAL ENVIRONMENT PERCEIVED CONTROL RELATIONSHIPS HOME BASE RECOGNITION LIFE CHANGES EXPERIENCED PERSONAL PROBLEMS BEFORE

STRESS BUFFERS n n n n 1. 2. 3. 4. 5. 6. 7. 8.

STRESS BUFFERS n n n n 1. 2. 3. 4. 5. 6. 7. 8. EMOTIONAL SUPPORT ESTEEM SUPPORT PHYSICAL SUPPORT INFORMATION SUPPORT SOCIAL NETWORK TEMPERAMENT HARDINESS CONDITIONED HARDINESS PERCEIVED CONTROL

HARDINESS PROFILE n n n 1. 2. 3. 4. 5. 6. 7. 8. 9.

HARDINESS PROFILE n n n 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. LEADERSHIP THEY GET STUCK INTO TASKS SUPPORT WITHOUT COMPLAINT INTELLIGENT CALM UNDER PRESSURE EMOTIONALLY STABLE RELATIONSHIPS STABLE GOOD HEALTH FAST WITH MOTOR SKILLS EXTROVERT NOT THE OLDEST IN FAMILY FULLY TRAINED

CONTROL ENHANCERS n n n n 1. 2. 3. 4. 5. 6. 7. ACTIVITY

CONTROL ENHANCERS n n n n 1. 2. 3. 4. 5. 6. 7. ACTIVITY INFORMATION FAITH/PHILOSOPHY RELAXATION STRATEGIES PERSONAL LIFE GOALS NO UNSOLVED ISSUES GOOD ROLE MODELS

ACUTE STRESS DISORDER n n PTSD IS NOT SPOKEN OF BEFORE THREE MONTHS ACUTE

ACUTE STRESS DISORDER n n PTSD IS NOT SPOKEN OF BEFORE THREE MONTHS ACUTE STRESS DISORDER INVOLVES n n n HIGH INTRUSION – DREAMS, FLASHBACKS MEMORIES COMING IN UNWANTED AVOIDANCE AND NUMBING RESPONSES AS WE TRY TO BLOCK OUT DISTRESS HYPER-AROUSAL – STARTLE RESPONSE AND IRRITABILITY AND ANGER

CISM n n n n CRITICAL INCIDENT STRESS MANAGEMENT INVOLVES MANY FACTORS WORKING TOGETHER.

CISM n n n n CRITICAL INCIDENT STRESS MANAGEMENT INVOLVES MANY FACTORS WORKING TOGETHER. CLEAR POLICIES /ACCOUNTABILITY EDUCATION ON STRESS/TRAUMA FOR ALL PEER SUPPORT PROGRAM TRAINING/SUPPORT FOR PEERS COUNSELLING ONE TO ONE DEBRIEFINGS/DEFUSINGS SPOUSAL SUPPORT

DEBRIEFING Part 1 n STAGE ONE n n n INTRODUCTION ACKNOWLEDGE, SUPPORT, HEAR, REASSURE,

DEBRIEFING Part 1 n STAGE ONE n n n INTRODUCTION ACKNOWLEDGE, SUPPORT, HEAR, REASSURE, STRESS MANAGE, NOT AN OPERATIONAL BRIEF. CONFIDENTIALITY NO BREAKS UNTIL FINISHED QUESTIONS

DEBRIEFING Parts 2 and 3 n STAGE 2 n n n INTRODUCE YOURSELF EXPLAIN

DEBRIEFING Parts 2 and 3 n STAGE 2 n n n INTRODUCE YOURSELF EXPLAIN WHAT YOUR ROLE WAS STAGE 3 n n FACTS STAGE THOUGHTS STAGE WHAT WERE YOUR FIRST THOUGHTS WHAT WERE YOU THINKING AT THE TIME WHAT THOUGHTS DID YOU TAKE AWAY WHAT THOUGHTS HAVE STAYED WITH YOU

DEBRIEFING STAGES 4 AND 5 n STAGE 4 REACTIONS STAGE n n WHAT WAS

DEBRIEFING STAGES 4 AND 5 n STAGE 4 REACTIONS STAGE n n WHAT WAS THE WORST THING FOR YOU WHAT HAD THE GREATEST IMPACT IF YOU COULD ELIMINATE ONE THING STAGE 5 SYMPTOMS STAGE n n HOW DO YOU KNOW THIS HAD IMPACT HOW HAS YOUR BEHAVIOUR CHANGED ANYTHING DIFFERENT ABOUT YOU ANY DISTRESS SINCE THE INCIDENT

DEBRIEFING STAGES 6 AND 7 n STAGE 6 n n PHYSIOLOGY OF STRESS/TRAUMA SYMPTOMS

DEBRIEFING STAGES 6 AND 7 n STAGE 6 n n PHYSIOLOGY OF STRESS/TRAUMA SYMPTOMS - DANGERS - GP RECOVERY STRATEGIES STAGE 7 n n n TEACHING STAGE RE-ENTRY STAGE ACTIVE NOT PASSIVE SUPPORT NETWORKS WHAT IFS QUESTIONS

UROLOGICAL TRAUMA RENAL TRAUMA n Renal trauma occursUROLOGICAL TRAUMA RENAL TRAUMA n Renal trauma occurs
APPROACH TO ABDOMINAL TRAUMA DR MOHAMMADZADEH TRAUMA TraumaAPPROACH TO ABDOMINAL TRAUMA DR MOHAMMADZADEH TRAUMA Trauma
TRAUMA TORAX TRAUMA TORAX Cualquier agresin o traumaTRAUMA TORAX TRAUMA TORAX Cualquier agresin o trauma
Trauma Gestione generale Trauma Dinamica Distinzione fra traumaTrauma Gestione generale Trauma Dinamica Distinzione fra trauma
TRAUMA GINJALUroogenital 1 Etiologi Trauma ginjal adalah traumaTRAUMA GINJALUroogenital 1 Etiologi Trauma ginjal adalah trauma
Neck Trauma Penetrating trauma Blunt trauma Near HangingNeck Trauma Penetrating trauma Blunt trauma Near Hanging
TRAUMA GENITOURINARI 1 TRAUMA GINJAL 2 TRAUMA URETERTRAUMA GENITOURINARI 1 TRAUMA GINJAL 2 TRAUMA URETER
Trauma BY Dr ALI ADIL TRAUMA v TraumaTrauma BY Dr ALI ADIL TRAUMA v Trauma
CHEST TRAUMA Majid Pourfahraji ANATOMY TRAUMA v TraumaCHEST TRAUMA Majid Pourfahraji ANATOMY TRAUMA v Trauma
Understanding trauma What is trauma A trauma isUnderstanding trauma What is trauma A trauma is
Section 2 Trauma What is trauma trauma nSection 2 Trauma What is trauma trauma n
Burn Kit Trauma Kit Trauma Kit Trauma KitBurn Kit Trauma Kit Trauma Kit Trauma Kit
Dealing with Noisy Data Dealing with Noisy DataDealing with Noisy Data Dealing with Noisy Data
Dealing with editors Peter Philimore Dealing with EditorsDealing with editors Peter Philimore Dealing with Editors
Dealing with Missing Values Dealing with Missing ValuesDealing with Missing Values Dealing with Missing Values
Dealing with Suicide KNOWLEDGE EXCHANGE SEMINAR SERIES DealingDealing with Suicide KNOWLEDGE EXCHANGE SEMINAR SERIES Dealing
Dealing with patients jenny crinion adam liston DealingDealing with patients jenny crinion adam liston Dealing
Dealing with Noisy Data Dealing with Noisy DataDealing with Noisy Data Dealing with Noisy Data