Post traumatic stress disorder (PTSD) - a paramedic's perspective.

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Post traumatic stress disorder (PTSD) or "burn-out" has always been and issue for paramedics and other emergency responders, but it wasn't recognized or even considered to be a significant problem. The causes of PTSD range from a major life-threatening incident (e.g. war, act of violence, accident and disaster) to a prolonged series of events (e.g. bullying, harassment, abuse, living with a violent partner). PTSD was introduced in the 1980s, before then it has been known by many names including shell shock, war neurosis, soldier's heart, gross stress reaction, transient situation disturbance, combat stress, combat fatigue, battle fatigue, stress breakdown, traumatic neurosis. The following is a list of PTSD symptoms that I have gathered from various sources, but mostly from psychology courses that I have taken in the paramedic program:

*sleep problems, nightmares and waking early

*flashbacks and replays which the victim can't switch off

*impaired memory, forgetfulness, inability to recall names, facts and dates that are well known to you

*impaired concentration

*poor memory and inability to concentrate

*exaggerated startle response

*irritability, sudden intense anger, occasional violent outbursts

*panic attacks

*hypersensitivity, whereby every remark is perceived as critical

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*obsessive - the experience takes over your life, you can't get it out of your mind

*joint and muscle pains which have no obvious cause

*feelings of nervousness, anxiety

*reactive depression

*excessive levels of shame, embarrassment

*survivor guilt for having survived when others perished

*a feeling of having been given a second chance at life

*undue fear

*low self-esteem and shattered self-confidence

*emotional numbness, inability to feel love or joy

*feelings of detachment

*avoidance of anything that reminds you of the experience

*physical and mental paralysis at any reminder of the experience

So what types of experiences are most likely to cause PTSD? Is PTSD more prevalent in highly populated areas or is it just as likely in less populated regions?

I'm most interested in PTSD rates of paramedics because I'm a paramedic student just starting to participate in ambulance ride outs. So in three days I start getting exposed to the same situations as real paramedics. For someone who will be entering the service next year I want to avoid PTSD myself so I can have a long and healthy career as a paramedic.

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When I first became interested in becoming a paramedic I heard from friends and others in the emergency services that a lot of paramedics quit and go on to other jobs because of the stress. This sounded logical to me but of coarse I couldn't be sure till I either experienced it or researched the matter. I will be alternating my ride-outs between two ambulance bases. One that has a low call volume and the other has a high call volume.

Here are a few facts from the Mosby's Paramedic Text that is probably the most widely used in North America:

- "About 30% of men and women who spent time in war zones experience this disorder." (Sanders, 2001, p.1152)

-"Posttraumatic Syndrome frequently occurs after...natural or human disasters; and accidents." (Sanders, 2001, p.1152)

-"Depression, alcohol or other substance abuse...often accompanies posttraumatic syndrome." (Sanders, 2001, p.1152)

-"About 5.2 million people in the United States have posttraumatic syndrome

during the course of a given year" (Sanders, 2001, p.1152).

I think the cognitive perspective is the most appropriate for dealing with and answering this question. The cognitive perspective shows "how we encode, process, store, and retrieve information" (Myers, 2001, p.6). Paramedics are right in there during high stress emergency calls, how they encode and process this information at the scene

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and after the call during a debriefing is important. How they store and retrieve the information...
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