title: Critical incident stress intervention after loss of an air ambulance: two-year follow up.
abstract: OBJECTIVE
  Following an air ambulance crash with five fatalities, critical incident stress debriefing (CISD) was provided for involved paramedics, physicians, and nurses. A study was conducted to evaluate the long-term effects of a critical incident with critical incident stress debriefing according to the Mitchell model.
  
  
  METHODS
  Six months following the incident, empirically designed questionnaires were mailed to all transport paramedics and directly involved medical staff, and a random sample of both nurses from the dispatch/receiving institution and paramedics from around the province. Twenty-four months post-incident, all members of the transport paramedics completed the Impact of Events Scale and the General Health Questionnaires.
  
  
  RESULTS
  There were no differences between groups on any scores, except for disturbed sleep patterns, bad dreams, and the need for personal counseling being greater among transport paramedics at one day. There was no correlation between how well the deceased individuals were known, amount of debriefing, and symptom severity. A trend was seen for those with pre-existing stress management routines to have less severe symptoms at six months (p = 0.07). At two years, 16% of transport paramedics still had significant abnormal behavior.
  
  
  CONCLUSIONS
  CISD did not appear to affect the severity of stress symptoms, whereas having pre-existing stress management strategies may. These findings give justification for proceeding to a randomized, controlled trial of different levels of critical incident stress intervention.
authors.affiliation: Paediatric Transport Program, British Columbia Children's Hospital, Vancouver, Canada.
authors.forename: A J
authors.initials: AJ
authors.lastname: Macnab
authors.forename: J A
authors.initials: JA
authors.lastname: Russell
authors.forename: J P
authors.initials: JP
authors.lastname: Lowe
authors.forename: F
authors.initials: F
authors.lastname: Gagnon
mesh_terms: D000060:Accidents, Aviation; D017732:Air Ambulances; D000488:Allied Health Personnel; D003419:Crisis Intervention; D005500:Follow-Up Studies; D006801:Humans; D013315:Stress, Psychological / Q000517:prevention & control*