title: Frozen moments: flashback memories of critical incidents in emergency personnel.
abstract: BACKGROUND
  Emergency Department personnel regularly face highly stressful situations or critical incidents (CIs) that may subsequently be recalled as unbidden intrusive memories. In their most extreme form, such memories are reexperienced as if they were happening again in the present, as flashbacks. This study examined (1) which CIs are associated with flashback memories; (2) candidate person and work-related features that predict flashback memories; and (3) the association between flashback memories and anxiety, depression, and emotional exhaustion.
  
  
  METHODS
  Emergency nurses (N = 91; 80.2% female) were recruited from two urban teaching hospitals and filled in self-report questionnaires.
  
  
  RESULTS
  A majority (n = 59, 65%) experienced intrusive memories; almost half of the sample reported that their memories had flashback character. Those involved in resuscitations in the past week were at a fourfold risk for experiencing flashbacks. Having worked more consecutive days without taking time off was associated with a somewhat lower incidence of flashbacks. Moreover, older individuals who reported more work-related conflicts were at greater risk for experiencing flashback memories than their younger colleagues with heightened work conflict and flashback memory scores, respectively. Flashback memories were associated with heightened symptoms of anxiety, depression, and emotional exhaustion.
  
  
  CONCLUSIONS
  The present findings have implications for evidence-based health promotion in emergency personnel and other individuals regularly exposed to CIs.
authors.affiliation: Department of Experimental Psychotherapy, University of Zurich Zurich, Switzerland ; Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Zurich Zurich, Switzerland.
authors.forename: Birgit
authors.initials: B
authors.lastname: Kleim
authors.affiliation: Department of Emergency Medicine, University Hospital Basel Basel, Switzerland.
authors.forename: Martina-Barbara
authors.initials: MB
authors.lastname: Bingisser
authors.affiliation: Department of Psychology, Pace University Pleasantville, New York ; New York State Psychiatric Institute, Columbia University New York, New York.
authors.forename: Maren
authors.initials: M
authors.lastname: Westphal
authors.affiliation: Department of Emergency Medicine, University Hospital Basel Basel, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Bingisser
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety; D003220:Conflict, Psychological; D003863:Depression; D004632:Emergency Medical Services; D005221:Fatigue; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008568:Memory; D009726:Nurses / Q000523:psychology*; D057566:Self Report; D011795:Surveys and Questionnaires; D014505:Urban Population
keywords: Anxiety; burnout; depression; emergency department; emotional memory; flashback; intrusion