Management of post-incident trauma: a fire service perspective.

Post-incident trauma relates to the results of exposure to death and destruction. It has specific features relating both to the incident and symptoms it produces. Reactive symptoms occur in most people in the immediate after-period but rising or persisting anxiety towards the end of the first week indicates a risk of a serious disorder developing. Management should start immediately after the event and is a three stage process. Immediate management involves de-briefing and peer group support of the participants in the incident. For those who continue to experience rising or persisting anxiety after the first week, referral to occupational health advisers, welfare/counsellors or general practitioners is necessary and, if symptoms persist or recur, tertiary referral to specialist advisers such as psychologists or psychiatrists may be required. The most important factor in the treatment of post-incident trauma is to acknowledge its existence. Whilst the coping mechanisms are well established in theory, they require widespread implementation in practice.