Support for Family & Friends
Critical Incident Stress: Supporting those you love.

If a Paramedic or Emergency Dispatcher is someone you love – you are likely already aware of the emotional and psychological demands of their work. Paramedics and dispatchers manage critical and traumatic events as part of their everyday duties. Exposure to a critical, traumatic or high stress incident can result in critical incident stress (CIS) for your loved one. Critical incident stress is a normal reaction to an abnormal event. Critical incident stress is manifested and managed differently for everyone. You can help your loved one by knowing the signs and symptoms of CIS and knowing what resources are available to them when they need some extra help.

Operational Stress Injury: What is that?

An operational stress injury (OSI) is non-clinical term that refers to a psychological injury that results from events and duties performed at work. Although the most well-known OSI is post-traumatic stress disorder (PTSD), a psychological injury can manifest in many different ways and degrees of severity, including anxiety, depression and substance use disorder. An OSI can develop as a result of a single traumatic event or continued exposure to high stress situations causing operational fatigue. Through healthy and appropriate management of critical incident stress, we can manage and protect ourselves and our loved ones from an operational stress injury.

The Signs and Symptoms: What does CIS look like?

Family members and close friends are often the first people to notice a change in their loved one’s behaviour or mood. Knowing the signs and symptoms of critical incident stress will help you to recognize when your loved one is being affected. Signs and symptoms can by physical, behavioural, emotional and/or cognitive. Your loved one may experience one or more symptom at a time, with presentation ranging from subtle to obvious.

Physical Emotional

  • Nausea, vomiting or GI problems
  • Exhaustion/lethargy
  • Chest pain
  • Palpitations/racing heart
  • Shortness of breath
  • Headaches
  • Fainting (syncope)/dizziness
  • Frustration
  • Guilt
  • Anxiety
  • Depression
  • Irritability
  • Isolation
  • Anger
  • Lack of control or inhibition
Behavioural Cognitive
  • Changes to the following:
    • Eating habits – either an increase or decrease in food consumption
    • Sleep patterns – a significant decrease or increase in the amount of daily sleep
    • Substance use – an increase in the use of alcohol, tobacco or other substances
    • Sex drive – either a significant increase or decrease
    • Daily routine –  including a decrease or increase in exercise, activity level, social engagements etc.
  • Emotional outbursts
  • Restless
  • Hypervigilance
  • Difficulty relaxing
  • Confusion
  • Flashbacks
  • Poor concentration/easily distracted
  • Loss of self-confidence
  • Nightmares
  • Memory disturbances
  • Decreased attention span
* Signs & symptoms source:

Resources: Where can you go for help?

If you recognize the signs and symptoms of critical incident stress in your loved one, you may find the need for more help. Below is a list of resources available to BC Paramedics and Emergency Dispatchers and their family members.

Critical Incident Stress Management (for BCEHS employees):

This resource gives you access to both peer support and a network of clinical trauma psychologists.

Homewood Health Solutions Employee and Family Assistance Program (for BCEHS employees and family members):

This resource is available to all BCEHS employees and their immediate family members and provides counselling and a variety of services.

BC First Responder Mental Health – “Share it, don’t wear it”

This website was created for first responders by first responders and stakeholders. Here you can
find tools for self-assessment and gain access to further resources to help your loved one.

The Canadian Institute of Public Safety Research and Treatment (CIPSRT)

CIPRST is committed to the protection of Canadian public safety officers’ mental health. Their website contains self-assessment tools, resources for finding a therapist and crisis information for suicide prevention.

Alcohol or Substance-use Related Resources:

Al-anon Family Groups – “help and hope for family and friends of alcoholics”
Nar-anon Family Groups – “a 12 step program for family and friends of addicts”
bc211 – a non-profit organization that specializes in providing information and referrals regarding community, government and social services in BC including Alcohol and Drug Information Referral Services and Problem Gambling Help Line.
Call or text 2-1-1 on Vancouver Island/Gulf Islands and in the Metro Vancouver, Fraser Valley, Squamish-Lillooet, and Sunshine Coast regional districts to talk with an Information & Referral Specialist. This service is free, confidential, multilingual, and available 24/7.

Stigma: Overcoming obstacles
Paramedics and Dispatchers are trained to help others in their time of need. Sometimes, it can be hard for those that are used to being the “helper” to reach out and ask for help themselves. Unfortunately, there is still a stigma surrounding mental health both in the public at large, and in the first responder community. First-responders may fear that asking for help or exhibiting an emotional response following a critical or traumatic event is a sign of weakness. Nothing could be further from the truth – it takes strength to protect and help others and to protect and help yourself.

Let your loved ones know that their response to critical and traumatic events are normal. That is what critical incident stress is – a normal response to an abnormal event. Allow and encourage your loved one to talk about their experiences – let them express emotion as necessary. For many first responders, friends and family are their first point of contact and resource – it is important they feel supported.

Check out these resources on ending the stigma and supporting your loved one:

British Columbia Emergency Service – “Supporting the First Responder in Your Life”
Bell “Let’s Talk” – 5 ways you can help end the stigma
Here to Help – “Supporting a Friend of Family Member with a Mental Illness”
BC First Responders’ Mental Health – “Looking to Help”

More Resources