A Canadian study from British Columbia Children's Hospital finds that Critical Incident Stress Debriefing had no effect on stress symptoms in paramedics, physicians and nurses, while previously established stress management routines did.. Canadian researchers from the Paediatric Transport Program, at British Columbia Children''s Hospital in Vancouver examined the efficacy of Critical Incident Stress Debriefing (CISD) on paramedics, physicians and nurses who were involved in helping with an air ambulance crash with five fatalities.

Six months following the accident, 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.

The study found no differences between groups on any scores, except for, at one day, disturbed sleep patterns, bad dreams, and the need for personal counseling was greater among transport paramedics. There was no correlation between how well the deceased individuals were known, the amount of debriefing and severity of symptoms.

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.

The study concludes that the technique of CISD did not appear to affect the severity of stress symptoms, whereas having pre-existing stress management strategies may.

Citation: Macnab AJ, Russell JA, Lowe JP, Gagnon F Critical incident stress intervention after loss of an air ambulance: two-year follow up. Prehospital Disaster Medicine. 1999 Jan-Mar;14 (1):pp 8-12.