Episode 171 S5-8
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The term PTSD stands for Post Traumatic Stress Disorder. This is a condition resulting from emotionally disturbing situations. To label anything a "disorder" can make people feel that they have some kind of sickness. This disorder stems more from an injury rather than a biological shortcoming. Thus the name is being altered to PTSI or Post Traumatic Stress Injury.
PTSI happens when a person's emotional coping mechanisms fail. This can result in a negative coping behavior that can affect the individual on a long term basis. This can stem from a biological injury after a traumatic event. PTSI results from long term exposure to emotionally compromising situations. It presents itself as flashbacks, nightmares, day mares or general interference with an individual's daily life.
When you are in stressful situations, your body reacts with a flight or fight mechanism. The body physically and mentally prepares to handle a potentially dangerous situation. Physical responses include pupil dilation, heart rate increase, adrenaline release, etc. This survival mechanism is meant for short term periods of time to protect the individual. When this condition is triggered over and over it can result in long term problems or PTSI.
PTSI can present itself differently in children and adults. Each individual is different and the reactions will depend on the individual as well as their age. Smaller children can't put themselves in other people's shoes as well. They have a hard time understanding the ramifications of a situation in other people's lives. They only focus on how it will protect their lives. This age tends to take on personal blame for things that happen. They feel they caused the trauma somehow.
During a traumatic event, all children may revert to behavior that they displayed as a younger child. It is a way of coping by relying on behaviors that made them feel safe and comfortable in the past.
Older children may become angry, aggressive or withdraw from life. Some may want to talk and some may not. They will depend heavily on their caretakers to support their emotional being. In addition, they may mimic the behavior of the parents. As a parent or caretaker, you must be careful not to feed your children gloom and doom. Don't refer to traumatic events as life ending. Try to see a way through it that you share with your children. They will follow your behavioral patterns.
There are certain changes in your child that you can look for to indicate that they may be suffering from PTSI. It is normal for anyone to exhibit short term behavioral changes after a traumatic event. However, if these changes become long-term patterns, the child may be suffering from PTSI. Also, it may take a while for the child to show signs of PTSI. Some of these changes include:
eating and sleeping problems
sensitivity to sound
acting-out/unwillingness to cooperate
they may try to act tough
children may regress: bed wetting, want to be held, teenagers may cry for parents.
May take a while for them to feel safe in their home
protective behavior - they want to protect themselves and you
Try to make kids part of any process. Younger kids may be more resilient to traumatic events. Kids that hold things inside are more at risk.
There are ways you can help your child. Try to stop symptoms before they develop into PTSI. Set up time to discuss the event. Sit down with your child and use appropriately aged material. Use a soft calming voice and a gentle touch when talking with them. Try to understand their feelings. Give them a chance to vocalize them and don't dismiss them. Talk about your feelings. Let them know it is normal to feel mixed up about a traumatic event. Don't make promises to them that you can't keep.
Engaging in physical expression with children is a great idea. Let them draw to express emotions. Imaginary play with stuffed animals is another great way to release emotions.
If a child become belligerent, talk to them about your personal experiences. Let them know that they have a right to their feelings, however, inappropriate behavior effects everyone. Show them that they are a role model for younger children and how their behavior will be mimicked. Do not alienate them or allow them to alienate themselves.
If they are depressed, continue talking about it. Extreme depression can alter an individual's ability to cope. If they regress, allow them to express their feelings and give it time. Be as consistent as you can with their schedule. Give them a job to do so that their feelings of helplessness and uselessness are minimized. Have children write letters to helpers and first responders.
After a long term disaster, each individual will be effected differently. Background education of the individual can make a huge difference. Did you give the child the ability to take care of themselves? Did you encourage them to be adaptable? Did you explain that unforeseen circumstances may come up and there is a game plan they can use to survive it?
Be aware of a child's normal coping mechanisms. Are they healthy outlets or could you assist them to develop more constructive ways to handle trauma?
Children that survive long term traumatic events may have decreased impulse control. They will have an increased risk of depression and suicide. Let them know that there is a family plan and a community plan designed to keep them safe.
Explain to them that you are strong so you can protect them but that doesn't mean that you don't have feelings too. Let them in so they can understand that you recovered and that means they can too.
Make sure your children have a role to play in a traumatic situation. Run drills and make them fun for the family to practice. Let them have a responsibility that they are in charge of. Educate them on what to do before a traumatic event happens. Do not sideline your children when disaster hits. This will make them feel useless and helpless. Listen to them and allow them to contribute to the family recovery plan.
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Sam Bradley, MS, EMT-P, has been in EMS for 38 years as a Paramedic, Clinical and Educational Services Coordinator and ambulance company paramedic field supervisor. She also spent many years as an EMS educator. Sam currently works as a QI consultant and EMS educator for fire departments and communications centers. A prolific writer, she does freelance work for EMS related journals, online publications and textbook publishers. Sam has published a number of fiction stories and is very involved in social media and blogging. Following her passion for disaster EMS, she is the Training Officer for the federal Disaster Medical Assistance Team (DMAT) CA-6. She also dabbles in photography and videography. She is currently residing in Colorado and spends her time working on EMS CE content and writing EMS textbooks and novels. She co-hosts a popular weekly podcast that is in its fifth year. She loves dogs and banana cream pie.
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