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The importance of critical incident debriefing in preventing psychological injuries

SafeWork NSW has recently circulated information highlighting the risk of crush injuries, as a result of two fatal incidents where truck drivers have died while working on or near their trucks. And it got us thinking… what about the psychological injuries caused to others who are unfortunate enough to witness incidents like these?

 

History tells us that high risk industries are almost guaranteed to succumb to a worker fatality at some point.

 

As of the 6th of June there had been 64 Australian workers killed at work in 2019. In 2018, that number totalled 157.

 

What history also tells us, is that for those who are exposed to or involved in a workplace incident, the first two hours are critical in assisting workers deal with their physical and emotional reactions.

And the reason being is because exposure to critical incidents can lead to significant distress; recurrent thoughts, anxiousness, mood changes, restlessness and shock. And gone untreated, distress can lead to long-term physiological issues such as Acute Stress Disorder or Post Traumatic Stress Disorder.

By providing really early intervention to a fatality or major incident on site, psychologists can counsel workers to assess their current state of mind, diagnose shock and determine if they are at risk of developing long-term psychological injuries.

Here are five critical incident management tools to assist in supporting workers:

1. If you’re in a high risk industry, prepare workers for a possible critical incident:
• Develop procedures for responding to and identifying critical incidents and ensure staff are educated and aware of procedures
• Contract suitably qualified safety consultants with experience in critical incidents and critical incident management
• Asses the workplace for safety hazards and ensure all necessary PPE is available

2. Demobilisation (rest, information and time out) is the best way to calm workers following a critical incident, ensuring their immediate needs are met as soon as possible:
• Convene with all workers, summarising the incident and clarify any uncertainties (ensure all workers have the opportunity to ask questions)
• Provide Psychological First Aid (supportive and practical assistance via assessing needs and concerns, ensuring basic needs are met and connecting people with information)
• Provide a course of action moving forward, and alter workplace responsibilities and roles where necessary

3. Defusing (immediate small group support) should be conducted by a qualified employee or external contractor and is an opportunity for workers to review the event, talk about what happened, receive advice and support. Defusing should take place within 12 hours of the critical incident occurring.

4. Debriefing as a group should take place approximately one week after the critical incident. It is an opportunity for workers to put things into perspective once they’ve had a chance to process what has happened. Often a knee-jerk reaction to a critical incident will be that ‘I don’t need to talk about it’, but often within a few days the worker may find that they are now experiencing other psychological or physical issues as a result. Debriefing allows a qualified counsellor or safety expert to assess the risk of long-term psychological injuries, determine if acute stress is present for individual workers, and can provide management techniques and tools to handle emotional reactions.

5. Follow-up support is key in psychological injuries; shock around trauma is known to manifest over time and can worsen if not addressed or spoken about. If workers find that their shock builds momentum, they are losing sleep, having recurring thoughts of the incident and are struggling to move on with every day duties, this may be a sign of a psychological injury such as acute PTSD. Workers who expressed significant concerns at earlier stages of the critical incident management process should have continual follow up support with a trained professional.

When it comes to preventing the onset of shock, and potentially acute stress or PTSD, after a critical incident, it’s recommended that all workers be involved in the critical incident debriefing process. Although many workers will be able to return to normal duties within a short time frame, if not immediately, it’s important to note that serious accidents are one of the leading causes of PTSD in Australia. But more importantly, it’s treatable and, with the right help, avoidable.

For more information or help with regards to critical incidents and psychological injuries, see our Work Health Safety Services or call 02 9957 1300.

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