Macnab A J, Russell J A, Lowe J P, Gagnon F
Paediatric Transport Program, British Columbia Children's Hospital, Vancouver, Canada.
Prehosp Disaster Med. 1999 Jan-Mar;14(1):8-12.
Following an air ambulance crash with five fatalities, critical incident stress debriefing (CISD) was provided for involved paramedics, physicians, and nurses. A study was conducted to evaluate the long-term effects of a critical incident with critical incident stress debriefing according to the Mitchell model.
Six months following the incident, 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.
There were no differences between groups on any scores, except for disturbed sleep patterns, bad dreams, and the need for personal counseling being greater among transport paramedics at one day. There was no correlation between how well the deceased individuals were known, amount of debriefing, and symptom severity. 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.
CISD did not appear to affect the severity of stress symptoms, whereas having pre-existing stress management strategies may. These findings give justification for proceeding to a randomized, controlled trial of different levels of critical incident stress intervention.
在一次导致5人死亡的空中救护飞机坠毁事件发生后，为参与救援的护理人员、医生和护士提供了危机事件应激晤谈（CISD）。开展了一项研究，以根据米切尔模型评估危机事件应激晤谈对危机事件的长期影响。
事件发生6个月后，将根据经验设计的问卷邮寄给所有运输护理人员和直接参与救援的医务人员，以及调度/接收机构的护士和全省护理人员的随机样本。事件发生24个月后，所有运输护理人员完成了事件影响量表和一般健康问卷。
除了事发一天后运输护理人员的睡眠模式紊乱、噩梦以及个人咨询需求更为强烈外，各群体在任何得分上均无差异。对死者的熟悉程度、晤谈次数和症状严重程度之间没有相关性。有迹象表明，已有压力管理常规的人员在6个月时症状较轻（p = 0.07）。在两年时，16%的运输护理人员仍有明显的异常行为。
危机事件应激晤谈似乎并未影响应激症状的严重程度，而已有压力管理策略可能会有影响。这些发现为开展不同水平危机事件应激干预的随机对照试验提供了依据。
