“Mass Casualty Incident- youth group bus turned over on high mountain pass. Report of multiple injuries. Approximately 20 minors and 4 adults on board. State patrol, medical, fire, and mutual aid en-route.”
Arriving on the scene, Scott was hit by the typical wave of chaos that this kind of incident carries. Teenagers with injuries ranging from minor to critical, along with bits of metal and broken glass, were scattered all over the highway pullout surrounding the upside-down tour bus.
Pausing by the young person closest to him as he opened the door to the medical truck, he knelt and attempted to make eye contact with a young girl about 14. Distraught and curled over, head down over her knees, her breathing was rapid and shallow as she clutched her arm tight to her chest- blood dripping between clenched fingers.
“Hey there- my name is Scott. I’m a firefighter with the local fire department and we are here to help you and your friends. Can you look at me? Look at my eyes. I need you to breathe with me as I ask you some questions. I’m going to need to take a look at that arm and find out if there is anything else that is hurting you so we can get you the help you need.”
She looked blankly up at him at first, and then with growing awareness, tears spilled over her cheeks and great gulping sobs shook her entire body.
“Ok, ok- breathe with me, breathe with me. Let’s slow things down here. Count with me- in, 1234, out, 1234. And again- in, 1234, out, 1234. There you go- lets slow that breathing down so we can find out what all is going on.”
Through the course of our service as firefighters and first responders, long before we were aware of stabilizing and grounding tools, we already knew that the effectiveness of our care for others in critical incidents relied on our ability to quickly stabilize and calm so we could gather the information we needed to assess the situation and get the individuals involved to safety.
Even today, as our team responds to crises and disasters around the world, the first step is always to stay calm, regardless of what we might be entering into. A phrase we frequently use as we prepare to enter a crisis context is to “remain the non-anxious person in an anxious environment”.
Staying calm is critical, particularly when the crisis involves children or teenagers. Children already learn from and mirror the responses of the adults around them. In situations where a child’s sense of safety and stability is in question, such as a crisis or critical incident, they will look even more intently to parents and trusted caregivers to assess what response is required for stabilization and safety to return.
Any one of us could find ourselves as a crisis caregiver at any time. We can be tempted only to place what we consider “big incidents”, such as natural disasters or war, into the “crisis” category.
Yet, because trauma is an individual or community’s response to an event, not the details of the event itself, any event or series of events has the potential to be a crisis leading to trauma responses.
Children are uniquely susceptible to traumatic impacts from the events they experience. Their perception of events is very different than adults due to their smaller size, the limited life experience they have to draw from to make sense of and contextualize situations, and the reality that they are only in the early stages of understanding what coping strategies are effective for them. A scary experience with a gorilla at the zoo can result in long-term traumatic impacts where an adult may simply disregard the experience. In contrast, evacuation from a war zone could be particularly traumatic for the adults involved, and children could view the trip as simply an unexpected vacation.
Parents and caregivers must develop and maintain a robust toolbox of care options they can draw from to assist children experiencing and processing crisis events. Developed by the Colorado Department of Health and Education for first responders and medical personnel, the “Engage-Calm-Distract” resource is an excellent one to dig through. It provides various suggestions and tools for children experiencing crises or critical incidents and you can find this resource here: Engage-Calm-Distract.
The Resilience Resource Team has put together a multi-media, online, on-demand course titled “Helping Children in Crisis,” also filled with research-backed, trauma-informed resources to help you and your community practically and effectively support the children you love and care for. You can find more information and register for this course here: Helping Children in Crisis.