g. a child, someone related to the ambulance crew, someone who sustained gruesome injuries or died), the situation (e.g. danger to ambulance personnel, problems with how the call was relayed), and the EMT/paramedic’s personal response (e.g. feeling helpless) [2-5]. These lists suggest that EMT/paramedics may be able to identify the types of situations that cause acute distress. However, the tantalizing question remains: which acutely stressful CAL-101 cost incidents result in ongoing symptoms and impaired functioning? Inhibitors,research,lifescience,medical Work stress, including the effects

of critical incidents, burdens EMT/paramedics and their organizations, and may interfere with patient care. Posttraumatic Stress Disorder (PTSD) Inhibitors,research,lifescience,medical is often associated

with EMT/paramedics’ critical incidents and is found in 12% to 20% of EMT/paramedics compared to a community prevalence of 1-3% [6]. Burnout, depression and anxiety have also been attributed to critical incidents [5]. These syndromes likely contribute to EMT/paramedics’ high sickness-absence rates compared to other health professions [7]. There is also evidence that acute stress in EMT/paramedics increases medical errors [8]. It would be useful to quickly Inhibitors,research,lifescience,medical and easily identify events that are likely to have these serious sequelae in order to take measures to reduce their impact. Objective tools to identify critical incidents which are likely to result in emotional difficulties might also reduce the stigma that EMT/paramedics experience when reporting such incidents, thus facilitating timely support. The first goal of this investigation was to develop an inventory of Inhibitors,research,lifescience,medical critical incident characteristics which are significantly associated with emotional distress at the time of an index critical incident and test the relationship of these characteristics with potential later sequelae, including slower recovery from symptoms of acute stress, and emotional symptoms occurring long after Inhibitors,research,lifescience,medical the incident. The second goal

was to make this inventory as brief and useful as possible by eliminating items which did not add substantially to the strength of the associations which were found. We chose to study both recovery from acute stress symptoms soon after a critical incident CYTH4 as well as occurrence of later emotional symptoms, because a chain of events may follow a critical incident. First, events which are appraised to be a greater threat than one has the resources to handle effectively elicit distress through an iterative process of appraisal, response and reappraisal [9]. Immediate (peritraumatic) distress may lead to the Acute Stress Reaction [10], which commonly includes physical arousal, distressing emotions, irritability, impaired sleep and social withdrawal, and usually returns to normal within hours or at most a few days.