Psychological disequilibrium in pedatrics (Kids see bad stuff and freak out)

[Whocares]

Perhaps these are part of the legacy of He Who Shall Not be Named which deserves a revisit. A 12 or 14 year old cadet has no business approaching a crash or other emergency site where casualties and/or fatalities exist.

You may not, I may not, but until it is changed at NHQ, the choice is up to the GTL, GBD, or IC.  The question that comes is where and how do you draw the line? 

At the same time, we are only talking of crashed airplanes, what about DR, Missing persons, etc.  How do you limit the scope of cadets participating in ES?

How do you measure or otherwise determine if a person (cadet or SM) is capable of handling real world ES?  What happens when the only SM freaks out?  What happens if every one freaks out? 

Should we mandate a release signed by the parents stating that is possible for their child to see and partiicpate in possible hazardous situations? 

Out of curiousity, who exactly is responsible for pyschological care if someone does break down?  Does the USAF pay for it since it is one of their missions?  the member?  I wonder.

[SARMedTech]

Another interesting question. I suppose if a SM saw something so horrific that they ended up needing mental health care, you could say to CAP " I got this way doing your missions for America." But I also suspect that their answer would be "Well..thanks...but you knew what you might be facing and weren't REQUIRED to go."

To paraphrase what Barack Obama said in Pennsylvania last night: get in trouble, and you're on your own.

I do like the line of your thinking though.  As for me, being involved with a Composite Sqdn, Im going to do my utmost to keep cadets away from things which could do them mental or emotional harm, and having been a mass casualty EMT for several years now, I know there are lots of things I would rather not have seen, let alone if I had been a 14 year old.

[flyerthom]

I was kind of scared of this. I didn't want this to be a discussion of limitation of adolescent capabilities based on opinions. I wanted to know what information a commander or GTL would find useful in determining whether a cadet in their stead is ready, what symptoms to look for in traumatic exposure, and mitigative efforts. Please give me at least a few things you'd like to know before this degrades into an argument of capability (noting that this is an issue of concern I will address).

How they are trained. Not just CAP but outside of CAP. As I remarked previous, training is mitigating. Also if you can get a copy of Mitchell's CISM books they can give you signs/ symptoms of stress issues. A perusal through articles in JEMS magazine as well as Firehouse and ENA's journal should have some good resources.

[Eclipse]

Bob,

1.  Many cadets (especially GT members) are adults.

Legally, yes. In the eyes of the program, no.  A cadet, regardless of age, is preparing to accept the responsibilities of adulthood, but for whatever reason (opportunities, inability, inertia, etc.) has chosen
not to accept those responsibilities.  Within the program, they must be protected equally, whether 12 or 21.  If they don't like that, it is time to transition.

2.  Why is it OK to "emotionally harm" senior members, but not cadets?

"Adults", by whatever definition you choose, are legally able to accept personal responsibility for themselves, cadets are not "adults" in the eyes of the program, therefore they cannot.

With a note to lordmonor above, the fact that someone would have died is besides the point.  And yes, if we do not have enough senior members to properly staff our ES teams, then its time to stand down until we do.

[lordmonar]

This is all off topic...can we get a split...because I think this particular issue should be discussed.

[sandman]

So, in a recent meeting the issue of a cadet who came upon a crash site on a mission and had a bit of a bad reaction to it came up. There was a discussion about how teenagers perceive a disaster and cope with its effects. More pointedly, it was discussed whether cadets can handle seeing a smoking hole. Granted, put a twelve year old in this situation is probably a bad idea. The literature shows that adolescents up to the age of 16 can be vulnerable due to cognitive development and the capability to cope with the state of psychological disequilibrium we all feel when we see something that far out of the norm.

Considering that a lot of people were able to give anecdotal evidence showing 17 year olds who couldn't handle it and 14 year olds who did just fine, and the fact that I just got done writing a sizeable research paper for my masters on the very topic, I've decided to pony up and distill that sizeable paper into a useable briefing for senior leaders. My question is what, as commanders and ground team leaders, would you like to know about the subject? There's literally tons of research on this subject, but what would be really helpful to you all?

I'm looking for questions, best practices, and a few anecdotes. The anecdotes are to be used as supporting evidence to best practices or pitfalls. I don't want the document to turn into a long discussion on what happened to people so much as a way to prevent future occurrence or mitigate the effects. Also, out of common decency and a sense of non attribution, please do not relay an anecdote on the board that can be tracked back to a single person by a particularly savvy reader. If information needs to be spread of this nature, PM me directly.

I will post this on cadet stuff later (both in the adult board and the general access boards). Thanks in advance for all your help!

Capt. Hiles

I think you have a good topic here and could be a good tool (if and when developed as such) for CAP health service officers to use to better advise GTL's and squadron CO's. Perhaps a screening tool for cadet participation?

/r

LT

[chiles]

I figured I'd write two versions of it. One for the HSO, the other for the commander. Like most CAP documents (or CAP sanctioned documents), I'll have to walk that fine line between doctrine and suggestion. I wanted to include a tool, as well. Preferrably something written by a specialist and in the public domain (I've found a couple). I'll post whatever I develop up here for comment. I hope to have them posted on my Wing's website once completed and signed off on by all the legal and command folks. I appreciate the comment and encouragement!

[sandman]

Sounds good. You have a big project ahead of you if you really follow up on this. Perhaps even a doctorate thesis!

Keep up the good work!

/r
LT

PS

Add link to your wing website when you have this up and running!

[flyerthom]

Sounds good. You have a big project ahead of you if you really follow up on this. Perhaps even a doctorate thesis!

Keep up the good work!

/r
LT

PS

Add link to your wing website when you have this up and running!

Ask over here too:  http://groups.yahoo.com/group/CAP_HEALTH_SERVICES/

[chiles]

I've been on that list for about 2 years (and it's been dead save for Penny's CDC updates). I'm going to hit them up when I have a first cut of it so I can get specific comments.

[flyerthom]

I've been on that list for about 2 years (and it's been dead save for Penny's CDC updates). I'm going to hit them up when I have a first cut of it so I can get specific comments.

Yea, it was pretty active when it began but since the specialty track got sidetracked (rimshot) it's slower than an ER waiting room. This might kick start it. If Dr Greenberg is still about he had some stuff on Suicide prevention started.

[chiles]

Just an update, I've finished researching the subject and there is a lot of material out there. Once I knock out the last two papers for one of my masters classes, I'll focus on this project and will have a draft completed soon after. If anyone wants to be a guinea pig... errr... reviewer, please PM me with your information. Thanks!

[ThorntonOL]

Not being nitpicky here but 21 is considered adult in CAP from either aspect. (cadet or senior)
18-20 would be cadets.

[TEAM SURGE]

If you ask me, everybody in life is going to see death at least once in there life. I don't see how seeing a dead body is such a big deal!

[mikeylikey]

Lets also not forget that some 17 year old kids are currently fighting a war.  So I can see where coming upon a dead person at 12 years old could be more traumatic than doing the same at 18.  

I hope no one here ever has to come upon a crash scene where there were no survivors.  However in our line of volunteer work, that is a big possibility.  That is why there is a system in place to immediately address members that do walk upon that scene.

I am very interested to read your thesis.      

[mikeylikey]

If you ask me, everybody in life is going to see death at least once in there life. I don't see how seeing a dead body is such a big deal!

It all depends.  Some handle it well, while others do not.  You can not honestly know how you will react until you actually react.

I had 50 year old NCO's breakdown and cry after two weeks in Afghanistan, while I had 18 year old Privates appear not even phased. 

What is more important is the attitude after the traumatic event.  If the person goes out in search of more of the same bad experience, they are messed up in a real bad way.  If they show emotion and a sense of afterthought that is expected of civilized people, they will most likely overcome the experience. 

Immediate attendance to the traumatized individual is so important.  I think that is something CAP has been proven to do very well for Cadets. 

[TEAM SURGE]

If you ask me, everybody in life is going to see death at least once in there life. I don't see how seeing a dead body is such a big deal!

It all depends.  Some handle it well, while others do not.  You can not honestly know how you will react until you actually react.

I had 50 year old NCO's breakdown and cry after two weeks in Afghanistan, while I had 18 year old Privates appear not even phased. 

What is more important is the attitude after the traumatic event.  If the person goes out in search of more of the same bad experience, they are messed up in a real bad way.  If they show emotion and a sense of afterthought that is expected of civilized people, they will most likely overcome the experience. 

Immediate attendance to the traumatized individual is so important.  I think that is something CAP has been proven to do very well for Cadets. 

Well true, like my dad deployed 3 times to Iraq, he says it's not that bad.

Your right it does depends on who sees it. I mean personnally I can walk up to a crash sight, no problem. Younger, or more sheltered or, cadets who have never seen anything traumatic like that will break down, cry. It really just depends on who and what you have experienced.

I just recently learned about the programs that CAP has to offer cadets who were traumatized by something like this. For a volunteer program, thats impressing!

[SARMedTech]

If you ask me, everybody in life is going to see death at least once in there life. I don't see how seeing a dead body is such a big deal!

Yes, youre right. Most people will see death at some point and for most, it will probably be in a funeral home. Most people just dont have to get up close and personal with it.  I'll be starting my paramedic training in September and if its anything like EMT school, we will get part way through and then when we stop looking at simulations and photos of mocked up injuries and  get to the part of the training where we are having state troopers stand with sheets around a dead body on an interstate so no on sees the casualty that doesnt have to,we will probably start losing people whose stomachs and/or psyches simply will not allow them to process the kinds of things that we have to deal with regularly.

Most of the people in my class will be above the age of 21 and about 50% will have some kind of medical experience under their belts.  There just isnt any valuable, learning based reason to expose 12 or 14 year olds to the kind of "gore" that older and more mature emergency responders might have trouble with.  A good suggestion:  if it makes a SM turn grey and/or puke, its a good idea to keep kids away from it. They simply do not have to coping mechanisms to turn that kind of thing off after a couple of days.  In fact I have met alot of SMs and other responders of various kinds that dont have the required type of fortitude for it or are not able to "situationally numb" themselves to get through the task at hand and then go have a good cry or talk to their priest of whatever it is that they do.  Personally, what does it to me are disaster scenes involving babies and children. But what I have that a 12 year old doesnt is a wide variety of options in terms of how I may choose to handle the "film that wont stop playing."

When you start playing with the minds of young teenagers just because there arent any regs that say you cant, sure as shooting you will have a problem, a lawsuit or both.  Exposing CHILDREN to the most horrible things that the world has to offer has nothing to offer in terms of helping them grow and develop as mature and well adjusted adults and has EVERYTHING to offer in terms of stunting their development or winding them up in a state home for a stint dosed up on Vitamin "H". No, I dont believe they are wilting flowers, but there are kids in Columbine that never went back to school and they closed the building where the shootings happened at NIU and those "youngsters" mostly had a few years on the theoretical 12 year old cadet.

[Fireball]

     Different people react differently. Period. I have had cadets that were not phased by anything in ES (on beginning training I have painted a worst  case encounter scenario to them and their parents). On the other hand, I've seen adults blanch at the mere mention of blood.
     In addition to my job as a machinist, one of my duties is a volunteer First Responder at work. I have seen more than my share of lacerations and broken bones, so I've become pretty thick skinned. I had an experience the other day that really brought home the fact that everyone reacts differently. A couple of other Responders and I were sitting with other machinists at break. We started discussing the most recent "event" (bad cut, severe bleeding)  from the aspect of clean up, no mention of names or specific details. All was well, we talked of bleach and disposal, then I mentioned that blood seeped into a machine panel, necessitating the removal of the panel to properly cleanup. On the mention of blood, one of the other machinists (non responder, a tough biker type) abruptly got up, threw his snack in the trash and left the break room. We did not go into gory detail, all I said was "if we had not removed that panel, blood would have seeped out the rest of the day". Just one word, blood, and a 42 year old went off. Now I have always made a concerted effort to be polite and not upset non emergency personnel with lots of detail.  That just emphasised to me that everyone reacts differently and not to judge a book by its cover or age.

[Flying Pig]

Ive dealt with this in the manner of being a cop and having explorers ride with me.  I have been on several gnarly accidents, some involving children.  Sometimes, because I may the the first or second unit on scene, a 14 year old explorer may end up standing right next to me dealing with someone screaming in pain, or completely smashed in the seat of their car.  If I have any control over where the explorer goes, its at the intersection laying down flares or something.

Ive never had one break down on me, but I had a couple ask to be done for the night. You can see it in their face.  They try to play the part because they all want to be police officers some day, and don't want to look like a "kid" in front of the guys.  But you realize, they just seem to be in deep concentration, while all of the officers are headed off to their next call, or telling jokes over a cup of coffee.

As a training officer, a primary training tool is to take every call you can squeeze in.  This involves going to traffic accidents. I had a trainee who was older.  We rolled up on a roll over accident of a car load of High School kids who were pretty badly injured, all laying in the street.  The driver was pinned in and the gas tank was ruptured.  (Yeah, I know sounds like a made for TV movie)  He jumped out of the car, paused for a second and  said "Oh S$%^!"  He then shook it off and got the job done.

So as far as cadets dealing with trauma, I don't know how many here have actually seen a plane crash with bodies before, but its almost surreal.   I mean, there are pieces of people everywhere!  Not that it doesn't affect adults, I think we have just developed our ways of dealing with what we see to where it less obvious that we are affected.  This is where the famous "sick sense of humor" cops and EMS people get.  Outsiders see it as insensitive,   but I think its more of a way to talk about it with your buddies and vent ad still be able to not loose it.

I tell newer officer now, that when it comes to accidents or trauma situations, that they need to go on them to get over the shock of it.  They need to be able to know what to expect for the times when they are the first on scene.  After they are familiar with it, go if you are needed.  There is no need to rubber neck because someday you are going to see something you wish you hadn't.