Sometimes, when preparing to render aid at the scene of an accident, the greatest challenge is not the physical condition of the victim, but the emotional condition of the victim or bystanders. Moderate panic should be expected on any scene and will generally subside when someone confidently assumes a leadership role and begins to assist the injured person. Panic that does not subside not only distracts, but, in severe cases, threatens the safety of the panic-stricken, bystanders, and the rescuers themselves.

In times of fear or arousal, the adrenal medulla secretes the hormone epinephrine, or adrenaline. This secretion acts as a powerful stimulant which increases breathing, heart, and metabolic rates, constricts blood vessels, and strengthens muscle contraction. It's like adding an octane booster to your gas tank - you become supercharged, ready to take action. It creates what is commonly called the "fight or flight" reaction. This extra power, by the way, can come in handy when you need to jump over a deep, dark crevasse or run from a ferocious grizzly. It can be a real hindrance when the only thing you have to do is stand around with your hands in your pockets. All that energy has to go somewhere. Right? Some folks will panic, or even become hysterical to the extent that they experience emotion-induced paralysis.

Kate Dernocoeur, EMT-P, (Rescue, January/February 1990), recommends a technique called "repetitive persistence" to help panicky people return to a calmer emotional state. "Repetitive persistence" involves selecting the message you want the subject to hear and then repeating it over and over until the message is received. She gives the following examples: "Mrs. McCarthy, you're going to have to calm down so we can help your baby," or "Please settle down, Mr. Lee, so we can assist your wife."

Here, in Ms. Dernocoeur's words are five principles to keep in mind when using "repetitive persistence":

1. Make each repetition identical to the last. Keeping the message consistent creates a "gentle hammer" to knock against the hysteria.

2. Use the victim's name. A person's own name may be the first bit of reason to penetrate the hysteria, and improved self-control may quickly follow.

3. Use positive phrasing. Repeating negative words such as "can't," "don't," or "won't" can be self-defeating and sound authoritative.

4. Be patient. it may take only two or three repetitions to achieve the desired result. It may take a few more. In any event, facing the hysteria at the outset results in a smoother scene.

5. Be tolerant. Remind yourself that hysteria is a loss of control; the person is not so much unwilling as unable to gain control.

END OF ARTICLE 

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