Background Critical incident stress is an occupational hazard for medical and emergency services personnel. Programs to alleviate the effects of exposure to traumatic events are increasingly requested, but little evidence supports such interventions which are costly, and may have negative effects .Subjects Infant Transport Team personnel, medical staff, nursing staff, and paramedics experiencing the loss of 5 personnel in an Air Ambulance crash.

Interventions A defusing/debriefing critical incident stress management program as described by J. Mitchell. A symptom course and intervention efficacy questionnaire conducted at 6 months, and the Impact of Events Score (IES) at 2 years following the crash. Results 133 of 155 responded (86%). At 6 months, the most significant stress response was Grief, scoring a mean of 0.4 on a scale of 0 to 3. Those closest to the lost team reported no higher than others. At 2 years, 10 of 19 immediate coworkers(53%) scored >7 on the IES, overall mean 10±11. (mean score for acute exposure=7)

Conclusion Two years following the crash, the event still intruded significantly. A prospective, randomized study of graded intervention would determine optimum intervention, if any, for alleviating critical incident stress.