DALLAS — Dr. Stefan Poloczek, the medical director for the Berlin Fire Brigade, spoke at the 20th Annual EMS State of the Science: A Gathering of Eagles meeting. He discussed the terrorist attack at the Berlin Christmas Market in December 2016 and how he used his experiences in the days, weeks and months after to build a 10-point checklist focused on post-disaster resiliency.
Memorable quotes on post-disaster resiliency
Here are some of Poloczek’s more memorable quotes on resiliency:
- “To be honest, we respond better than we train.”
- “I completely underestimated the work after a terror attack and I think [being prepared] is a very important part of resiliency.”
- Because of the nature of their injuries, “people on the scene were awake and dying in the hands of the medics.”
- “Not sure if scene is 100 percent safe, but which scene is 100 percent safe?”
- “Have your shopping list ready” for when you’re offered funding.
Top takeaways on post-disaster resiliency
Here are the 10 items that should be included in a post-MCI checklist for resiliency.
1. Preparation for the next MCI – Cleaning is also psychosocial hygiene
Since you don’t know if the next event will be in a few hours or a few minutes, preparation must begin immediately. Cleaning the blood can then serve two purposes, operational preparation as well as the beginning stages of psychological healing.
2. Defusing and debriefing of all responders
From a big picture perspective, it’s very important to start debriefing immediately. In Berlin, crews took over a hotel lobby near the scene and began the same day. Dr. Poloczek cited the fact that many of the fatalities happened after the medics were on scene, which was extremely distressing for the providers.
Knowing the physical and physiological symptoms of PTSD is also important to providers for understanding that what they are feeling is a “normal reaction to a non-normal event.”
3. Care about commanders – They dictate the decisions
Commanders make one of the most critical decisions after any terrorist attack: determining scene safety such that first responders can begin caring for the wounded. But this puts them at risk for a sort of hindsight bias from their peers due to the high risk nature of the original event.
4. Rumor prevention – Talk about what happened
First responders in Berlin received a fake email warning of a secondary attack. Luckily, no one saw the email until the next morning. Even with trying to control the rumor mill, some still believed there was a secondary attack.
5. Take part in memorial ceremonies – Be aware it increases the workload
It’s very important for the first responders, but also allows the community to see EMS. Thus, you serve a dual purpose by participating and acting as a part of the security plan for these events.
6. Prepare for communication with press and politicians
Media and politicians will all want to speak with everyone involved across the spectrum of EMS from the line level staff, to the commanders, to the physicians.
7. Inform colleagues and other professionals about your lessons learned
After the attack, Berlin leadership hosted a debriefing session covering the lessons learned. More than 350 responders were in attendance.
8. Prepare for the question: Do you need more money?
It’s a great thing to be asked, but it comes fast. The Berlin Fire Brigade was asked only eight days after the attack. If you turn down the money, it will simply be distributed across the other organizations. If you ask for too much, it will make the organization seem unprepared for the actual event.
Also it should be noted to be wary of the organizations that approach politicians offering something that isn’t needed immediately.
9. What’s next?
Prepare for the next event on the horizon. Expect for an extensive response to prevent a repeat attack of the same nature, that may create barriers for normal patient care.
10. Be aware of the anniversary
Not only do first responders have their own emotions surrounding the anniversary, but the public will want to acknowledge the event and the political discussions surrounding the event may center on what could have been done differently.
Additional resources on disaster resiliency
Here are EMS1 articles and quizzes to learn more about post-disaster resiliency:
- Q&A: How can leaders identify and help EMS providers who need support?
- Healing first responders through critical incident stress management interventions
- Treating first responder mental health, addiction, PTSD and suicide
- Peer support for EMS provider mental health
- Use the RESPOND method to assess EMS provider PTSD
- ‘Groundbreaking’ treatment could help first responders with PTSD
- Organization working on new PTSD diagnosis method
- PTSD quiz: Find out if your symptoms qualify
