100
Chapter 24
ANXIETY AND STRESS REACTIONS IN THE
WILDERNESS
Recommendations are considered Category 1B by the WMS Panel of Expert Reviewers
I. GENERAL INFORMATION
Accidental injuries in the wilderness, particularly when severe, are accompanied
by significant psychological distress in victims, other party members, and in rescuers.
Panic and anxiety reactions are common in stressful situations. Other emotions, such as
grief or depression, may also occur. The reactions of victims or witnesses may be so
severe that their safety and that of other party members is compromised.
The incidents that generate strong emotions include: serious injury or death of a
participant or bystander; multiple deaths or serious injuries; serious injury or death of a
child; and incidents that attract unusual attention by the media. Having a person die in
spite of diligent rescue efforts and intensive care is particularly stressful.
An immediate stress reaction is normal, not a sign of psychological problems, and
may have physical, emotional, cognitive, and behavioral components.
II. CARE IN THE FIELD
Medical care for physical injuries, and securing the safety of all party members,
should take first priority following a wilderness accident. But care for anxiety and stress
reactions, which should be anticipated, can begin almost immediately, and should be
given regardless of whether the individual is manifesting signs or symptoms. Some basic
considerations in anxiety management include:
·
Injured persons should be encouraged to talk. They can talk about anything, and may
ramble about totally unrelated events. Gentle encouragement to talk about how they
are feeling at the moment is helpful.
·
The primary role of the psychologic caregiver is to listen and show concern.
·
Realistic, but optimistic, feedback should be provided. Questions must be answered
truthfully, but gently.
·
Injured persons should be encouraged, even pushed, to play as large a role in their
care and rescue as possible to help restore their self-esteem and sense of self worth.
III. MEDICATIONS
Drugs should be avoided if possible, but when needed the drugs of choice for
anxiety reduction are the benzodiazepines: diazepam (Valium®), chlordiazepoxide
