Crisis intervention in the emergency service

the crisis intervention in the emergency service (also: Crisis intervention team, abbreviation for both: KIT) cares for intact involved ones and member with heavy accidents and other emergencies. KIT is frequent, but not always a component of the emergency service and usually by the task forces locally or by the rescue directing center is alarmed. Within some ranges KIT is operated also by the fire-brigade or in the form of independent associations.

Table of contents

term

the designation crisis intervention in the emergency service and the abbreviation KIT as well as the Kit Logo are protected registered trade marks workers of the Samariter of federation regional association Munich and Upper Bavaria. They are however as pars per toto meanwhile a being certain term in the emergency measures.

The alternative expansion from KITS to crisis intervention team is likewise common, suggested however by the term team that with a kit employment several kit coworkers are locally, which with smaller employments the case is usually not (further designations see below).

history

the first KIT became world-wide on initiative residents of Munich deacon and rescue assistant of Andreas Mueller Cyran to 9. March 1994 in the worker Samariter federation based. Last-finite trip was a heavy traffic accident with a streetcar, with which a child was killed and which intact parents (nearly) without each support in the employment place had to stay. This situation was numerous coworkers of the emergency service and emergency surgeons a thorn in the eye - however the emergency service was at this time exclusively to it aligned „vital function mechanics “, like the lifesaving was partly spöttisch called to operate.

The fact that the KIT pushed into a gap occupies the employment numbers alone for the KIT Munich: From 268 in the first nine months 1994 they constantly rose to meanwhile 846 2003. KIT is not any more the only offer for structured post office trauma tables support: In the emergency service range Munich is additionally still the crisis intervention in employment use (KED), which by the private emergency service Aicher outpatient clinic union after the model of the KIT was originally based, in the employment, so that altogether still substantially more crisis intervention employments are taken over.

Meanwhile KIT is a firm component of the emergency service, numerous of these kits by the KIT Munich was trained, so for example the KIT Leipzig, KIT Erding /freesings or also the KIT Luxembourg in numerous German cities (Unité de Support Psychologique, USP).

The KIT Munich created for this purpose its own training and advanced training mechanism, the kit academy.

Meanwhile the bases of the crisis intervention under the key word basis crisis intervention were taken up to the curriculum of the rescue assistant training.

member

and other concerning care for tasks of KITS after acutely psychologically traumatisierenden events. KIT directly in the peritraumatischen phase actively and interventiert still in the acute load reaction.

its own indication catalog, thus a list of possible emergencies has indications KITS, with which it is very probably meaningful to alarm KITS.

The most frequent indication is the support of members with a death, is it after unsuccessful Reanimation or also without Reanimation. The emergency service personnel must over the necessity to alarm decide KITS. Preferred it alarms therefore KITS with special circumstances, like an unexpected death of a relatively young patient, Suizid, death in the public or with (more socially) Vereinsamung of the survivors. Also with confused survivors KIT is frequently alarmed, although the support of confused or psychotischer persons does not belong to the tasks of the KIT.

Beispiel eines (gestellten) Einsatzes. KIT betreut die Mutter des verunglückten Kindes.
Example (posed) of an employment. KIT cares for the nut/mother of the had an accident child.
A clear kit indication is the death of a child, is it by accident, acute illness or by sudden child death (SIDS).

In co-operation with the police KIT brings also death messages. For the officials, in addition, for the members, that means frequently a large discharge.

KIT also with heavy traffic, rail or industrial accidents alarmed and cared for then eye-witnesses and/or the driving personnel of the public transporting enterprises, for example the MVG, the German course AG and other directly concerning. A frequent cause for kit employments are thereby also Suizidversuche by rolling over with the course. In Vienna and Munich in addition pilot studies run at present in co-operation with the media, which on such Suizide to no more do not report. In Vienna thereby the frequency of these Suizidmethode decreased/went back altogether, in Munich is not declining the number, but the acts arise successfully in larger time intervals, that the imitator effect (value ago effect) were thus eliminated.

Also when substantial force experience and/or threat, as for example , takings of hostages or rape would bank-attack, care for KIT the victims.

Also with other employments, with which with a psychological Traumatisierung of physically intact ones, as for example fires on severely woundeds person or dead ones, is to be counted, KITS alarmed. The decision is incumbent on thereby always the task forces locally.

With certain reporting pictures KIT is already alarmed meanwhile by the rescue directing centers due to the emergency call parallel to the emergency service. Straight one in accidents within the public range is KIT thereby promptly in the employment place and reached so also eye-witness.

objective

by early intervention immediately after the event creates KITS for the area concerned for its mourning, makes it again authorized to act and bends thereby the emergence post office trauma tables of a load disturbance (PTBS) forwards.

employment

KIT exclusively becomes from task forces of the emergency service, which alarms fire-brigade and the police, which can decide due to the situation locally. With certain employment indications, with which with a very high probability KIT is needed, KIT is already alarmed by the directing center due to the reporting picture with.

The intervention by a KIT takes usually few hours (average of the KIT Munich: approx. ), however there, although rarely, are two hours employments, with which coworkers are up to 8 hours locally.

KIT cares for all clients independently of skin color or religion. The latter differentiates the KIT from the Notfallseelsorge developed later. KIT makes also no liturgical actions. Should be wished by the clients, exists frequently a co-operation with the local Notfallseelsorge. In Munich on initiative of a KIT of coworker the Bereitschaftsseelsorge Munich was based.

Einsatzfahrzeug des KIT München
Employment vehicle of the KIT Munich
for start to the place of work order numerous KITS (e.g. KIT Munich, KIT Erding/freesing, in addition, the kits in Austria or Luxembourg) over an employment vehicle of the emergency service and can thereby if necessary under demand separating and right of way be requested. In Germany is due to the not yet completely clarified legal situation in the organizations regionally differently regulated, so that there are areas, in which the KIT no special rights on start take up can. In these areas there are partial co-operation with the police, which can zubringen if necessary the task forces.

In order to be able, become to shield the clients of the KIT with employments on the road from curious views , in addition, before the media as employment vehicles usually minibuses, as for example VOLKSWAGEN uses bus or Mercedes Benz Vito. Thus it is possible to create a calm care atmosphere (Setting, see below).

expiration and methods

the operation with a crisis intervention in the emergency service can be divided into phases, with which different aspects and methods in the foreground:

  1. Preparation and organization phase - this phase begins before the contact to the client with the information collection to the event and makes it for the coworker possible, that clients opposite to be later informationable (which is happened? Who is to be cared for?).
  2. Security and stop mediate - with beginning of care the kit coworker should ensure that the concerning is in a surrounding field (Setting), in which it can permit emotions and against disturbing influences of the environment is protected. An important principle of the support in the context of the crisis intervention is the continuity of the care situation, in order to avoid an additional load by repeated change of the reference person.
  3. Structure create - there the cared for one the loading situation usually from a passive victim role experienced, is considered the recovery of the capacity to act as a short term goal of the crisis intervention. If necessary the possibility of one plays from the deceased an essential role, also information about organizational operational sequence of the next hours and days (corpse-look, funeral, register office) is the concerning to enable of leaving the victim role.
  4. Bridge function - at the end of the crisis intervention the delivery to the social net should take place. An activation of family or friendly reference persons of the client, if possible by this, guarantees a further support of the concerning, also information about professional offers of help (advisory boards, groups of self-helps) belonged to this point.

principle of the uniqueness

a crisis intervention takes place only in the peritraumatischen period, repetition attendance is not usual. Reason for this is the changed relations structure between care and responsible person, to which it comes with a renewed establishment of contact. Thus the methods of the crisis intervention would not any longer be in the emergency service easily applicable and an optimal supply of the client thus not ensured. Besides this temporal delimitation is to reduce the load of the kit coworker.

large damage situations

of KITS is used increased also with large damage situations. The first extensive use for the crisis intervention and Notfallseelsorge with large interest of medium were 1998 with the ICE misfortune of Eschede. The KIT Munich was among other things also on the occasion of the notice at the hospital in bath realm-resounds, the Concorde - crash in Paris, mountain railway - misfortune in cape ch. 2000, the bus accidents in Siófok (Hungary), Lyon (France) and Vicenza (Italy) (ever 2003), to which school assassination attempts in Erfurt and freesing (together with the KIT Erding/freesing), (ever 2002), the forced landing of a passenger plane in the early summer 2004 at the airport Munich (together with the KIT Erding/freesing) and a taking of hostages at the airport Munich likewise 2004 (together with the KIT Erding/freesing), that rapid-transit railway - accident at the resident of Munich light mountain ring 2004 and on the occasion of the assassination attempt up the World trade center at the 11. September 2001 in New York in the employment. In December 2004 the KIT Munich was common with the KIT Hanover in Thailand on the occasion of the tide disaster, which by a Tsunami was released, in use.

Numerous kit teams from Upper Bavaria (among other things KIT Munich, KIT Erding, KIT freesing and KIT trusting stone) were with the ice resounding collapse in bath realm-resound in January 2006 together with SbE teams, among other things also the German Federal Armed Forces, which the task forces cared for, in the employment.

Employments abroad requested thereby generally from the Foreign Office, which employments in freesing, Erfurt and cape run took place when desired the ministry of the Interior.

training

the training is differently regulated in each KIT. The KIT Munich has as first KIT and advisor and structure aid of numerous further kits (e.g. Leipzig, Hamburg, Erding, Augsburg, trusting stone, Luxembourg and South Tyrol) thereby yardsticks set. Therefore the training of the KIT Munich is presented exemplary for all kits.

At least within the range Bavaria was standardized the kit training 2004 on basis of the training of the KIT Munich. As basis for it a work of Andreas , served Mueller Cyran and Peter Zehentner, who was already published in May 2000.

Condition for entrance is emergency service experience of many years with the minimum qualification rescue medic. In exceptional cases higher fire-brigade ranks with according to long employment experience are conceivable. In a photograph discussion the personal motivations and abilities are clarified. Only after it a practical course under guidance of experienced coworkers is possible in the employment use.

After the practical course the kit course takes place.

In a following practice phase, whose duration is individually agreed upon, the training is only with an experienced colleague as Praxisanleiter in the service. A firm length of the practice phase does not have itself due to the inter-individual different conditions for entrance and also the impossibility to plan employment situations worked satisfactorily.

After end of the practice phase a conclusion discussion is led, due to whose result it is then decided whether the training becomes fuller now „“coworker. For the first employment months he receives then a Mentor and a godfather to the side posed.

financing

KIT cannot account for in Germany at present (still) with the health insurance companies. Also no calculation is placed to the client. Therefore KIT finances itself from donations and by the carrier, usually a relief organization economically is usually supported.

demarcation

KIT does not operate treatment of stresses after loading employment events (SbE). SbE addresses itself to task forces. KIT contacts non--task forces.

This separation is necessary, since task forces in employment use are concerned in other way and also in the first time thereafter and react as a member. Therefore another procedure is necessary for the intervention for task forces. Generally is used for the treatment of stresses for task forces thereby the method described by Jeffrey Mitchell, which is avowed after loading employment events in the article treatment of stresses.

However coworkers are trained additionally in SbE, the founder and technical director/conductor of the KIT Munich Mueller Cyran for example are in the Erzdiözese Munich-freesing responsible for the Seelsorge in fire-brigade and emergency service in many kits.

KIT world-wide

in numerous European countries was furnished after the model of the KIT Munich a KIT. Therefore here the bases by the example of the KIT Munich are avowed. Some KITS were trained thereby also by the KIT Munich, so for example the KIT in Luxembourg and South Tyrol.

In Austria a crisis intervention is meanwhile nearly surface-thinking available, at present the latter in the summer 2004 in the Land of the Federal Republic Kärnten was installed. The only Land of the Federal Republic in Austria without crisis intervention is the castle country, where still no financial aids were. In Switzerland it is to be furnished planned, after the German and Austrian model a KIT.

designations

the KIT Munich the first KIT was world-wide. Gradually were based further organizations, which act with same setting of tasks as KITS.

KIT
K giant I ntervention in R ettungsdienst and/or. also K giant i nterventions t eam, the latter is however more rarely used, there usually only one kit coworker locally present is and thus the term team for the task forces locally difficult to reconstruct was
KID
K giant I nterventions D ienst
KED
K giant intervention in the E in-corrodes D ienst
NFS
N ot f all S eelsorge
OPEN
(O rganisierte P ersonalbetreuung with E xtremeinsätzen and N oh-ensures)

literature

  • Karl-Heinz Daschner, crisis intervention in the emergency service (KIT), stump & Kossendey, Edewecht, 2003, ISBN 3932750888
  • Karl-Heinz Daschner, case example. Crisis intervention in the emergency service. in “emergency service” 1997, S. 17ff., stump & Kossendey publishing house, Edewecht, 1997
  • Bernd finished, Hanjo of Wieterheim (Hrsg), human company and crisis intervention in the emergency service, stump & Kossendey publishing house, Edewecht, 1997, ISBN 3923124686
  • Andreas Mueller Cyran; Birgit gasoline, a vacation trip, which is infinite. The KIT Munich in the employment, in: Emergency service 07/2003, stump & Kossendey publishing house, Edewecht, 2003
  • Birgit judge, Regina Karl, Krisenintervention in the emergency service. The KIT Munich. A explorative study to the kit function, thesis (diploma), LMU Munich, Munich, 2000
  • Peter Jaeggi, first assistance for the soul. As with rapid crisis intervention wrong is moderated in: New inhabitants of zurich newspaper of Tuesday, 13. July 2004, page 9, Zurich, 2004 ([1])
  • Annette Ramelsberger, first assistance for the soul. If death comes home - on the way with humans, the terrible message brings into South German newspaper of Saturday, Sunday, 27. / 28. March 2004, page 3, Munich, 2004
  • Peter Zehentner, the course to the crisis. An socialeducationally oriented training course, thesis (diploma), FH Munich, 2000

Web on the left of

 

  > German to English > de.wikipedia.org (Machine translated into English)