overly emotional after lecture from Coroner

[Eydawn]

I would like to call attention to the fact that cumulative trauma exposure can in fact increase the risk of adverse psychological effects... "desensitization" is bullshit, IMHO.

When you're busy dealing with a shitty scene, you have to compartmentalize your emotional reaction away from your thinking self for a while... you shut down your reactions, finish the job, and then process the call later. This has a natural kind of sequence to it- go on call, realize call is shitty, defer reaction, process back at station (or for the next few weeks, etc.) Pictures out of nowhere showing violently abused children and all variety of death and dismemberment? What's the purpose of subjecting people to that? The truth of the matter is, you never know how you will react to the actual scene until you're in it. And then you deal with it. Showing a group of people every nasty picture imaginable will not only NOT "prepare" them for reality, but will possibly make things worse- see my opening statement...

My major question is whether the coroner warned the class that the slide show would be extremely graphic. No warning? Stupid educator. Appropriate advance warning and explanation of why the images where chosen? More appropriate... yet still questionable if there's no other purpose than to "show you reality." If there's something to actively be learned and the pictures were presented with an explanatory context, then it would make more sense (e.g. how to recognize physical abuse, how to recognize a crime scene...)

I'm with Mobey on this one, especially with regard to understanding psychology and the fact that these students probably weren't presented with any psychological education to help them understand their reactions to these photos...

Wendy

CO EMT-B

[medicgirl05]

I had a very similar experience in basic class. It was the first night and they were trying to weed out people. I can say it worked because we started with 30 people and only 23 showed up the second night. Im not going to judge if this was good or bad but it hapened. I was very disturbed by the pictures. It gave me nightmares for a week. It also made me think that all calls were gore and guts.

Ive now been in EMS five years and recieved my medic and I can tell you from experience that pictures disgust me. TV shows with operations make me ill. Some OR clinicals have made me gag. The good news is I have done and seen some absolutely gruesome stuff and have never been sick on a call. It doesnt even cross my mind that I have my hand in a mans brain trying to roll him over on the street where he leanded after ejection from his 1050. I can manipulate a childs obviously broken arm without reacting. I can deal with extreme violence and not be sick. However when I get back to the station I may have to sit and take a breather,

My advice is dont let a slideshow deter you from the field. If youve seen some gore in the ER and it hasnt bothered you dont give up. JMO.

[AnthonyM83]

I think one shouldn't go straight to assuming everything was done inappropriately until we're told so. this seems almost like hanging a fellow EMT out to dry when we read a news article on an incident without knowing details...

[HERBIE1]

Well, I suppose I should have prefaced my comments with the statement that the teacher SHOULD have given a warning about what was coming, and I certainly disagree with using gore to weed out folks on the first day of class, but I still see no problem with showing this stuff. Problem is, how often do we get a warning in the field that we may encounter a horrific crime scene, a horrible case of child abuse, or a nasty self inflicted GSW?

I recall a situation where we were called for an injured victim, and it turned out to be a triple homicide- 3 people with their throats cut ear to ear. Shocking? Damn right.

According to the OP, this was the last class. At this point, students should realize what may be in store for them. I assume they already had ride alongs/clinicals, so this should not have been their first exposure to anything gory.

[chbare]

A fair amount of assumption going on. Perhaps the OP could answer some questions before we make any judgments?

Take care,

chbare.

[DwayneEMTP]

Of course I agree with those that say that we don't have enough information to really judge here...

I do find medicgirl's observation interesting as I've noticed the same thing in myself. I have never, not a single time that I can think of, been 'grossed out' on scene, needed to turn away, or have failed in caring for my patients because of their situation or the condition of their body. But I have been grossed out by pictures. I continue to be bothered by some images, not a particular class, but some that seem to be random...and that seems weird to me, as I would expect it to be the reverse.

Anyway, as MG said, because you can't look at grody pics doesn't meant that you can't handle gore, especially if you've been exposed before and had no problems. One of the strongest lady medics I know can't walk into the morgue without passing out, yet she's worked a gazillion bloody, ugly calls from all age groups. "Association does not equal causation.." or whatever that quote is. Because it seems like there should be a relationship doesn't mean that there is.

Though Wendy made a really interesting point with her comment on cumulative exposures...

Dwayne

[uglyEMT]

I reread the OP multiple times to see if I understand her correctly.

I think what she was saying (my opinion here) is that the final lecture was for infield pronouncment. Thus I believe it would be a medic class as I dont know any Basics that can make a call unless outwordly obvious (full decap, rigor, decay). So seeing the images, they seemed to be instructional, and the lecture that went along with them would be in a normal course of duties as far as pronouncment goes. I believe the infant abuse images were disturbing her. Now here is where I read into it, I dont think the images were overtly graphic but meraly the fact they are of infants is what got disturbing. If this is the case then its not anyone fault. The coroner was trying to be thorough and as we all have probably experienced just certain things get us more than others.

Now if this was a one hour slide show of the most horrific things without a medical basis then yes it was wrong. But if an image was put on screen then discussed medically by the coroner and class then I do see a benifit. It exposes the would be medic to rationally look at a body and make a call in the field but in a controled environment where mistakes dont cause issues.

When we were in basic class and came to our trauma module one of our lectures was a slide show showing trauma. Every slide was discussed medically and broken down to what would need to be done ect. Yes some of the images were disturbing due to age or MOI but to me were vital. Being in a basic class and not having been exposed to those sort of thing before hand (I have in my job but not from an EMT perspective) in was a great learning tool. If we missed an intervention the only thing that happened was we went back over it, we didnt potentionally kill a patient.

Another example, in CEBRN class seeing examples of small pox, sarin, vx, mustard gas patients was disturbing but educational. How would we know what to look for unless it was shown. Will I ever see one of those patients, I hope to God NO, but at least if it happens I know what to be on the look out for. Hazmat class showing meth lab burns, graphic and educational.

Yes I do believe there is a line where you go from educational to slasher film but if its presented in a way that takes time between images to discuss medically then it is educational. If its just slide after slide with no discussion then forget about it, your just trying to stimulate a reaction from the class.

I cant wait to hear from the OP to see what else happened during the class and maybe answer some or all of our questions.

[tcripp]

I've been in EMS since 2004. I know that I have not seen it all by any stretch of the imagination. However, I have seen enough that when I make scene I don't get grossed out, at least not in a while.

With that being said, I attended 15 hours of classes at a conference a few weeks back. There were several classes that had quite a few pictures; one was on sports injuries and another was on pedi trauma. I watched a few people turn their heads so that they could hear the lecture but not have to witness the photos. That worked for them and accomplished the task.

For me, I got the "ew" factor several times. In addition to the material presented, I walked away with the knowledge that I am still a "feeling" person. It confirmed that I am still grounded.

How's that for a CE?

I'm not sure I would fault any education that provides visual aids...as long as they preface the lecture with the disclaimer that it does include graphic material and that you can turn away or step out if needed.

[lilabean]

Wow, I certainly didn't expect such a response. I have to say after thinking about it I can respect the school's reasoning behind the lecture and I believe there is some educational value, especially in the case of being able to recognize certain sign of child abuse etc. I definitely am not aiming to start any trouble for the school, it is truly a terrific program and in all honesty I cannot say that they are at any fault here. I don't see myself making a formal complaint especially since out of a class of 20+ students I was the only one that I know of who had such a reaction. In all fairness they did warn us ahead of time that it would be graphic, and thus I could have excused myself. I also did my best to just look at my desk for most of the time but ultimately I could have excused myself. I think the purpose of my post really was just to get some feedback in terms of my self doubts going into this line of work, meaning, if I can't stomach a sideshow how will I be able to handle it in real life? But I appreciate every one's feed back and comments.

[AnthonyM83]

As I thought a lot of people got carried away with their own agendas instead of giving the help you asked for.

Sometimes things affect us in a weird way. If you were fine at the ER on an on going basis honestly you'll probably be fine. It's good that you went to others for advice though.

Sometimes in the classroom you have more time to think about the pictures since there isn't a task at hand to concentrate on. Your mind then just keeps thinking about the awfulness of it. In addition the pics you saw weren't things you'll see day in and day out. They were probably the difficult cases the coroner pulled out because they caused problems for EMS in the past.

BTW, EMTs can still determine someone dead like a medic. It's the same criteria for the most part except ones having to do with calling an arrest or requiring EKG rhythms...the minority of death determinations that I've seen.

But don't worry you'll be just fine. I can psych myself out too if I think about certain scenarios yet be just fine on scene.