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~ Acute Traumatic Response ~

The Acute Traumatic Response is the response that occurs during or immediately following the traumatic event. The reactions are often noted by trauma responders--firefighters, police, emergency personnel and by emergency room staff. There are a variety of "normal responses and symptoms"--physiological, emotional, cognitive and behavioral responses that can be experienced either during or shortly after a traumatic event. The following physical, emotional, cognitive and behavioral reactions are commonly observed during traumatic exposure. It is important to remember that these responses are not unhealthy or maladaptive responses. Rather they are normal responses to an abnormal event.

Note: Not every response is evidenced by every person.

Physical Reactions: Acute Traumatic Response
** Difficulty breathing
** Shock symptoms
** Chest pains
** Palpitations
* Rapid heart beat
* Elevated blood pressure
* Fatigue
* Fainting
* Headaches
* Thirst
* Dizziness
* Gastrointestinal upset
Flushed face
Muscle tension & pains
Pale appearance
Chills
Cold, clammy skin
Increased sweating
Vertigo
Hyperventilation
Grinding of teeth
Twitches

** Require IMMEDIATE Medical Evaluation
* May need Medical Evaluation

Emotional Reactions: Acute Traumatic Response

Shock
Denial
Dissociation
Panic
Fear
Intense feelings of aloneness
Hopelessness
Helplessness
Emptiness
Uncertainty
Horror
Terror
Anger
Hostility
Irritability
Depression
Grief
Feelings of Guilt
Emotional outbursts
Feeling overwhelmed
Inappropriate

Cognitive Reactions: Acute Traumatic Response

Poor concentration
Confusion
Disorientation
Difficulty in making a decision
A short attention span
Suggestibility
Vulnerability
Forgetfulness
Self blame
Blaming others
Lowered self-efficacy
Thoughts of losing control
Hyper vigilance
Perseverative thoughts of the traumatic event
Nightmares
Intrusive memories
Flashbacks
Questioning religious values
Feeling as though the world no longer "makes sense"
Difficulty remembering the event

Behavioral Reactions: Acute Traumatic Response

Withdrawal
"Spacing out"
Non Communication
Changes in speech patterns
Regressive behaviors
Erratic movements
Impulsively
Reluctance to abandon property
Aimless walking
Pacing
Inability to sit still
Exaggerated startle response
Antisocial behaviors
Increased alcohol consumption
Inability to attach importance to anything but this event
Refusing to talk
Feeling that one should not cry

Resources
Foa EB, Hembree EA, Riggs D, Rauch S, Franklin M. Common Reactions to Trauma. At: http://www.ncptsd.org/facts/disasters/fs_foa_handout.html Leaving Site
Dyer KA. The Potential Impact of CODES on Team Members: Examining Medical Education Training. Trauma Journal. Available at: http://www.aaets.org/arts/art95.htm Leaving Site
Lerner MD, Shelton RD. Acute Traumatic Stress Management. Commack, N.Y.: The American Academy of Experts in Traumatic Stress, 2001. Available from: http://www.aaets.org Leaving Site
American Red Cross. When Bad Things Happen. Available at: http://www.redcross.org/services/disaster/keepsafe/badthings.html Leaving Site
American Red Cross. Why Do I Feel Like This? Avialable at: http://www.redcross.org/services/disaster/keepsafe/terror.html Leaving Site
Acute and Post Traumatic Stress Disorders. Mental Health Report of the Surgeon General, Chapter 4 - Anxiety Disorders. Available at: http://www.surgeongeneral.gov/library/mentalhealth/chapter4/sec2.html Leaving Site
Khouzam HR. A simple mnemonic for the diagnostic criteria for post traumatic stress disorder. WJM 2001;174:424 Available at: http://www.ewjm.com/cgi/content/full/174/6/424 Leaving Site
National Institute of Mental Health. Facts about Post Traumatic Stress Disorder
http://www.nimh.nih.gov/anxiety/ptsdfacts.cfm Leaving Site
National Institute of Mental Health. Post Traumatic Stress Disorder, A Real Illness - Signs and Symptoms, Ways of improving. June 14, 2000. Available at:  http://www.nimh.nih.gov/anxiety/ptsdri1.cfm  Leaving Site
National Institute of Mental Health. Reliving Trauma - PTSD. Available at: http://www.nimh.nih.gov/publicat/reliving.cfm  Leaving Site
National Center for Post Traumatic Stress Disorder. Screening for PTSD In a Primary Care Setting Avialable at: http://www.ncptsd.org/screen_disaster.html Leaving Site


The acute responses to loss are not unhealthy or maladaptive responses.
Rather they are normal responses to an abnormal event.

Kirsti A. Dyer, MD, MS

See the Emergency 911 Page for links to immediate resources
if you are feeling helpless, hopeless, overwhelmingly depressed, or suicidal.

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Last update Sept. 11, 2002