There is an expectation that a trip into the wilderness—even just for the weekend—entails certain risk not found in daily life. A good trip entails a lot of physical effort and teamwork. People expect to be able to cope with the usual demands of the wilderness, and, thus, they develop unusual coping mechanisms. Sometimes, however, for some or all of the people on the trip, events surpass standard coping mechanisms. Then a wilderness-style critical incident has occurred.
A critical incident is almost any incident in which the circumstances are so unusual or the sights and sounds so distressing as to produce a high level of immediate or delayed emotional reaction that surpasses an individual’s normal coping mechanisms. Critical incidents are events that cause predictable signs and symptoms of exceptional stress in normal people who are having normal reactions to something abnormal that has happened to them. A critical incident from a wilderness perspective may be caused by such events as the sudden death or serious injury of a member of the group, a multiple-death accident, or any event involving a prolonged expenditure of physical and emotional energy.
People respond to critical incidents differently. Sometimes the stress is too much right away, and signs and symptoms appear while the event is still happening. This is acute stress; this member of the group is rendered nonfunctional by the situation and needs care. More often the signs and symptoms of stress come later, once the pressing needs of the situation have been addressed. This is delayed stress. A third sort of stress, common to us all, is cumulative stress. In the context of the wilderness, cumulative stress might arise if multiple, serial disasters strike the same wilderness party.
The course of symptom development when a person is going from the normal stresses of day-to-day living into distress (where life becomes uncomfortable) is like a downward spiral. People are not hit with the entire continuum of signs and symptoms at once. However, after a critical incident, a person may be affected by a large number of signs and symptoms within a short time frame, usually 24 to 48 hours.
The degree or impairment an event causes an individual depends on several factors. Each person has life lessons that can help, or sometimes hinder, the ability to cope. Factors affecting the degree of impact an event has on the individual include the following:
1. Age. People who are older tend to have had more life lessons to develop good coping mechanisms.
2. Degree of education.
3. Duration of the event, as well as its suddenness and degree of intensity.
4. Resources available for help. These may be internal (a personal belief system) or external (a trained, local critical-incident stress debriefing team).
5. Level of loss. One death may be easier than several, although the nature of a relationship (marriage partners or siblings, for example) would affect this factor.
Signs and symptoms of stress manifest in three ways: physical, emotional, and cognitive. Stress manifests differently from one person to the next. Signs and symptoms that occur in one person may not occur in another, who has responses of his or her own.
Buck Tilton (Wilderness First Responder: How to Recognize, Treat, and Prevent Emergencies in the Backcountry)