After the Emergency: Looking After Yourself After Giving First Aid

1What Your Body Does During an Emergency

The moment you realise something serious is happening, your body switches over without asking you. Adrenaline and noradrenaline flood your system. Your heart rate and blood pressure jump. Blood moves away from your gut and skin and towards your large muscles. Your pupils widen. Your blood sugar rises so your muscles have fuel.

This is useful. It is also why things feel strange while it is happening. Common effects during a real emergency include:

• Tunnel vision. Your field of view narrows and you stop noticing things at the edges. People miss a first aid kit sitting two metres away.
• Auditory exclusion. Sound drops out. Bystanders say they shouted at you and you never heard them.
• Time distortion. Two minutes of CPR feels like twenty. Or twenty minutes feels like two.
• Loss of fine motor skill. Gloves stick. Zips stop working. Phone keypads become impossible.
• Patchy memory. You remember some details with photographic clarity and lose others entirely.

None of that is a personal failing. It is standard human physiology. It is also the reason first aid is taught as a sequence you practise with your hands rather than facts you memorise. Under that much adrenaline, you do not recall information, you run habits. That is the whole point of the DRSABCD action plan.

2The Crash Afterwards

When it is over, all that chemistry has to go somewhere. This is the part people are least prepared for.

Within minutes to an hour of handing over to paramedics, most people experience some mix of:

• Shaking hands, wobbly legs, teeth chattering even on a warm day
• Nausea, or a sudden urge to eat everything in the house
• A pounding headache
• Bone deep tiredness that arrives all at once
• Talking very fast, or not being able to talk at all
• Crying without expecting to
• Feeling weirdly fine, then not fine two hours later

Feeling nothing at all is also common and is not a sign you are cold or uncaring. Numbness is one of the standard ways the nervous system handles overload. It usually thaws over the following day or two.

3Your First 24 Hours

You do not need a complicated plan. You need five basic things, in roughly this order.

1. Sit down and get warm. Your body has just burned through a lot. Find somewhere safe, sit, and let your legs stop working for a minute.
2. Eat and drink something. Water first, then food with some carbohydrate in it. Low blood sugar after an adrenaline dump makes everything feel worse than it is.
3. Slow your breathing. Longer out than in. Four counts in, six counts out, for a couple of minutes. This is the fastest lever you have on a racing heart.
4. Tell one person. Not the whole story to the whole world. One person you trust, in your own words, at your own pace.
5. Move a little, then rest. A walk around the block helps burn off leftover adrenaline. Then let yourself sleep when sleep comes, even if it is at a strange hour.

Two practical extras that people forget. First, write down what happened while it is fresh, especially if it was a workplace incident. Time, what you found, what you did, who else was there. It protects you and it helps the investigation. Second, do not drive straight away if you are shaking badly. Give it fifteen minutes.

4Why You Keep Replaying It

The most common complaint we hear from people after a real incident is not fear. It is the replay. The scene keeps arriving uninvited: a sound, an image, the feel of a chest under your hands, usually one specific moment on a loop.

These are called intrusive memories. During a high stress event, your brain lays down the sensory parts of the memory very strongly and the ordered story part of it weakly. You end up with a set of vivid fragments that have not been filed properly, so they keep surfacing to be dealt with.

For most people this fades over one to three weeks as the memory gets consolidated and put in order. Things that speed that along are the boring ones: sleep, routine, daylight, movement, and talking about it in a normal voice to someone who is not panicking on your behalf.

There is also an interesting line of research into using visual attention tasks, including Tetris, soon after a traumatic event to reduce intrusive memories. It is promising rather than proven, and it is not a treatment, but it is worth understanding. We covered it in detail in Can a video game heal the mind? and looked at the practical support side in first aid, trauma and recovery support.

5What Actually Helps

The evidence here is reasonably clear, and it is less dramatic than people expect.

• Practical support first. Somewhere to sit, a lift home, someone covering your shift, a meal. The approach known as psychological first aid is mostly this: safety, comfort, information and connection, not therapy.
• Accurate information. Not knowing what happened to the person is often harder than knowing. Ask your supervisor or the ambulance service what can be shared. Sometimes nothing can, and knowing that is still better than wondering.
• Normal routine. Going back to work, the gym, the school run. Routine tells your nervous system the danger is over.
• Sleep protection. Same bedtime, dark room, screens down, no caffeine after mid afternoon. Sleep is where the memory gets filed.
• Movement. Walking, swimming, anything rhythmic. It burns off the leftover stress hormones and helps sleep.
• Talking when you want to. To a partner, a mate, a colleague who was there, a peer supporter. On your timing, not someone else's.

6What Does Not Help

Worth naming, because some of these are done with the best intentions.

7The Guilt Trap

Almost everyone who has given first aid at a serious incident has run some version of this loop: I should have started sooner. I should have pushed harder. I should have noticed. I froze for a second.

Two things are worth holding onto here.

You are judging yourself on the outcome, not the decision. This is called outcome bias, and it is deeply unfair when you apply it to yourself. The question is not whether the person survived. It is whether you made reasonable decisions with the information you had, in the seconds you had, with the training you had. Almost always the answer is yes.

The baseline is not a paramedic. It is nobody. If you had not been there, there would have been no compressions at all. Out of hospital cardiac arrest survival in Australia sits in the single digits to low teens even with everything going right. Bystander CPR roughly doubles or triples a person's chance. You moved the odds. The odds were still hard.

8When the Outcome Was Bad

Sometimes you do everything right and the person dies anyway. That is the hardest version of this, and it deserves to be dealt with directly rather than skated past.

A few things that people who have been through it find useful:

• Separate what you controlled from what you did not. You controlled your response time, your sequence and your effort. You did not control the underlying medical event, how long they were down before you arrived, or how far away the ambulance was.
• Expect grief, even for a stranger. You were present at the end of someone's life and physically involved in trying to stop it. Feeling grief for a person you never met is a normal human response, not an overreaction.
• Consider whether you want contact with the family. Some people find it helps enormously. Some find it much harder. There is no correct answer and no obligation either way. If it is a workplace incident, talk to your employer before reaching out.
• Mark it somehow. Many first aiders find that some small acknowledgement, a walk somewhere quiet, a note written and put away, a donation, helps close a loop that otherwise stays open.
• Watch the anniversary. Dates carry weight. Knowing that in advance takes most of the sting out of it.

If you are struggling after an incident like this, that is not a sign you were not cut out for it. It is a sign you were there.

9Debriefing at Work: What Good Looks Like

If an incident happens at your workplace, what management does in the next 48 hours makes a real difference. Good practice looks like this.

On the day

• Take the first aider off the floor. Do not send them straight back to a customer or a machine.
• Offer a lift home, or ask someone to drive them.
• Give them accurate information about what happened, as far as it can be shared.
• Tell them clearly that their response was appropriate and appreciated. Say it out loud, on the day.
• Restock the kit and replace the AED pads so the next person is not caught short.

In the following days

• Check in personally, more than once, not just by email.
• Offer the Employee Assistance Program and make it easy to access. Give them the number rather than telling them to find it on the intranet.
• Run an operational review of the incident separately from any wellbeing conversation. Mixing "what can we improve" with "how are you going" makes people defensive and helps nobody.
• Be flexible about shifts and duties for a week or two.
• Keep an eye on the quiet ones. The person who says the least is often the one carrying the most.

What good does not look like: a mandatory group session where everyone describes the graphic details, a single generic email, or treating the incident as a performance problem.

10Supporting Someone Else Who Was There

If it was a colleague, a friend or a family member who gave the first aid, you can help a lot without saying anything clever.

• Do practical things. Bring food. Take the kids. Drive them. Cover the shift. Practical help says more than words.
• Ask once, then be available. "Do you want to talk about it, now or later or not at all?" Then let them choose. Repeating the question every day turns into pressure.
• Listen without fixing. You do not have to have an answer. Most people just need to say it out loud to someone who does not flinch.
• Do not ask for the details out of curiosity. They can tell you what happened medically or they can tell you how they are. Let them pick which.
• Do not tell them how they should feel. "You did everything you could" is true and often useless on day one. "That sounds like a lot" lands better.
• Notice the trend. Are they sleeping? Eating? Still avoiding the street where it happened three weeks later? Gently raise it if things are not easing.

11What WA Employers Need to Know

This is not just good manners. In Western Australia, psychosocial hazards are covered by work health and safety law, and WorkSafe WA has published a code of practice on psychosocial hazards in the workplace. Exposure to a traumatic event at work is one of the hazards that has to be identified and managed like any other.

Practically, that means a workplace should have:

• A plan for what happens after a serious incident, written down before you need it
• Named people responsible for checking in on staff who were involved
• Access to support such as an EAP, and staff who know it exists
• Enough trained first aiders that one person is not carrying every incident alone
• A first aid risk assessment that considers the aftermath, not just the kit contents

If an incident at work leads to a psychological injury, it may be a workers compensation matter through WorkCover WA. Report it, keep your notes and get medical advice early rather than late.

12When to Get Professional Help

Most people do not need therapy after an incident. They need a fortnight, some sleep and a few good conversations. That said, some do, and the sooner it happens the easier it is.

Australian clinical guidance suggests watchful waiting for the first couple of weeks, because symptoms settle on their own for the majority of people. After about four weeks, ongoing symptoms are worth assessing.

Start with your GP. Ask about a Mental Health Treatment Plan, which gives you subsidised sessions with a psychologist. Trauma focused therapies including trauma focused CBT and EMDR have good evidence behind them, and they work better the earlier you start.

If you need to talk to someone tonight: Lifeline 13 11 14, Beyond Blue 1300 22 4636, or 13YARN 13 92 76 for Aboriginal and Torres Strait Islander callers. In an emergency call 000.

13Two Real World Examples

The advice above is easier to picture with a scenario attached. These are composites, not real people, but both are built from the kinds of situations we hear about in courses across WA.

The warehouse

Mel does compressions on a workmate at a Canning Vale warehouse for six minutes until paramedics arrive. He survives. She is fine for about two hours, then cannot stop shaking in the car park and does not trust herself to drive. Her supervisor sends her home with a colleague, calls her that evening with an update from the hospital, and takes her off the forklift roster for three days.

Mel sleeps badly for a week and keeps hearing the sound of the first breath he took. It fades. At two weeks she is sleeping normally. What helped: being taken off the floor immediately, being told what happened to him, and one long conversation with her sister where she said the whole thing out loud without being interrupted.

The roadside

Dan stops at a single vehicle crash on a regional highway. He manages the scene, controls bleeding and stays with the driver until the ambulance arrives forty minutes later. The driver dies in hospital two days later. Dan never finds out directly and hears it second hand.

He tells nobody, because he was not injured and it was not his job. Three weeks on he is avoiding that stretch of road, snapping at his kids and drinking more in the evenings. His partner raises it. He sees his GP, gets a Mental Health Treatment Plan and has six sessions with a psychologist. By the second month he is sleeping again.

Two very different outcomes, and the difference between them is not toughness. It is information, support and how long it took before someone said something.

14When Children or Teenagers Were There

Children who witness an emergency, or who help at one, need the same things adults do in a simpler form. If your child was present when you gave first aid, or gave it themselves, a few things are worth knowing.

• Give them the facts at their level. Vague answers leave gaps that children fill with something worse. Short, honest, age appropriate information settles them faster than reassurance.
• Expect it to come out sideways. Younger children process through play, drawing, questions at bedtime, or a sudden return to old habits. Teenagers often go quiet and then raise it in the car.
• Keep routine tight. School, meals, bedtime. Predictability is the main thing that tells a child the world is safe again.
• Answer the same question as many times as they ask it. Repetition is how they process it.
• Praise what they did, not the outcome. "You went and got help straight away, that was exactly right."
• Watch the same four week mark. If sleep, school, appetite or behaviour have not settled, talk to your GP or the school psychologist.

The same applies at a school or a childcare service. Staff who were present need support too, and so do the children who saw it. A service with a clear post incident plan handles this far better than one improvising on the day.

15Building Your Resilience Before the Next One

You cannot prevent the next emergency. You can make yourself better prepared for the day after it.

• Decide now who you would call. Pick the person, and tell them they are the person. Trying to work that out at 10pm while shaking is much harder.
• Know your workplace support before you need it. Find the EAP number and save it to your phone today.
• Keep your skills current. Confidence in the moment is the single biggest protective factor against guilt afterwards. People who knew what they were doing second guess themselves far less.
• Talk about it in your team in advance. Workplaces where people have already discussed "what would we do if" handle the real thing much better.
• Do not carry every incident alone. If you are the only trained first aider in your workplace, that is a risk to you as well as a gap in coverage. Push for more people to be trained.
• Build the boring foundations. Sleep, exercise, connection, something that is not work. These sound generic until the week you need them.

16Why Training Helps More Than People Expect

The obvious benefit of a first aid course is that you know what to do. The less obvious benefit is what it does to you afterwards.

When you have practised a sequence dozens of times, three things change. You act faster, because you are not deciding, you are executing. You remember the incident more clearly, because you had a structure to hang it on. And you second guess yourself far less, because you can look back and see that you followed the plan you were taught.

At REACHAU we build that in deliberately. Our courses are hands on, scenario based and focused on confidence, not just competence, because the goal is not a certificate on the wall. It is a person who can act in a real situation and walk away from it intact.

• HLTAID009 Provide CPR for the yearly CPR and AED refresher.
• HLTAID011 Provide First Aid for the full workplace first aid qualification.
• HLTAID012 for education and care settings.

Frequently Asked Questions

Written by Britt Brennan

Empowerment-Focused First Aid Trainer and Employment Coach, and founder of REACHAU. Britt trains workplaces, schools and communities across Western Australia to act with confidence and look after themselves afterwards.

This article is general information about common reactions after a critical incident. It is not medical or psychological advice and does not replace assessment by a qualified professional. If you need support, speak with your GP, or call Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636. In an emergency call 000.