A couple blogs ago I was reminiscent about a night working for the fire department when my partner and I where in a physical confrontation with two Recon Marines that where on leave and intoxicated. (Will You Survive Your Next Stand By ?)Without retelling the whole story, they got into a fight with some local patrons at a bar. The business called the police and ambulance, as luck would have it we beat the police to the scene. As we hit the “On Scene ” button on our MODAT they came pouring out of the front door in a ball of fist, kicks and profanity. In defense of the Marines they did not start the fight and did all they could to diffuse the situation.

 Since October 2001, approximately 1.6 million members of the Armed Forces have served in Iraq or Afghanistan. Nearly 20 percent of military service members who have returned from Iraq and Afghanistan report symptoms of post traumatic stress disorder or major depression, yet only slightly more than half have sought treatment, according to a 2008 RAND Corporation study.

 The associate press reported June 30, 2004 that 1 in 8 returning American soldiers suffer from PTSD and in 2008 the RAND Corporation study placed the number closer to to 1 in 5. The Army’s own study of the mental health of troops who fought in Iraq found that about one in eight reported symptoms of post-traumatic stress disorder.

 The average veteran solider is in their early to mid twenties. Returning from their “Deployment” their friends quit often want to help them readjust and have some fun. This often takes the form of drinking and partying. In this environment with mood altering substances being envied something as subtle as a smell or inert noise can trigger a “Flash Back”. People who are having a flash backs actually feel as if they are experiencing a traumatic moment from their past.

 When responding to a call for assistance for someone suffering from PTSD, EMS providers never know if the flash back is of a violent encounter and could possibly trigger a violent response. People returning from a war zone are returning from a life or death struggle. Conditioned to kill or be killed they believe at that moment they are back in a life or death struggle, and may instinctively response with lethal force. This is why event medical personnel need to be aware of PTSD signs and symptoms.

 Post-traumatic stress disorder is defined in terms of the trauma itself and the person’s response to that trauma. Trauma occurs when a person has experienced, witnessed, or been confronted with a terrible event that is an actual occurrence. Alternatively, the person may have been threatened with a terrible event, perhaps injury (physical or psychological) or death to themselves or others. Then, the person’s response to the event or to the threat involves intense fear, helplessness, and/or horror.

 Often soldiers suffering from PTSD can be set off by the simplest of questions, even a friendly, “How are you today?,” can cause them to feel choked-up, anxious or confused. People suffering from PTSD often report that it reveals itself when they don’t want it to. The hallmark of PTSD is “intrusive re-experiencing.” of a traumatic event.

 In September SEMSNation will air a discussion with PTSD experts as they explore in depth the phenomenon of PTSD. It will cover how we as a profession should begin to address the influx of traumatized citizen back into the population. How can we safely address the needs of these patients and deliver the best care possible while remaining safe ?