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The Effects of Trauma on Brain and Body
Published in Mark B. Constantian, Childhood Abuse, Body Shame, and Addictive Plastic Surgery, 2018
We all observe the ways in which muscles from these five cranial nerves synchronize: soothing voices alter facial expression; laryngeal and pharyngeal muscles coordinate prosody and intonation with head turning. The neural mechanisms for eye contact are shared with those that modulate voice. As a trauma patient’s stress load increases, the social engagement system drops out and the autonomic system takes over. Alarmed patients cannot hear what I am saying; they have impaired abilities to discriminate emotions. Their eyes defocus and begin to disengage and resemble the “thousand yard stare” of PTSD. Compare the eyes in Figures 7.5 and 7.6. They are not posed: they are the patients’ facial expressions when taking routine preoperative photographs. The differences, which are measurable, can connote trust, confidence, self-worth, and appreciation just as they display shame, fear, disempowerment, profound sadness, and other powerful, revealing emotions. There are associations between these expressions and the likelihood of satisfaction after plastic surgery.131,132
A Qualitative Analysis of the Experiences of EMS Clinicians in Recognizing and Treating Witnessed Cardiac Arrests
Published in Prehospital Emergency Care, 2023
Susan J. Burnett, Johanna C. Innes, Renoj Varughese, Eric Frazer, Brian M. Clemency
Even when an additional paramedic was not available to advanced level crews, the responsiveness of partners and team members on scene was paramount. Despite varying levels of care and experience, the ability of crew members to take and follow instructions was reported as helpful. For example, one paramedic, when he found a pale, dyspneic male sitting on a porch with a “thousand-yard stare”, knew he and his team needed to act quickly to attempt to prevent and eventually treat a witnessed arrest. He expressed gratitude for his partner, with whom he has a “good relationship,” because “she knew what I wanted as I needed it, so she was handing me stuff without me asking.” He also did not know the firefighters well but reported they “were responsive to what I needed” and “willing to get in there” to perform interventions.