Frozen moments: flashback memories of critical incidents in emergency personnel

Brain Behav. 2015 Jul;5(7):e00325. doi: 10.1002/brb3.325. Epub 2015 May 13.


Background: Emergency Department personnel regularly face highly stressful situations or critical incidents (CIs) that may subsequently be recalled as unbidden intrusive memories. In their most extreme form, such memories are reexperienced as if they were happening again in the present, as flashbacks. This study examined (1) which CIs are associated with flashback memories; (2) candidate person and work-related features that predict flashback memories; and (3) the association between flashback memories and anxiety, depression, and emotional exhaustion.

Methods: Emergency nurses (N = 91; 80.2% female) were recruited from two urban teaching hospitals and filled in self-report questionnaires.

Results: A majority (n = 59, 65%) experienced intrusive memories; almost half of the sample reported that their memories had flashback character. Those involved in resuscitations in the past week were at a fourfold risk for experiencing flashbacks. Having worked more consecutive days without taking time off was associated with a somewhat lower incidence of flashbacks. Moreover, older individuals who reported more work-related conflicts were at greater risk for experiencing flashback memories than their younger colleagues with heightened work conflict and flashback memory scores, respectively. Flashback memories were associated with heightened symptoms of anxiety, depression, and emotional exhaustion.

Conclusions: The present findings have implications for evidence-based health promotion in emergency personnel and other individuals regularly exposed to CIs.

Keywords: Anxiety; burnout; depression; emergency department; emotional memory; flashback; intrusion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Anxiety
  • Conflict, Psychological
  • Depression
  • Emergency Medical Services*
  • Fatigue
  • Female
  • Hospitals, Teaching
  • Humans
  • Male
  • Memory*
  • Nurses / psychology*
  • Self Report
  • Surveys and Questionnaires
  • Urban Population