View source for Second victim

==Background==
*Second victims are healthcare providers in the midst of a medical mistake or error and become victimized because of their role. 

*University of Missouri Health canter found almost 1 in 7 staff reported experiencing a patient safety event resulting in personal disturbed emotions.<ref>Scott SD. The "second victim" phenomenon: a harsh reality of health care professions. AHRQ; WebM&M Perspectives on Safety; May 2011.</ref>

==Clinical Features==
*Immediate.
**Stress related psychological and physical reactions:
***Sadness, Fear, shame and anger
***Panicking, horrified and apprehensive.
***Sympathomimetic reaction with tachypnea, tachycardia, elevated blood pressure and difficulty concentrating.
***Lonliness and fear of being called names and losing job.
*Subsequent.
**Fear of returning to work.
***Loss of confidence.
***Self doubt, remorse.
***Hypervigilence, second guessing everything.
*Ongoing till resolved.
**Characteristics of PTSD (inability to process the feeling of fear, sadness, guilt and shame).
**Resulting in:
***Insomnia, flashbacks and thoughts of suicide.
***Damaged self perception.
***Loss of self security.

==Differential Diagnosis==
*Anxiety neurosis
*[[Thyrotoxicosis]]
*PTSD
*Depression

==Evaluation==
*It is not easy to spot a second victim unless we specifically look for them.
*Second victims should be protected and shielded from public eye until the situation is properly studied.
*The second victim should be treated on urgent basis.
*Second victim code should be announced and a separate team should provide help to the person, besides the team evaluating the incidence.

==Management==
*Five rights of the second victim.<ref> Denham CR.TRUST: the 5 rights of the second victim.  J Patient Saf.  2007; 3: 107-119</ref>
**'''T'''reatment that is just.
**'''R'''espect.
**'''U'''nderstanding and compassion.
**'''S'''uppostive care.
**'''T'''ransparency and opprtunity to contribute.

*Recovery process of the second victim.<ref>Scott SD, Hirschinger LE, Cox KR, et al. The natural history of recovery for the health care provider "second victim" after adverse patient events. Qual Saf Health Care 2009;18:325-30.</ref>
# Chaos and accident response.
# Intrusive reflections.
# Restoring personal integrety.
# Enduring the inquisition.
# Obtaining emotional first aid.
# Moving on. Which can lead to either of the three.
## Dropping out.
## Surviving.
## Thriving.

==See Also==

==External Links==

https://archive.ahrq.gov/news/newsroom/commentaries/second-victim-syndrome.html


[[Category:Misc/General]]

==References==
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