Hi. In this video we will introduce the protective and risk factors for adults in massive emergencies. But before we begin I must make an important warning. This video is designed as a complement to the video 3.6 in which we explain the risk and protective factors in daily emergencies. And to avoid saying the same thing twice, in this video we will only refer to what's different from daily crisis in massive emergencies. So if you haven't seen the previous video, we recommend you to see this video first, the 3.6 one, and then go back to this one, 3.7, so that you can properly follow its instructions and understand its content. Which are the distinctive features in massive emergencies? Well, there are four negative characteristics and one positive protective factor. One of the negative characteristics that will strengthen risk factors we have the fact that massive emergencies usually affect a big number of people. They also generate a lot of media expectation and this causes a high presence of media in the emergency scenario, the scenario in which the relatives of the affected people are reunited and informed. In third place, massive emergencies almost always involve the community's available resources, because the community is ready to assist a determined number of daily crisis, but a massive emergency is usually outside of what the community can answer quickly, and so we there's an initial moment in which there aren't enough resources. And if the massive emergency is also caused by a natural disaster, it is possible that the infrastructures are disrupted and broken, which will generate more difficulties. These four characteristics generate a certain chaos situation at the beginning of the emergency management, and this chaos and this overflowing will probably difficult the people's recovery because the activation levels of the affected people will rise, as you have seen before. On the other side, the protective factor is that massive emergencies usually cause a big empathy in the community which throws itself into assisting the affected ones and showing its solidarity, and this will help them recovering faster. Let's now see what we mean when we are talking on massive emergencies. Well, we classify them in four categories. In first place there are the natural disasters, fires, floods, earthquakes, all the situations in which nature, for one or another reason, unleashes and causes damage, human lives losses, injured people and material losses. In second place there are the terrorist attacks in which there are also human lives losses, injuries and material damage but in this case they are caused voluntarily by some people that decided to blow up an infrastructure or end with their fellow citizens' lives. In third place there are the huge accidents. Massive means of transportation such as trains, ships and planes don't usually have accidents, but when they do they affect a lot of people. And although sometimes these big accidents luckily don't have a great number of mortal victims, they are very spectacular and so they increase the risk of traumatizing in the people that were traveling in that mean of transport at the moment of the accident. And in the fourth category we set all the other incidents that don't fit the three previous categories, such as the fall of a building but not due to a terrorist attack, but due to a gas explosion or any kind of incident that causes a great amount of material damage and probably victims. Which is the main problem in massive emergencies? I explained it a bit before. During massive emergencies management, due to the big amount of affected people and probably because of the infrastructures damage, it's almost impossible to prevent a certain chaos. This chaos, which is related to the fact that the priority is saving lives and trying to help the injured, generates a lack of information. You have already learned that both are factors that difficult the answer to a critical incident. So if we have a certain overflowing situation and lack of information, not because we want to but simply because there are priority tasks before informing, we will generate secondary victimization. And this secondary victimization is the main risk factor linked to massive emergencies. What is secondary victimization? What do we mean when we talk on secondary damage? Well, this is a very important concept. In any daily or massive critical incident we differentiate primary damage and secondary damage. The primary damage is the one produced directly by the critical incident damage, a building falls because of a gas explosion and generates a certain amount of dead people, let's say five, a number of injured people, let's say 20, and 50 affected people that lived in the building, which are unharmed but have lost their houses and their belongings, primary damage. From this primary damage that we couldn't avoid when we arrived to help the affected, a second damage appears related to how we managed the primary damage. That is, when people who lost a loved one have to go from one to another hospital to get some info, when it takes a lot of time for injured people to get information on their relatives, when that person's information and belongings management, or about the people who lived in the building isn't enough, we are causing avoidable damage, as it is a damage that is is generated after the primary damage, during the critical incident management. You will obviously understand that for people that participate and for you as psychological first aid providers, the main task we do from the moment we get to a massive emergency scene is trying to avoid secondary damage, because, I insist, we can't avoid primary damage, but secondary damage depends mostly on what we do. We recommend you that in this sense you briefly review the concepts "protective factor", "risk factor" and "vulnerability" we have exposed in the video 2.5, because they will help you understand the next slide, that talks about protective factors in massive emergencies. Which are these protective factors? Well, we have classified them in three categories, we have protective factors inside the situation, we have protective factors referring to the affected person itself, we have protective factors that are related to the incident management. Just to make it clear, I will focus on exposing the protective factors, that is, what we can do with what we have to try to minimize the damage. But each of the protective factors is, at the same time, a risk factor. Let's begin with protective factors regarding the situation. For affected people it's easier to accept a natural disaster, because natural disasters are considered unavoidable. While the fact that the emergency that harmed us, that stole our loved ones' lives, is a terrorist attack, we would be talking on a risk factor, because we consider this was avoidable, that someone planned doing this damage, and so it hurts twice. Also protective factors, and it's very important that in a massive emergency some people, some affected people don't lose any member of their family, no matter how terrible the experience has been, also if the family is unharmed, without any loss, this will be a protective factor. In factor analogies, if we are so lucky that in a family people also don't get hurt, we have another protective factor, because not having people with physical damage helps us overcoming with what happened sooner. And a protective factor that might surprise you is that the massive emergency happens during daylight. Studies have proved that those massive emergencies that happen during the night generate more terror because during the night we can't see, we are more vulnerable, because usually we are in the bed in pajamas and all these factors make us more scared, more vulnerable, and this will become a risk factor. Which are the protective factors in a massive emergency that are related to the person, with how someone that is involved in a massive emergency is? Well, the first of them is being someone that had a good capacity of stress confrontation, being able to manage hard situations, having certain experience of having come over other stressing experiences will help you going out of the current emergency. Of course, a second factor is counting with a good support social network. And all the factors we have seen during resilience, that is, all the factors that increase someone's personal resilience, will also help us during the answer to the massive emergency. A last protective factor in massive emergencies is that the person doesn't deny or dissociate for a long time. In other words, when we are managing a massive emergency we will always see a certain number of people who find it hard to assume what is happening and that are denying and trying to convince themselves that in the end nothing is wrong. This attitude is a risk factor. While people who relatively understand what's happening and what it involves quickly, that's a protective factor. And finally, and these are the ones we're more interested in, when we are participating, the protective factors that are related to the incident's management. You know that the more tranquility there is, the lower the activation level will be and so, we will be protecting the affected ones from the risk of suffering important traumas. But you will have also sensed how hard is keeping calm and tranquility and low activation levels during emergencies, it is very, very hard, I would dare to say it's even infrequent. What else is a protective factor during massive emergencies? Having quality information available, and this is where we have more chances to participate. It is important that you, as psychological first aid providers, remember that information helps and it must be always present. And if you don't have any new info, try to explain that you don't have any new information but in 30 minutes or 45 minutes you will try to give more information, so that people know you are doing your best to inform. An obvious factor we sometimes forget is the good treatment affected people receive from participants. Treating the affected person properly, as you will do after learning what you are learning in this course, is a very high protective factor towards whatever happened in the massive emergency. And obviously you have guessed that and you are thinking, applying psychological first aid that help us reducing the risk factors will be a very high stimulation for a positive recovery of the affected people.