Back to Top Skip to main content

Combat stress techniques help military providers during COVID pandemic

Image of soldier in a hazmat suit with a medical-grade mask Lt. Tiffany Bradley participates in fit testing for an N95 respirator and survival mask at Naval Hospital Okinawa, Okinawa, Japan March 27, 2020. The wearing of protective gear while battling the COVID-19 pandemic can cause adverse reactions in health care workers. (U.S. Marine Corps photo by 1st Lt. Tori Sharpe)

Recommended Content:

Combat Support | Coronavirus

Among the images from the heroic response to the coronavirus pandemic are the faces of medical professionals bruised by personal protective equipment worn during long hospital shifts. Anyone in the military who has done field training exercises in protective gear knows that equipment can be uncomfortable and in some cases, cause panic attacks and other claustrophobic symptoms. These symptoms can lead to noncompliance with guidelines for wearing personal protective equipment, or could result in a member of the medical team being temporarily unable to provide medical services to those in need.

Researchers at the Walter Reed Army Institute of Research developed a six-step, peer-based intervention to treat panic attacks or severe claustrophobic symptoms in warfighters wearing protective gear. This protocol, called iCover, helps medical providers on the front lines of the COVID-19 pandemic.

The six steps follow the acronym iCOVER:

  1. Identify the individual experiencing an acute stress reaction.
  2. Connect with the individual by speaking their name, making eye contact, and holding their arm.
  3. Offer commitment by letting them know they are not alone.
  4. Verify facts with two to three simple questions to get their thinking kickstarted (e.g., “What hospital is this?” and “What section of the hospital are you in?”)
  5. Establish an order of events to ground them in the present moment by stating what happened, what is happening, and what needs to happen in three simple sentences. (e.g., “You donned your PPE. You are checking the seal. We are about to check on a patient.”)
  6. Request action of the individual to restore them to purposeful behavior (e.g., “Double check the oxygen saturation on that patient and report back.”)

WRAIR developed the iCOVER protocol for operational units. However, recent events, have caused medical providers across the nation to request use of iCOVER with hospital staff when they begin to feel panic symptoms due to the wearing of personal protective equipment, or when they become acutely overwhelmed for any reason. These experiences from the field suggest that iCOVER may be a rapid, effective way to help medical team members keep their co-workers in the fight. This is a great example of how techniques developed for combat and operational stress control can play a role in the current fight against the coronavirus pandemic.

The iCOVER training video is available on WRAIR’s YouTube channel, and the complete training module with detailed trainer notes is available on request from the Psychological Health Center of Excellence. A specific version of iCOVER training for medical staff is being developed and will be ready soon.

Also, check out the WRAIR COVID19 Leadership Checklist for Mitigating Team Stress.

You also may be interested in...

BAMC recognized by American College of Surgeons for outstanding care

Article
11/27/2020
Medical team, wearing masks, rushing a patient in a hospital bed down the hallway

“BAMC provides more complex care to the nation than any other military treatment facility..."

Recommended Content:

Health Readiness | Combat Support

Minimize COVID-19 holiday spread with small gatherings, mask wearing

Article
11/25/2020
Soldiers standing in a line, wearing masks

The holiday season is upon us, and so is a drastic rise in coronavirus cases.

Recommended Content:

Coronavirus

NMRTU Everett Hospitalman makes a difference

Article
11/24/2020
Technician wearing a mask, giving a shot to a soldier

For much of 2020, Scott has also done her share and more to help stop the spread of COVID-19.

Recommended Content:

Coronavirus | Public Health

Army conducts commercial aircraft decontamination efficacy test

Article
11/24/2020
Man wearing mask, looking at ceiling of an airplane

Two commercial sprayers and two commercial liquid disinfectants will be tried in different combinations on surfaces in the passenger area to gauge effectiveness.

Recommended Content:

Coronavirus

Navy PA continues to care for COVID-19 caregivers

Article
11/19/2020
Three soldiers, wearing masks, demonstrating a hearing test

As a PAt, Osborn works hand-in-hand with supervising physicians and surgeons.

Recommended Content:

Coronavirus

NICoE & ISC Network maintain TBI care during COVID-19

Article
11/19/2020
Image of United States map with locations noted

The Network leveraged their geographic distribution to help each other quickly adapt to changing times.

Recommended Content:

Coronavirus | Traumatic Brain Injury

San Antonio volunteers sought for Warp Speed vaccine trials

Article
11/18/2020
Woman typing on laptop

DOD sites are open on a voluntary basis to Military Health System beneficiaries.

Recommended Content:

COVID-19 Vaccine Efforts | Coronavirus

Army combat medic earns U.S. citizenship, plans to continue serving

Article
11/18/2020
Two men wearing masks, one in a car, one leaning in the car

The native of Brazil is part of the COVID-19 testing team.

Recommended Content:

Coronavirus

Army doctors provide COVID-19 safety tips for the holiday season

Article
11/17/2020
Soldiers wearing masks, looking at flight information in airport

Celebrating the holidays during a pandemic may bring additional challenges for people this year.

Recommended Content:

Coronavirus | November Toolkit | November Holidays and Observances

Military Health System participating in COVID-19 vaccine trial

Article
11/17/2020
Woman measuring out a vaccine into a needle

How you can help test the vaccine.

Recommended Content:

Coronavirus | COVID-19 Vaccine Efforts

DHA leaders recognize CCP collection campaign contributors & donors

Article
11/16/2020
Three military personnel in uniform, wearing masks, in front of flags

The ceremony honored those who contributed to exceeding the goal of collecting 10,000 units of COVID-19 convalescent plasma.

Recommended Content:

Coronavirus | Convalescent Plasma Collection Program

NMRTU Everett staff collaborate to ensure Patient Centered Care

Article
11/16/2020
Image of two military personnel wearing masks

NMRTU Everett was commended by the MHS 2020 Advancement towards High Reliability Healthcare Awards Program as a Patient Centeredness Award winner.

Recommended Content:

Combat Support | Public Health | Coronavirus

Naval Medical Forces Pacific’s commander tours NH Twentynine Palms

Article
11/12/2020
Four military personnel in uniform, wearing masks

Weber was briefed on the implementation of MHS GENESIS...and the hospital's response to COVID-19.

Recommended Content:

Combat Support | Health Readiness | Coronavirus | MHS GENESIS

Forging of civil-military anvil against COVID-19 focus at GHSA

Article
11/9/2020
U.S. and Thai soldiers stand together during a medical exercise.

“Defense partnerships around the world are key.”

Recommended Content:

Coronavirus | Global Health Engagement | Health Readiness | Global Health Engagement

Wave PENDLETON sees more MTFs deploy new electronic health record

Article
11/5/2020
Military technician, wearing a mask, in front of a computer screen

Wave PENDLETON is the third major deployment of MHS GENESIS.

Recommended Content:

Public Health | Coronavirus | MHS GENESIS
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 19

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.