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Psychological debriefing (PD) is a brief, short-term intervention aimed at mitigating long-term distress and preventing the emergence of posttraumatic stress. In recent years, it has become a ubiquitous intervention, one which has evolved as almost prescriptive following harrowing events and grew through a practical need to offer assistance to those who are exposed to severe trauma. Despite disturbing data from the recent refereed literature of psychology, it is still referred to as the “standard of care” for disaster and crisis response and its use in many quarters continues. This article critically reviews the evidence for and against its use and outlines the weaknesses in the research. The emphasis of this review is on the appropriateness of debriefing in organizations. This article also proposes a set of hypothesized constructs that may, in part, be responsible for the paradoxical effects found in some outcome studies on debriefing. Guidelines are also proposed to help organizations and professionals react appropriately using evidence-based interventions.

Amniotic fluid embolism is one of the most catastrophic complications of pregnancy. First described in 1941, the condition is exceedingly rare and the exact pathophysiology is still unknown. The etiology was thought to be embolic in nature, but more recent evidence suggests an immunologic basis. Common presenting symptoms include dyspnea, nonreassuring fetal status, hypotension, seizures, and disseminated intravascular coagulation. Early recognition of amniotic fluid embolism is critical to a successful outcome. However, despite intensive resuscitation, outcomes are frequently poor for both infant and mother. Recently, aggressive and successful management of amniotic fluid embolism with recombinant factor VIIa and a ventricular assist device, inhaled nitric oxide, cardiopulmonary bypass and intraaortic balloon pump with extracorporeal membrane oxygenation have been reported and should be considered in select cases.

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