Police officers, firefighters and ambulance crews routinely step into situations that would send most people running for cover. But because they are trained to remain calm under stress, emergency responders' priority is to get the situation in hand. To do that, they must subdue their own fear, anger or shock to get the job done.

But those reactions don't just evaporate. Instead, "A lot of times, people will suppress those feelings," said Emergency Management Technician Jason T. Smith. He is the director for EMS provider services, under the auspices of the Northeastern PA EMS Council.

Those buried emotions simmer, and if not dealt with, may boil over, scalding families, friends or co-workers, Smith told members of Lansford Borough Council on Wednesday. Smith spoke about the EMS Council's Critical Incident Stress Management program, which provides support and counseling to help cool the reactions before they reach the boiling point.

The symptoms of suppressed stress can include poor concentration, memory problems, poor attention span, difficulties with calculations, difficulty making decisions, slowed problem solving, loss of emotional control, grief, depression, anxiety, fear, guilt and feeling lost or overwhelmed.

The buried stress can also manifest itself in physical symptoms, including muscle tremors, chest pain, gastrointestinal distress, difficulty breathing, headaches and elevated blood pressure.

Behavioral symptoms can include excessive silence, sleep disturbance, unusual behaviors, changes in eating habits, withdrawal from contact and changes in work habits.

CISM emphasizes that police, fire and ambulance personnel are "normal people experiencing common reactions to abnormal events," Smith said.

Smith, accompanied by CISM peer counselor John Dworsky, said it helps to be able to talk to a trained peer counselor or a professional. CISM even employs a friendly helper dog to break the ice. Smith said that during group sessions, a specially-trained dog is often brought into the room.

"Those canines go right to the person who most needs the help," he said.

The program also offer family support, to help family members understand how the stress of responding to emergency situations may affect their loved ones.

CISM services are confidential, and provided free of charge, Smith said. The services provided by CISM have proved effective at "stopping the escalation of symptoms, in reducing acute stress reactions, in restoring adaptive functioning, and in facilitating access for more care as necessary. The team provides individual and group interventions on scene or at a later time when assistance is deemed necessary. The team also responds to stress caused by cumulative effects over time," according to the CISM website.

The CISM Hotline is answered 24 hours a day, seven days a week. For assistance or information, call (610) 973-1624. The Eastern PA EMS Council serves Berks, Carbon, Lehigh, Monroe, Northampton, and Schuylkill counties.