First responders are exposed to traumatic, nontraumatic and organisational stressors that conspire to create stress, potentially leading to emotional issues and/or physical or psychological illness. In addition to individual consequences, stress also takes a toll on the function of emergency departments and their communities. Fortunately, police, fire and ambulance agencies have initiated various preventive measures in an effort to mitigate the ill-effects of continued exposure to stressors by their personnel. However, combating stress effectively requires more than offering individual coping skills and access to counseling for first responders. To best preserve the wellbeing of their workers, emergency service administrators must recognise the impact of stress from a variety of sources, including organisational factors, and approach stress prevention in a multi-staged and comprehensive manner, paying special attention to primary stage interventions. When agencies embrace and act on a broad, holistic view of stress management that includes instituting cultural and organisational changes to support stress prevention, significant improvements in the stress level and health of first responders will be possible.