Following the Buizingen train-crash disaster on February 15, 2010, nineteen dead bodies were evacuated to the morgue of the Military Hospital. According to the hospital's emergency incident management system, the reception plan for the deceased was activated and an EM organized. Aim: To determine the psychological impact of exposure to current death and to evaluate the effect of proactive outreach in DRW deployed in an EM.

For five consecutive days 62 hospital staff personnel were involved in the daily activities of an EM: disaster victim identification, autopsies, care for the dead, logistic support and reception and mental relief of the families. Besides a critical incident debriefing on day 5, a postal questionnaire survey of these 62 DRW was conducted, including the Davidson Trauma Scale (DTS) – detecting acute post-traumatic stress reactions/symptoms (ASR/S) – and the Symptom Checklist SCL 90 self-report inventory – measuring primary symptoms and global distress – administered 2, 4 and 7 months following the train-crash. Out of these, 35 (56%) initially responded (informed consent), followed by a return rate of 80% (28/35) and 68% (19/28) respectively. Six out of the 35 participants were identified suffering from acute psychological distress according to DTS and SCL 90 and subsequently followed up in the hospital's dedicated Military Centre for Crisis Psychology. In five of them, normalization of symptoms had occurred by the second inquiry and persisted. Ten months post-event, only 1 patient still needs psychological counseling, whereas 34 demonstrated psychological resilience.

Prevalence of chronification is low (1/35) compared to literature (5 to 10%). Timely detection of acute distress and proactive outreach may effectively counterbalance chronification in tertiary victims following a critical incident. Education and training should help hospital staff deal with ASR/S and improve coping. Hospitals should support professionals in the most disturbing situations.