Emergency services are under enormous pressure to offer programmes that could protect their staff from the psychological impact of stressors encountered in their roles. There has been a surge in the number of pre-incident training programmes aimed at first responders to maintain their psychological wellbeing after critical incidents. These include pre-employment screening programmes, psychoeducation, operational training, line manager training and interventions aimed at improving resilience, wellbeing or stress management. Whilst developed with the best intentions, these programmes vary in efficacy. Therefore, knowing what training to offer first responders prior to exposure to critical incidents is far from clear. In this review, we critique the available evidence and make recommendations about what to offer and what to avoid offering first responders prior to exposure to critical incidents. We found no evidence of the effectiveness of pre-employment screening or psychoeducation offered as a standalone package, and little evidence for interventions aimed to improve wellbeing and resilience to stress - although current trials of empirically-driven interventions for first responders are underway and show promise in preventing stress-related psychopathology. Operational and line manager training showed the most promise but need to be evaluated in high quality trials with sufficient follow-up to draw conclusions about their preventative benefits.

紧急服务部门承受着巨大压力，要求他们提供能够保护其员工免受其工作中遇到的压力源的心理影响的计划。针对急救人员在重大事件发生后维持其心理健康的事前培训计划数量激增。这些措施包括职前检查计划，心理教育，业务培训，直属经理培训以及旨在提高适应力，福祉或压力管理的干预措施。尽管这些程序是出于最好的意图而开发的，但它们的功效各不相同。因此，在暴露于重大事件之前，知道如何为急救人员提供培训尚不清楚。在这篇评论中 我们会对可用的证据进行评论，并就暴露于重大事件之前的应急措施提供建议和建议。我们发现没有证据表明可以独立进行职业前筛查或心理教育，而且几乎没有证据表明旨在改善幸福感和抵御压力的干预措施，尽管目前正在进行以经验为导向的针对急救人员的干预试验，并且显示出希望预防与压力有关的精神病理学。运营和直线经理培训显示出最大的希望，但需要在高质量的试验中进行评估，并进行充分的随访以得出有关其预防益处的结论。我们发现没有证据表明可以独立进行职前筛查或心理教育，也没有证据表明旨在改善幸福感和抗压能力的干预措施，尽管目前正在进行以经验为导向的针对急救人员的干预措施试验，并且显示出希望预防与压力有关的精神病理学。运营和直线经理培训显示出最大的希望，但需要在高质量的试验中进行评估，并进行充分的随访以得出有关其预防益处的结论。我们发现没有证据表明可以独立进行职业前筛查或心理教育，而且几乎没有证据表明旨在改善幸福感和抵御压力的干预措施，尽管目前正在进行以经验为导向的针对急救人员的干预试验，并且显示出希望预防与压力有关的精神病理学。运营和直线经理培训显示出最大的希望，但需要在高质量的试验中进行评估，并进行充分的随访以得出有关其预防益处的结论。