Four aspects of emergency medical workers' exposure to death in a mass casualty shooting incident were related to their reactions to the incident and their reported psychological and psychosomatic symptoms. This study assessed thirty-six emergency medical workers' psychological and psychosomatic symptoms self-rated for the weeks before and after the shooting; thirty-one responded again one month post-event. Obsessive-Compulsive, Hostility, Depression, Anxiety, and Global Severity Index SCL90R Scales showed acute elevations that resolved within a month except for the first two. Objective and subjective exposure to the twenty-one on-scene deaths was related to acute increases in Obsessive-Compulsive and Depression self-ratings; stress from triage decisions was also related to the former, and was best relieved by help from coworkers. A task-focused first reaction was associated with more positive outcomes than was an initial shock reaction.
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