It's during their down time first responders might think the most about what they've experienced.
"For me personally, it's not actually the heat of the moment, at that time," Washington County Sheriff Mike Robinson said. "It's very upsetting, but you do what you have to do. It's the down time later you start thinking."
Robinson, several deputies and volunteer rescue members from Blair, Arlington and Kennard responded to a one-vehicle accident on County Road 18, a half-mile west of County Road 23, on July 5. Heidy Martinez, 14, was killed, and five other juveniles — two boys and three girls ages 13 and 14 — were injured.
"I start thinking," Robinson said. "I have a 14-year-old granddaughter, the same age as Ms. Martinez, so I start thinking of her. You really sympathize."
Robinson and Blair Fire Chief Joe Leonard said services are available to responders following fatal accidents to help them cope with stress or other feelings they may have. Those services come through the Nebraska Critical Incident Stress Management (CISM) Program.
According to the Nebraska Department of Health and Human Services, CISM provides education, prevention, stress-coping techniques to reduce the risk of suicide and mitigate the effects of stress and other negative emotional reactions that could impair responders ability to function.
"We usually do (CISM) 48 hours after," Leonard said. "We had a debriefing on Sunday for anyone that was involved in the accident. It's not mandatory by any means, but it's there to help us cope with anything."
Leonard said the more times rescue members respond to scenes where they experience distressing events, the more it can take a toll on mental health.
"We try to mentally prepare ourselves for what we're coming to," he said. "We always think for the best ... once you're on scene, reality can hit."
Robinson also said responding to calls can take a toll, especially in a small, tight-knit community.
"From what I've seen when we respond to a fatality accident, one of the first things that goes through your mind — 'Is this somebody I know? Is this one of my relatives?'" he said. "You get there it may be a friend, or a friend of the family or anything. It is stressful. It does take a toll on a person."
He said that's not only true for officers, but for the people taking the initial 911 call.
"Dispatchers, they're not the ones who receive the glory, they don't receive the accolades, but without them, nobody could do their job," he said. "Someone calls 911 needing help, they're the first people they talk to. Sometimes people are — of course they're upset. (Dispatchers) do a fantastic job."
Leonard said it's good that the CISM team, founded in Nebraska in 1989, is available to responders since they can experience PTSD. The U.S. Department of Health and Human Services' Substance Abuse and Mental Services Administration estimates about 30 percent of first responders experience PTSD.
"We're starting to see higher numbers of suicide rates in first responders nationwide," Leonard said. "Luckily, we haven't had to deal too much with that in our department. We do a good job of getting those services ... we rely on each other as members of the department or of the wider fire and rescue family."
The CISM team is made up of volunteers, many who are officers or volunteer rescue members themselves. Responders who may need help can call one of those volunteers to talk or get information in the form of pamphlets to help with any stress or negative effects of their experience.
Leonard said he is always available to talk if someone in the department needs to.
"I don't care what time a day, reach out," he said.
Robinson said the sheriff's office makes sure to see how everyone is doing following a fatal accident. Officers go right back to work following a fatal accident, but if someone is having a hard time, the department reacts with care, he said, and encourages people to seek help if they need it.
"They go back and do their job," Robinson said. "Me, I came back to the office and started working on the budget. The deputies, they go back to service and respond to calls. If we know someone is having a difficult time though, we will send them home ... Just because you need the help, does not mean you're weak."