Vicarious trauma occurs when one is exposed to the traumatic experiences of another. This exposure is particularly prevalent among first responderslaw enforcement, firefighters, emergency medical services and victim assistance providerswhere the lines between vicarious trauma and direct trauma are thin. This review collects and synthesizes current information about the impacts of vicarious trauma and the methods to address it. Vicarious trauma can lead to severe individual consequences, including increased risk for PTSD, depression, substance use, cardiovascular disease, suicidal ideation and metabolic disease. These consequences radiate outward through the systems of the ecological model (Bronfenbrenner, 1992), affecting a first responder's friends and family, the employing organization or agency, and even the entire industry. The reverse is true as wellorganizational factors, including workload, work climate, and supervision, as well as individual factors such as coping style or history of traumatic experiences can influence the reaction to vicarious trauma within the first responder. Several methods have been explored to mitigate the impact of vicarious trauma. Self-care is effective, but it unfairly shifts the burden onto the individual affected. Other individual treatments, while potentially effective, may be difficult to access due to issues of stigma. Organizational strategies, such as Critical Incident Stress Management, should be combined with adaptations of existing policies and procedures to produce vicarious trauma informed organizations. College: Choose an item.