A 38-year-old female emergency medical technician presents 10 days after witnessing a fatal multi-vehicle accident in which she performed CPR on a child who died. She reports recurrent intrusive images of the child's face, nightmares about the event every night, avoidance of driving, hypervigilance, an exaggerated startle response, emotional numbness, and a persistent inability to experience positive emotions. She also describes episodes of feeling detached from her body, as though she is watching herself from outside. She is unable to return to work.