PRINCEVILLE, Hawaii -- The tour helicopter crash on Kauai that killed four people and critically injured three others has been hard on those who rushed to the scene to work to save lives.

"We get called from the emergency beeper and usually I just kind of dress up, and as I'm dressing I say a little prayer," American Medical Response emergency medical technician George Mones said.

Mones did his same routine on Thursday after getting the call that a tour helicopter went down with seven people aboard.

After talking with dispatchers, Mones said he and the other crews knew it was bad.

"It was pretty much a horrific scene. You come close to the wreckage and you see the intense, just the intensity of what just happened a few minutes prior," he said.

Three people were dead at the scene, another died on the way to the hospital. The paramedics took the other three to Wilcox Hospital in critical condition.

Mones credits all the first responders with doing a great job in a terrible situation. He said paramedics rely on their training to set up a triage area, stabilize patients and get them transported.

However, when their job is done, the reality sets in.

"It's pretty mentally exhausting. You're at the emergency room trying to pick up all the pieces, retrieve all your equipment and you're going through this kind of like a decompression time," Mones said.

He said that kind words from friends and neighbors help rescue crews recover from being so close to so much human tragedy.

First responders said that each member of the team responds differently to major incidents. Counselors are available if they are needed.