Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Chapter 35: Training for Performance Under Stress With thanks to author and instructor: Deb Ajango

The puzzle of who performs well under pressure, and why, has been studied extensively during the past two decades. The most recent findings, with the help of advances in neuroscience, could have a significant impact on the process of training for performance under pressure. Not only does this information offer a fascinating glimpse into the brain’s automated systems for dealing with danger, but by applying the findings to the field of wilder- ness medicine, first responders and their trainers On July 6, 2013, Asiana Flight 214 landed short of the runway in San Francisco, California. Within minutes, the Boeing 777 was engulfed in flames and destroyed, yet only two people died at the scene. Dramatic photos of the scorched fuselage left viewers dumbstruck as to how anyone could have survived. How could more than 300 passengers and crew have exited the aircraft within 90 seconds of land- ing? And how is it that everyone could evacuate so quickly and efficiently under such duress? can better prepare for real-life crises. Stress and the Brain

Asiana Flight 214 After hearing news of the July 6 crash, many people undoubtedly wondered how they would have performed had they been on the flight that day. Although we often fantasize about what we would do or how we would act in an emergency, research shows that our imaginations rarelymirror reality. Many people wrongly assume, for instance, that the average person panics in a disaster. In fact, numbers show that only 10 to 15 percent of people panic under pressure, while another 10 to 15 per- cent will perform very effectively. The other 70 to 80% of people, when confronted with a highly stressful and novel situation, will actually do very little to save themselves or others. This latter and larger group falls into what John Leach, author of Survival Psychology, calls a bewildered state. While this freeze response is not always dangerous,