Proper Breathing for the Proper Response

Training Notebook By RIC JORGE

If you are trapped, lost, or disoriented in an acrid, smoky environment and your self-contained breathing apparatus (SCBA) low-air alert activates signaling that you only have just a few minutes of air left, what would you do? Do you have a plan? Have you practiced your plan under realistic conditions? Victories do not come by accident; they are earned. In the fire service, we know even when you are well-prepared, the outcome is not guaranteed. The following is a series of breathing techniques that can shift the odds in your favor.

Training Minutes: Breathing Techniques

I have taught breathing techniques to firefighters who struggle with post-traumatic stress disorder (PTSD) for several years. This has led to the discovery of some new ways to repackage some old-school techniques and redeliver them in a way that incorporates some of our mental toughness techniques to benefit firefighters in extreme situations. Over the past couple of years, I have incorporated these techniques into rapid intervention team (RIT)/Mayday drills. The breathing techniques in these old drills are not new, but they’ve become a lost art in the fire service.

The Best Techniques

When I was in the fire academy, some of our cadre were Florida Smoke Divers and they taught us many emergency air techniques using the corrugated tubing (elephant trunk) of the older SCBA. One technique involved manipulating the wheel of my air bottle to increase the bottle’s life and extend my air supply. We were also taught “skip breathing.” However, I wasn’t getting good results with the skip breathing; if I just breathed normally, it seemed to extend my air supply better. So, I got away from the skip breathing, which I tried to no avail to master for years.

Figure. 1. Air Consumption Tests

Figure. 1. Air Consumption Tests

As a rookie, I never questioned members who used skip breathing to conserve air. Since then, science has shown it decreases your air supply instead of extending it, so you use more air than you would with normal breathing. A resource that you should consider reading is Air Management for the Fire Service, which addresses some of the effective breathing techniques discussed below (see references).

I teach three techniques that I have found to be most effective: box breathing (“square breathing”), belly breathing (“diaphragmatic” or “tactical breathing”), and the Riley Rescue Breathing technique (or the “hum technique,” some people use pursed lips rather than hum). I teach these techniques because firefighting is about options. No single technique will work for everyone; firefighters are as different as the fires to which they respond. Circumstances dictate response, not popular opinion.

Each of these breathing techniques has homeostasis effects and produces positive, effective results when practiced and used properly over long periods of time. I know this is true, having come back from severe anxiety secondary to PTSD by incorporating the breathing techniques described here. Using one of these breathing techniques properly is one way to keep your internal conditions (heart and respiratory rate, blood pressure, cognition, small motor functions) stable and relatively constant. This achievement is resiliency, but it is only one aspect of developing resiliency.

Through these breathing techniques, I have successfully taught hundreds of firefighter in four states how to increase their survivability profile by combining breathing with the old-school drill of manipulating the wheel of the SCBA with good results.

Training First, Then Drills

Prior to going live at fire conferences, breathing data had to be developed accurately. To obtain results that could be accurately compared to each other requires a relatively consistent platform on which to conduct tests. These results have been verified through experience, drill observation, and consultations with doctors, military and sports psychologists, professional athletes, and personal body sensor device manufacturer researchers.

We tested the firefighters using treadmills. At the start of the test, each SCBA would be filled to approximately 1,500 pounds per square inch (psi) pressure because the subjects didn’t need to breathe down a full bottle to start breathing hard. This drill is designed to show the difference in the extension of air bottle time when combining our techniques vs. using no technique. Common sense would dictate that the percentages should transfer to a full-pressure bottle just as accurately.

Drill 1. Researchers elevated the treadmill to 3.0 and set the speed at 3.7 miles per hour (mph). The drill is timed from the moment the firefighter gets on air. For Drill 1, the firefighter continues walking until his low-air alarm activates. Once it activates, the treadmill speed is slowed to 2.5 mph (approximating the transition from intense work to self-rescue efforts) until the subject is completely out of air. The clock stops when the firefighter disconnects from his face piece.

Drill 2. This drill is the same as Drill 1, except that prior to the test, the firefighters are taught the breathing techniques and they choose one to practice. During the second drill, when the firefighter’s low-air alarm activates, he steps off the treadmill and calls a Mayday. He then shelters in place (finds a safe refuge) and gets into a comfortable position. During this process, the firefighter doffs his SCBA, finds a comfortable position on the floor, turns the SCBA upside-down in front of him to facilitate manipulating the wheel and controlling his personal alert safety system (PASS) alarm, all while implementing his chosen breathing technique to “catch” his breath. Once breathing is restored to near-normal levels, the manipulation of the air bottle begins by the timing and the turning of the wheel combined with the breathing technique.

On inhalation of air, the wheel of the bottle is slowly closed as you gain a complete, full breath. If done correctly, the low-air alarm will stop as the wheel shuts off the bottle. Hence, the subject will have successfully used all the air in the lines, not leaving any residual air for the low-air alarm. During the exhale portion of the respiratory cycle, as you near the end of the exhalation cycle, crack open the bottle by slowly turning the wheel so as not to activate the low-air alarm as you begin the inspiratory cycle of your respiration.

It will take practice to find the “sweet spot” and be able to master this drill without activating the low-air alert. It will also take practice to develop the discipline necessary to master your breathing technique. There are a lot of moving parts to this drill, and your attention and focus will be tested when attempting it under duress.

Test Results

Seventy-five subjects were originally tested. Figure 1 shows the low and high averages consistently found in running the drills. Note that the first two graph items (Low-Air Alarm Only) involved no breathing to determine how long an air cylinder will last without human influence.

If your SCBA features a whistle or a bell, you may or may not be able to obtain the exact results described above, but regardless of the SCBA model, the breathing techniques will maximize your breathing efficiency and extend your air time. Admittedly, I have only tried them on SCBA like these a few times and have had success, but I cannot show consistent numbers with them. Mainly, we have tested SCBA with vibration alerts. Combining these two techniques creates some eye-opening results. They offer another option for self-rescue during a Mayday when a firefighter is trapped, lost, disoriented, or low on air. It improves the rescue profile relative to the average rapid intervention team contact times as shown in multiple studies.

You can also implement these breathing techniques in numerous scenarios in which rapid intervention team contact time is delayed or hindered because of debris; but working, struggling, or allowing anxiety to run its course will compromise your ability to extend your air supply. Make no mistake: The techniques discussed above are to be considered when the choice is sheltering in place vs. running out of air trying to self-rescue.

PASS Alarm Use

We can make a case for the constant activation of the PASS alarm vs. using the PASS alarm intermittently. The constant alert of a PASS while the firefighter is in a Mayday situation will add to sensory overload, to which the firefighter will respond physiologically with increases in anxiety, heart rate, and respiratory rate, which demands more air. Although the brain may represent only two percent of the body’s weight, it uses about 20 percent of the body’s metabolic energy. This breathing technique is only one technique used in classes in which we teach resiliency. We follow a very simple model: Mindset controls emotion, emotion will alter biology, and biology will affect performance. These tasks represent mental toughness and acuity of resiliency, so use these techniques to help put you in the right frame of mind to achieve victory because luck is not a sound fireground tactic.

Air Consumption Tests

Figure 1 shows the high and low averages of the test results. The SCBAs used account for the significant disparity in low-air alarm activation (71 vs. 110 minutes). The National Fire Protection Association allows for up to a 200-psi difference in either direction of the recommended 1,150-psi mark. Although getting a consistent number is impossible, getting a range is possible. In the drills, the time begins when the vibration alert stops; the drill stops when the cylinder is out of air. This was evaluated while the subject was breathing during modest exertion (walking on a treadmill).

The drill results are for the initial drill and provide the low average and high average times. The exact times recorded are as follows:

Drill 1. Six minutes, 20 seconds (6:20) (low); 12:10 (high).

Drill 2. 20:05 (low); 61:44 (high).

Obviously, after completing it once, you have greater understanding of how to do it. With practice, many subjects increased their times as follows: 42:58 (low); 52:10 (high).

References

Gagliano, M, Phillips, C, Jose, P, and Bernocco, S. (2008) Air Management for the Fire Service. Pennwell Books.

Jabr, Ferris. (July 18, 2012) “Does Thinking Really Hard Burn More Calories?” Scientific American. https://www.scientificamerican.com/article/thinking-hard-calories/.

RIC JORGE is a 28-year veteran of the fire service and a firefighter with Palm Beach (FL) Fire and Rescue. He is the founder of Tactical Resiliency Training LLC, which teaches firefighters survival techniques and instructional methodology. Jorge works part-time at a treatment center for first responders who have drug, alcohol, and posttraumatic stress disorder problems.

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