Overcoming Panic: Stress-Induced Training and Education

By NATHAN DEMAREE

You have just arrived for a fire with a report of people trapped. It’s hot, and the smoke is heavy with no real drift or indication of the source. You and your buddy have made your way deep inside the building and are conducting your search. Maybe you had to climb several flights to get there. Maybe you had to help the engine company stretch a line or force a few doors. Your heart rate is up, and you are breathing heavily. All of a sudden, you feel your mask squeeze to your face. What do you do?

This is a general scenario I often pre-sent to others. The most upsetting part of doing this is that the response I normally get is a long, lengthy answer that suggests several possibilities: “This is a true emergency!” “This is not the time to formulate a plan.” “You should be acting on instinct.” “You should be prepared for this.” Sometimes, I get this response: “I would turn to my buddy and tell him I need to buddy breathe.”

Okay, good! Then I ask, “What if his response is ‘What?’ ” I then explain the following: You already felt that mask suck to your face. Are you going to use your last amount of air trying to repeat this statement to your partner? What if you truly cannot hear one another? The truck could be up on the roof cutting a hole. You could have other crews working near you or the alarms are still active. You might be in a mechanical room and can’t hear one another even at a yell. How do you tell your partner you need to buddy breathe? Remember, this is still an emergency. How long has it been now since you have had a breath?

Let’s complicate the scenario further. Assume your partner is not right next to you at the time you suck your mask to your face. And, on top of your not being able to hear one another, smoke is banked to the floor and visibility is zero.

Now, find your buddy and tell him you need air. Do you tap him on the shoulder, pull down on his air line, or reach for his emergency buddy breathing system (EBBS)? How many fires have you been on that people pull, slap, and nudge you? What is the universal hand signal for “I am out of air”? Remember that smoke. What is the universal touch signal for “I need air”? Currently, there is no universal touch or hand signal for air emergencies.

What Is Panic?

Panic is the most basic human reflex. If you are not prepared for this situation, your body will not respond the way you will need it to to save your life or the firefighter next to you. One definition of panic is “a sudden sensation of fear which is so strong as to dominate or prevent reason and logical thinking, replacing it with overwhelming feelings of anxiety and frantic agitation consistent with an animalistic fight-or-flight reaction.”

On some level, we all are susceptible to panic. Most of us have run into these sensations or “feelings” on incidents from time to time. The way panic is manifested and how we deal with it differ with individuals. Some might handle these situations rather well. Experience does play a role and certainly helps, but that is never a guarantee. At some point in your career, you will be yanked into this reality by an equipment malfunction, a ceiling coming down, or the floor giving way. These events shouldn’t surprise us-after all, the building is on fire, right? You should factor in these inevitable occurrences. Yet, time and time again, these events continue to catch us off guard, and I have yet to see training focusing solely on these issues.

When Panic Happens

When faced with a stressor, your body sends signals to your amygdala (primitive brain), which hits the panic button. This releases adrenalin and cortisol hormones, which increase breathing, heart rate, and blood pressure-not the best of things to happen when you have become separated from your life-giving air. Some fears are preprogrammed. Few people can overcome these “primal fears” such as not being able to breathe. Your body’s natural reaction is to act on instinct and do whatever it needs to solve it. These instincts can cause more harm, such as leading you to pull off your mask because it just sucked to your face. The important thing to know is that those signals sent to your amygdala are processed twice as fast as in your cortex. Sometimes that delay can cause you to freeze. The body does not know what to do; it’s almost waiting for the frontal lobes to catch up. Or, your body can react to a “fearful” stimulus before the rest of your brain processes it to determine that it was not a real threat. The higher functions, such as reminding your body that you are in an immediately dangerous to life or health (IDLH) atmosphere, are in your cortex.

Ripping off that face piece will most certainly end in death. Unless you have trained under those very conditions, you most likely will do exactly what you should not do: pull off your mask and take one huge breath from hell. If you do not fully understand what I am saying, try this: Put on all your personal protective equipment (PPE), including self-contained breathing apparatus (SCBA). While breathing off your cylinder, perform some jumping jacks for 30 seconds to a minute, then have someone turn off your main valve. Get the picture? How long can you endure that sensation in your chest? That overwhelming desire to rip off your mask and cram “fresh air” into those burning lungs of yours? Let’s be honest. This is often a place we rarely venture into during our training.

How the Military Handles Panic

If we were to look at the training in any one of our Military’s Special Forces, what would we notice? These personnel do not just pass a simple entrance exam and go through basic knowledge into unconventional warfare. They are tested, often to the extreme. Peak physical fitness is a given, but that is a discussion for another day. What characterizes them as elite? Is it that their lives and the lives of their teammates rest on their ability to perform? They train realistically and as though their lives depend on it. As we all know, they do. If we were to compare that to modern firefighter training, both would seem to have a lot in common. Yet, that is not the whole truth.

Let us focus on just one aspect of their training, practicing building assaults using live rounds. Why do they do this? What is their focus? They do it because someone knew the difference between training and the reality of using real bullets. There is a sobering truth present during these events as opposed to other training. I once heard a “special operator” coin the phrase “Being just average scares the hell outta me!” What do you believe he was referring to?

We, as a whole, have become a very safety-conscious breed, especially when it comes to training. Of course, National Fire Protection Association (NFPA) 1403, Standard on Live Fire Training Evolutions, has its merit. It has most certainly limited unnecessary risks. When was the last time you felt you had been truly tested after a training burn-charging by the two backup lines through the well-ventilated hallway to valiantly extinguish three smoldering pallets and wet hay? If the ultimate goal is safety, at times it can feel as though the standard has attempted to eradicate risk all together. “The policy of being too cautious is the greatest risk of all.” (Jawaharlal Nehru)

The NFPA specifically has hundreds of standards, all of which have purpose and need, but have you heard of NFPA 1404, Standard for Fire Service Respiratory Protection Training? It specifically states that we should train realistically. What does that mean? By my limited interpretation, it means a whole heck of a lot more than the training I have seen. Unless you train to fail, you never really know how you will handle yourself. If you cannot overcome these evaluations when your life is not on the line, when your life is on the line, you will die.

Realistic Stress-Induced Training

Discovering the Military-Fire Service Link

What led me into this type of training? Years ago, I became aware of the Air Force’s Elite Pararescuemen (or PJs). Their training pipeline spans almost two years and is affectionately termed “Superman School.” When I learned about their water confidence and drownproofing evolutions, I was hooked. Some of those drills consist of bobbing, floating, traveling, flips, and mask recovery all while your hands and feet are bound and lengthy underwater swims with knot tying. One of the evolutions in PJ Indoc is the dreaded “buddy breathing,” sharing a snorkel with your buddy in the deep end while instructors provide “realistic surf conditions.” I began devoting a significant amount of time to those specific areas of focus. I practiced underwater drownproofing, buddy breathing, and any other sort of water confidence I could imagine. Amid the bobs and dolphin kicks with my hands and feet tied, I learned a great appreciation for fighting off panic and learning how to remain calm under pressure. I also learned that there was a direct correlation between my confidence in the water and my ability to remain composed and focused on the fireground and with my SCBA. I remember thinking, “Why is firefighter training not like this? I took those same drownproofing drills and began to tweak them for the fire department.

Most of us have had a close call or two, but the fireground is not the best place to test your skills. This program creates those fears/stressors and teaches firefighters how to combat them. It is more than just tasking students with what they feel is impossible. It is about repeatedly raising the bar, putting them in uncomfortable situations over and over until they change their focus. All the drills are progressive, and every class we ran operated at its own pace. Some people are able to grasp the concepts fairly quickly; others need more time and additional focus. The main point is that everyone improves.

What the Training Looks Like

In stress training, external events or circumstances force an internal emotional or cognitive response where students will either learn to adapt and overcome previously known or expected limitations or discover the ultimate threshold of their abilities for the exercise. The difficulty within this niche of training is there is no true maximum individuals can be measured against. Each individual would be set in opposition to his abilities. The advantage of this training is that the process of adapting to these stressors has a proven and reliable method that fits all modalities. The student can adapt to the stress of a Mayday incident or an air emergency using the same skill set or behavior modifications.

These exercises should not be attempted lightly or without the supreme respect they deserve. They are not hazing rituals or to be used for other than their intended purpose of stress-induced training and education.

To combat stress, the students must be able to overcome it. Surprisingly, it doesn’t take a lot to do this. The easiest way to do this is to get them focused on their air and then take it away. Not being able to breathe is a primal fear. Every person responds differently, and “applying stress” needs to be very systematic and requires keen observation. The point is to provide just enough stress so that the students feel uncomfortable but not so much that it ceases to be a learning experience. This is most important in the early phases because students need to get some wins under their belt before the stress is heaped on.

All the drills are the results of years of trials and adjustments. Below is a basic description of one of the drills. Remember, these things take time and the instructor’s deep understanding of the signs of stress. The exercise begins with the “buddy breathing” evolution. It is one of the most fundamental drills. It forces the individual to focus on his breathing, teamwork, and SCBA orientation. This is based on the Pararescue buddy breathing training mentioned above. The SCBAs we have always used for these drills have certain basic components such as an EBBS connection and an ability to disconnect the main air line from your face piece. There needs to be a way to swap between air lines while denying inhalation when not connected. All the evolutions are conducted in a non-IDLH environment. This provides a certain safety factor and allows for proper evaluation of each candidate.

Training Scenario

Following is a training scenario you may want to use in your department:

  • Two students wearing full PPE and a mask (blacked out) with a mounted regulator share the EBBS line from one SCBA while remaining calm and experiencing varied degrees of instructor harassment (mild, moderate, and full) for a prescribed time limit, generally two to five minutes.
  • On the command “Begin,” the firefighters position themselves “normally seated” around a single SCBA. They don their masks with regulators and begin buddy breathing from one EBBS.
  • One firefighter connects, takes a breath, disconnects, and passes the EBBS back to his buddy.
  • During the exercise period, the students maintain control of each other and their SCBA. A student should try to consider his buddy’s limited air supply and take only one breath before passing the EBBS back. During this exercise, the students breathe only through the EBBS.
  • To satisfactorily complete this exercise, each student must keep his face piece on and not breathe from the unconnected mask-mounted regulator during the entire exercise period. He must remain calm and maintain control of himself, his buddy, and the EBBS. The student is given one warning for unsatisfactory performance; on the next occurrence, he will be scored unsatisfactory for the exercise.
  • Harassment is added as a more intense form of buddy breathing. It involves the instructor providing the students with certain stressful situations to see if the students will panic (grip checks, pulling on PPE or the SCBA, grounding the firefighter, and denying breaths, for example). The same standards apply to this exercise. Note: During the “full harassment” phase, there is a strict two-minute time limit and never can the firefighter be denied more than two consecutive breaths.

I am well aware that it is highly unlikely that two firefighters would ever be in a situation where their only option is to share a single EBBS line. That is not the point of the drill. The point of the drill is to teach stress/panic management. That being said, it is a great introduction into these types of drills. Sit down with your crew and come up with scenarios where you could have an air emergency (fall, mask knocked off, valve not fully on, for example). Statistics will say these types of events have a low probability, but they are high-risk events, and the intent is to prevent becoming a statistic. Remember, today might be the day such an event will occur!


NATHAN DEMAREE is a 16-year veteran of the fire and rescue community and a firefighter with the District of Columbia, assigned to Truck 9. He is also a member of the Warrenton (VA) Volunteer Fire Company. Previously, he was a career firefighter with Loudoun County (VA) Fire-Rescue. He is a co-owner and lead instructor for First Alarm Solutions and Training.

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