Part 3 ( Lessons and Best Practices) Chapter 18: Lessons for First Responders Flashcards
A number of lessons came from research outside of emergency services such as
Military, medicine, nuclear power, and aviation
Lesson 1) Responders with poor SA can still have a good outcome, if only by luck.
They make good decisions (by luck) while operating with flawed SA and never know their SA was flawed in the first place
Lesson 2) A decision made with good SA can still have a bad outocme
Not every bad outcome can be linked with SA. Emergency services work in a highly unpredictable environment when unexpected bad things can happen that can lead to bad outcomes
Lesson 3) Maintaining SA requires a physical, mental, and emotional commitment to paying attention
Paying attention means capturing the clues/cues and applying Level 1, 2, and 3 SA. It means being consciously aware you’re taking all the necessary steps to develop and maintain your SA. Are you meta-aware? Are you paying attention to the big picture? Are you checking up to make sure you’re not losing SA
Lesson 4) What you should pay attention to is not always intuitive or obvious.
This requires a commander to be alert for subtle clues/cues that help build strong SA. Your primal instinct tells you that things that are moving and things that are close to your are dangerous which can take your attention away. Your primal instinct also draws your attention to loud noises, bright lights, and fast moving things
Lesson 5) Responders rarely realize they’re losing their SA until it’s too late -until that catastrophic incident or near-miss occurs
Realizing the loss of SA is not uncommon, but you may not always know it. It’s plausible to surmise that for some, the intuitive gut feeling becomes so overwhelming that it serves as their alarm system.
Lesson 6) It’s critically important to be able to form mental models of both the past and the future
Rarely is an emergency incident static; rather, the incident conditions are dynamic and rapidly changing. Taking a rear-view mirror approach of the incident is critical to forming SA of what took place prior to arrival. This helps draw on tacit knowledge and develop a plan of action
It can be extremely challenging for ____ to extract accurate and timely information from civilian callers who are upset.
dispatchers
A critical question is: Can my resources overwhelm the incident, slow down, and eventually stop the progression of undesirable events. If the answer is yes, an offensive operation can be deployed. If the answer is no, then
a defensive operations should be deployed until sufficient resources arrive on scene
If you deploy offensively when you are _______, you’re taking grave chances with the lives of the responders in your charge
under-resourced
Forming a mental model for predicting FUTURE events entails asking yourself 3 essential questions:
1) Where is the incident headed?
2) How long will it take to get there?
3) Can the resources I have at this moment change the course of the incident in a favorable way without jeopardizing any lives
Those most at risk are the ones who believe every incident can be managed with ______ ______. This is simply not true
aggressive tactics
In your mental model, you should envision what a ___ ____ would look like. This prediction of the future becomes the expectation against which you compare your progress
successful outcome
The leadership principle taught by Steven Covey from his best seller “Seven Habits of Highly Effective People” is:
Begin with the end in mind
If things are not going well, they wont align and this should set off major alarm bells in your head. The alarm may come as explicit (______) knowledge that things aren’t going well or more subtly as a gut feeling - your intuition (_________) alerting you that what is happening doesn’t match your tacit knowledge ( mental library of training and experiences)
conscious knowledge, unconscious knowledge
Common themes that resulted in near-miss reports and LODD investigations and case studies are what the author refers to as ______. There are 5 sure ways (red flags) to get into trouble
Red Flags
Red Flag 1) Failing to process the meaning of the critical clues/cues
responders to not see what’s happening right in front of them
For a structure fire, one of the most important clues is the _____
smoke
This is generated from decomposing hydrocarbon-based products and is fuel - as explosive and dangerous as gasoline
smoke
The color, volume, velocity, and density of smoke are critical ______
clues
If you miss a vital sign (clue) you’re far more likely to _____ the root problem
misdiagnose
Red Flag 2) Underestimating the speed of the incident
Whereas the initial size-up may need to be quick, it’s vitally important to watch the incident for a period of time to het a sense of how fast it is moving. The speed of the incident helps determine if there are enough resources available to overwhelm the incident and stop the progression. Tied closely to this red flag - overestimating the abilities of personnel
Red Flag 3) Overestimating the abilities of personnel
Every responder is not created equal. Predicting the crew’s abilities to perform certain tasks in predictable amount of time is essential to understand the characteristics that influence the time it will take to accomplish a task which are training, experience, age, fitness, stamina, coupled with crew size
_______ are analogous to little movies that play forward in your head to help predict the future of an incident
Mental Models
Commanders where asked to estimate how long it would take for certain tasks to be accomplished. Consistently, the commanders estimates were ____ to _____ the time it actually took to complete
1/2 to 1/3
Allocating more resources to the problem could be a viable option as love as the back up resources adequate enough to
overcome the situation
Red Flag 4) Feeling the pressure to take heroic action without considering the risk and benefit
We can never be certain that a victim is alive in an environment, but we can assess the probabilities vs the risk of FF’s
Many protocols prohibit CPR in trauma patients because the survivability of cardiac-arrest patients, secondary to multisystem trauma is ____
low
Decision making becomes _____ when the emotional component of a high risk/consequence decision is balanced against the impact of losing a civilian life or the consequence of losing a responder
safer
When aggressive tactics are not accompanied by negative consequences, it may lead to a false sense of ____ that such behavior is acceptable.
So it becomes the norma - the standard. This phenomenon is also known as the standardization of deviance, drifting toward failure, or error creep
behavior
____ can have strong influence on FF behavior. Especially for new responders who want to fit in with their senior counterparts. This may cause them to take risks beyond their capabilities
Peer Pressure
People will do things to get ______. Good or bad
attention
There is distinct difference between assuming the risk of an incident and creating the risk through reckless behavior
true
Red Flag 5) Focusing on the wrong things or trying to process too much information
The number of unrelated pieces of information a person can recall is 7 +/- 2.
As a 1st responder you can improve you chances of capturing the right information through practice. Medical personnel are arguably some of the best-trained responders for this skill. Just knowing you are vulnerable may be sufficient enough for you to consciously weigh the importance of data
Sometimes facts are ________ -changed in order to make more sense in the mind of the participant
confabulated
