By Lewis Lovell
In 2018, I attended a fire on the ninth floor of a residential building. The fire was contained to one apartment, but tough smoke conditions and multiple elderly victims made it an extremely challenging fire. It was my first high-rise fire as well as my first fire as an acting company officer. In hindsight, I identified several seemingly obvious things I could have done to improve my performance that day.
Around the same time, I read a piece of research on the decision making of company officers on the fireground. They found that 80 percent of the officers’ decisions were based on his or her experience. They weren’t long deliberations that sized up the tactical needs of the situation and weighed several options against each other. They were gut decisions, based on previous fires attended by the officer (Cohen-Hatton & Honey 2015). I realized my previous experience shaped the way I approached this fire. Although I didn’t realize it at the time, I took on this fire as if it were a single-family dwelling or a two- or three-story apartment fire, since that is where all my previous experience lay. I was aggressive; I wanted to get up there as quickly as we could to get in on the action before the first-in engine could put the fire out. This caused me to rush and not size the building up as well as I should have. I even missed the fire blowing out of the apartment window because I was focused on where we should position the engine.
In the fire service, experience is vital to making quick, correct decisions. In his book Sources of Power, Gary Klein writes that firefighters who “just knew what to do” were actually relying on what their years of experience had bought them: the ability to recognize patterns, a sense of what is typical, the ability to see anomalies, and their beliefs about what is possible. This is known as “tacit knowledge” and it is vastly more important to good decision making than “explicit knowledge” of facts and procedures.
In a nutshell, experience trumps policy knowledge when it comes to critical decision making. That said, a good fire officer will have both.
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The problem is that while we know experience will make us better firefighters and better decision makers, it’s impossible for us to distribute experience evenly across the board. There are so many chance factors when it comes to the number of emergencies you attend throughout your career. The best answer we have is to train, but it’s not just about putting reps on the board. Training must be progressive. Company-level training is vital to maintaining basic, essential skills. However, when firefighters attend multi-company training, they should be met with tasks that test their abilities and challenge their preparedness. The more situational stress we put on firefighters as they perform their training tasks, the more tacit knowledge we give them to draw on when it really counts.
Stress refers to the brain and body’s response to arousal. If you’ve ever felt a surge of adrenaline, then you’ve experienced an arousal response. Ever heard someone screaming their size-up on the radio? It’s most likely not their knowledge or skills that are letting them down but their body’s arousal response taking over.
It’s not hard to become stressed, either. Stress could arise from something as simple as trying to force a door with the rest of your crew and the engine company right beside you, everyone offering their friendly advice all the while fire conditions are deteriorating behind a locked door. It come take the form of dealing with a heavy victim 10 floors up in a high-rise building with zero visibility and low air. Both are stressful situations, although they may be on different ends of the same spectrum.
Lieutenant Col Dave Grossman, author of On Killing and On Combat, extensively studied the physiological response to arousal and the subsequent effects on performance. When we have an alarm response, the sympathetic nervous system prepares for fight or flight by flooding the body with adrenaline and cortisol, increasing heart and breathing rates, constricting blood vessels, and tightening muscles. Blood is diverted away from the digestive system and towards the muscles. With our heart rate between 115-145 beats per minute (bpm), we are in what Grossman calls “condition red.” The mind and body are primed for action; this is the optimal condition for tactical and survival scenarios. Complex motor skills such as forcing a door or deploying a hoseline are at their peak, as are reaction times. However, in this condition, fine motor skills will deteriorate, which would make it difficult to tie a knot or buddy breathe if you hadn’t already practiced those skills. It’s very easy for firefighters to get to this point. We are conditioned to spring into action at the sound of a pager or station buzzer. Consider how often your heart rate has shot up at the sound of your station printer and you’ll see how easy it is to slip into condition red.
The trouble really begins once we enter “condition gray,” where the heart rate rises above 145 bpm. Tunnel vision and lack of depth perception are common, as is a deterioration of motor skills. You are also prone to auditory exclusion at this point, making it easy to miss an important radio transmission or a cry from a victim.
Above 175 bpm, you enter “condition black,” which is a full “fight or flight” response. Blood will drain from the brain’s rational control center (the forebrain), leaving the midbrain in full control. The midbrain doesn’t know rational thought or decision-making processes; it knows action. At this point, you will do what you have trained to do, nothing more.
As firefighters, we spend significant on-duty time in these conditions. A spiraling fire scene could progress us from one condition to the next, or a building collapse could thrust us directly into condition black. This type of stress affects the way we process the information needed for critical decision-making. Since our processing capacity is finite, our likelihood of making a mistake under pressure increases alongside our stress level.
Although our physiological response to situational stress cannot be controlled, it can be mitigated. The more you are exposed to something, the less it will affect you and the less likely your arousal response will hinder your performance. This is called stress inoculation and it underscores the importance of realistic training for all fire departments.
Stress inoculation is a form of cognitive behavioral therapy where firefighters are exposed to stress in a controlled and measured way that increases their body’s tolerance to stressors. It is reached through a crawl-walk-run approach to training that starts with basic skills and progresses to realistic training under extreme pressure. This type of progressive training can take a daunting task and make the pressures manageable. First, the crews performing in the drill should have a specific task, something that can be practiced in a sterile environment and will be required on a call such as advancing a hoseline or throwing ladders. Next the crew is given a target, such as attacking the fire in Division Two or throwing ladders to the C side of the building. Finally, the crew is given challenges. In a live-burn scenario, the heat and smoke will be a challenge to overcome to advance to the seat of the fire. For the ladder company there may be victims hanging out of windows, power lines, or vehicles preventing ladder placement. Stress inoculation prepares firefighters in advance for the stress that their bodies and minds will inevitably encounter.
There is further evidence to show that our emotional response can affect our decision making. Think about a tabletop exercise where you are presented with a fire scenario and asked to size up the building, attack the fire, and search for victims. It’s likely that most firefighters could calmly and carefully examine the building, looking at the problem from a detached, calculated viewpoint. This is your “cold” state. When making decisions under pressure you are in a “hot” state, meaning that you are excited, scared, nervous, angry or any combination of those emotions. There is a gap between our anticipated performance when in a cold state compared to our hot state. This is called the “hot-cold empathy gap” and it demonstrates that cool, calm performance on a tabletop exercise is not a predictor of good performance on the fireground. Training that doesn’t elicit a stress response is not adequately preparing firefighters for decision making under pressure.
Often there is too large a gap between what we do in training and what we face on the street. The difference between putting a tourniquet on a training dummy or putting one on a kicking, screaming victim whose life is literally draining out of them is pretty dramatic. We are not properly equipping our firefighters if we only have them practice skills in the most sterile of environments. Firefighters need to go through training that puts them in condition red and keeps them from entering condition gray.
Fires are infrequent and there is no predictor for when they will occur. It is reasonable, then, that a company officer who hasn’t been to a fire in a year and hasn’t had their skills tested in training may struggle to handle his or her emotional response and perform at optimum levels during the next structure fire. The same could be said for engine or ladder companies who haven’t stretched a line or performed a primary search in a challenging environment.
Another crucial method of realistic training that should be frequently offered to firefighters is live-fire training. I’m not talking about burn buildings with gas fed props but acquired structures. Burning in acquired structures allows firefighters the opportunity to see the process and changes of fire behavior and how the heat in the room changes in various conditions. This stress-inoculation exercise provides tacit knowledge that will serve them well in emergency situations.
Every day we come to work there is a chance that we will make a decision or perform a skill that could result in the death of an unsuspecting person if we get it wrong. This is a serious business and we should train accordingly. If we fail to prepare firefighters properly we are gambling with the lives of the people we have sworn to protect and risking the lives of firefighters themselves. We cannot guarantee on-the-job experience, but we can provide the best, most realistic training possible to inoculate firefighters to the conditions they could face on any given day.
To incorporate stress inoculation into training, Driskell and Johnston propose using the following three goals to design training:
- Gain knowledge and familiarity of a stressful environment: For example, becoming familiar with the equipment and techniques of high-angle rescue while still safely on the ground. This is also the time to discuss the physiological and psychological responses to the training environment.
- Develop and practice task-specific skills, including decision making, to be performed under stress: This is an opportunity for training staff to express their expectations for the drill and for firefighters and company officers to practice the task-specific skills.
- Build confidence in an individual and company skills. In this phase, the skills are put to the test under challenging, realistic conditions. This helps both the individual and company gain confidence in their skills whilst providing tacit knowledge through experience that can be used on future calls.
Realistic training is meant to be stressful and it’s designed to challenge our firefighters, so we must expect some failure and performance that falls below expectations. It’s important to consider this and what it means for individuals who don’t make the grade. This type of training is also physically and mentally challenging and the appropriate precautions need to be taken.
Live-fire training, realistic extrication drills, realistic high-rise drills and EMS drills are crucial in challenging firefighters and giving them the experience that is difficult to obtain on the street.
If I go to a high-rise fire tomorrow, I will remember to size up the building fully from the outside. I will know to call command and verify the fire’s location, if it’s been established. If I am unable to find the seat of the fire, then I will call a unit outside and ask for their insight. I will do these things because I have learned that they are necessary to performing quickly and effectively on a high-rise fire. I was fortunate to gain that experience on a fire where no one was seriously injured. We owe all firefighters the opportunity to gain meaningful experience through realistic training—for the safety of our own people and those we serve.
References
Cohen-Hatton, Sabrina R. The Heat of the Moment: Life and Death Decision-Making From a Firefighter, Doubleday, 2019.
Cohen-Hatton Sabrina R., Butler, Philip C., Honey, Robert C., “An Investigation of Operational Decision Making in Situ: Incident Command in the U.K. Fire and Rescue Service,” Human Factors and Ergonomics Society, 2015.
Klein, Gary, Sources of Power: How People Make Decisions, The MIT Press, 1998.
Grossman, David, Christensen, Loren W., On Combat, The Psychology and Physiology of Deadly Conflict in War and in Peace, Warrior Science Publications, 2008.
Driskell, James E., Salas, Eduardo, Johnston, Joan H., Wollert, Terry N., “Stress Exposure Training: An Event-Based Approach,” Performance Under Stress, 2008.
Lauria, Mike, “Stress Inoculation Training,” EMCrit Blog, https://emcrit.org/emcrit/on-stress-inoculation-training, retrieved August 25, 2020.
Loewenstein, George, “Hot–Cold Empathy Gaps and Medical Decision Making,” Health Psychology, Volume 24, Number 4, 2005, S49 –S56.
Lewis Lovell is a lieutenant with the Raleigh (NC) Fire Department, which he joined in 2011. He is instructor with the department and entered the fire service in 2010 as a volunteer with Falls (NC) Fire Department.
