Prepared for emergencies? Get real…

Too often we find ourselves simulating emergency response scenarios in ideal, tightly controlled environments.? We give advance notice to participants of drills, which puts them in a wholly different mental place than if the drill was unannounced.? We often spend more time analysing the risk of personnel injury due to conducting a simulation than we do in preparing the scenario to adequately test the capabilities of responders.? And so we end up with a dress rehearsal rather than a live action spectacle, a canvas that is more paint-by-numbers than inspired by imagination.

How then can we have confidence that our well thought-out emergency response procedures will work as intended when we simulate these events without raising the heart rate, without generating a little bit of sweat on the brow?? Truth is, we can’t.??

Training that doesn’t elicit a stress response is not adequately preparing the people that you rely upon during an emergency for decision making under pressure.? We must insert controlled stress into our drills and simulations otherwise we render our responders highly vulnerable to the effects of pressure and nerves.

Preparedness makes us powerful - or does it?

Emergency response drills - whether they be field simulations for fire or leak scenarios, or desktop simulations of control operator response to a loss of power - are typically simplified compared to how they would actually unfold in a real event.? These simulations are often signalled in advance - especially if they are for major scenarios - and tend to escalate progressively and linearly, rather than erupting suddenly on a broad scale with unpredictable complexity.? Drills also lack the realistic conditions of real emergencies, for obvious reasons - it would be a little strange to set fire to the middle of an oil refinery in order to see how well the Fire Team sets up their mobile equipment, or to cause a process unit trip in order to see how well the Control Panel Operator and Field Technicians react...?

These factors mean that we don’t actually know how our personnel will perform under the stress of a real event.? Some people may feel unable to cope with the continuously increasing demands of an emergency situation, others may thrive.? It is vitally important to establish this before an emergency, and not learn it during the midst of one.

As Mike Tyson famously said in 1987 in the build up to a fight with Tyrell Biggs, “everybody has plans until they get hit for the first time”.

So whilst we may think that we are prepared because we conduct multiple major emergency drills every year, we may actually be lulling ourselves into a false sense of security because we simply don’t know how our operators and fire teams will react.

What stress does to humans

During times of extreme stress, the body's sensory and cognitive equipment simply does not respond the same way that it does when we are calm and controlled.? When confronted with an emergency situation, especially for the first time, our physiological functions can quickly move beyond our own control simply due to psychologically-induced stress.

When the heart rate rises above 145 bpm you can experience tunnel vision, lack of depth perception and deterioration of motor skills. You are also prone to auditory exclusion and a loss of global situational awareness at this point, making it easy to miss an important radio transmission or an instruction from a colleague.??

Above 175 bpm, you enter a full “fight, flight or freeze” response. Blood will drain from the brain’s rational control centre (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 only what you have trained to do, nothing more.? People have been known to repeat a given action that they have recently used again and again, seemingly stuck in an endless loop.

Although our physiological response to situational stress cannot be prevented - it is instinctual - it can be mitigated. The more you are exposed to something stressful (within limits), the less it will affect you and the less likely your body’s response will hinder your performance. This is called stress inoculation and it underscores the importance of realistic training for all personnel who are expected to respond to emergencies at industrial facilities.

Keep calm & carry on

In the early 1970s, Donald Meichenbaum, a Canadian psychologist, developed stress inoculation as a training program to help deal with stress and reduce anxiety in his patients.? The technique gained popularity in the military special forces, NASA and municipal fire fighting squadrons, where the tolerance for mistakes under pressure is virtually zero.??

The essence of stress inoculation is that by exposing people to increasing levels of perceived stress they will find suitable coping skills from within themselves and eventually develop increased tolerance - or immunity - to a particular stimulus.? Through the controlled exposure of stressors that simulate real-world emergencies, people can become better prepared to physiologically remain calm and collected if the real situation arises.? When you are less stressed, you process more of what is happening around you and therefore make better decisions that lead to better outcomes.

Stress inoculation should be a feature of the training for any person who will have a role to play in an emergency situation at an industrial facility - from the incident commander and firefighters, to the control room operator and the field technicians.???

Building immunity from stress

EDUCATION

The ultimate aim is to hold emergency simulations and drills which have more realistic levels of stress and pressure.? But before the first fake alarm is sounded, your personnel need to be aware of what they are likely to face; there is no value to be had in surprising them.

Participants need to be informed that during emergency simulations under stress a deterioration in their faculties is normal; it is nearly universal, it is a natural result of our psychology and it is no way a sign of weakness or inadequacy.? But by repeatedly exposing oneself to controlled stressors we can build up a sort of ‘immunity’ to the negative effects of stress, and gain access to the positive aspects, such as higher levels of energy and better decisiveness of action.?

There is a body of contemporary research which strongly suggests that having a ‘stress-is-enhancing’ mindset allows people to better sustain themselves during stressful challenges, whereas holding onto a ‘stress-is-debilitating’ view will lead to disengagement and self-defeat.? How you frame something in your head has a great influence on your neurobiological response to it… when you say to yourself “I know what to do here”, then that turns into a much more positive approach to the situation at hand.

Another preparatory aspect is to teach emergency response participants about the best breathing technique for calming oneself when the adrenaline starts pumping.? When you’re under stress and feel your heart rate picking up uncontrollably, take four full seconds to draw a deep breath. Hold that breath for four seconds, and then exhale for the next four seconds. Pause for another four seconds before repeating the entire 16-second sequence at least three times.? This technique slows the heart rate and brings the stress response under control, bringing back mental clarity and manual dexterity.

EXECUTION

The closer the emergency training scenario resembles the real thing, the greater the performance carryover into real life will be.? So when drills are designed, consider including some of these elements in order to bring in additional stressors for participants;

• Introduce purposeful distractions or annoyances - someone sitting on the radio button, nuisance calls to the control room panel, vehicles turning up at the cordon, etc.
• Make the situation fluid, so that participants have to react - for example, whilst an emergency response crew has just set up to attack a rim seal fire on a floating roof tank, an order is given that the roof looks like it is about to sink and a full surface fire will inevitably commence, and have the crew change their attack plan immediately.? Change the wind direction in the middle of the event that necessitates a fire team retreat and a second attack, etc.??
• Introduce elements of disorder - such as removing the radio from one of the Field Operators to simulate a loss of communications and see how that individual responds.? Place a section of hose in the water supply line with a hole in it (obviously advise the fire truck operator ahead of time so minimal pressure is put on the line) and observe what happens when the crew realises they have a burst section to replace.? Tell the Control Room Operator that the inert gas suppression system inside the control room has activated, and that they need to continue their work whilst wearing SCBA.? When disorder is introduced in training, decisions will be made under less-than-ideal conditions, providing valuable lessons for all those involved.
• Create a more realistic environment - this can mean things like artificially produced noise that makes communications more difficult and which makes structured thought more challenging; inserting panicked or angry participants who distract the Incident Commander; using props to make injured parties appear to have serious wounds, even up to the point of using actors to make more realistic injured parties, screaming in pain, clawing at first responders, not letting them leave their side, etc.? Most drills happen during the day time, but major emergencies don't respect normal working hours so throw in a few drills per year during the night.

Even something as simple as having a lot of people observing (from a safe distance) can raise the pressure level significantly on the emergency drill participants.? Based on the ‘social pressure hypothesis’, it has been shown in many different environments - from football players taking penalties to college students conducting difficult mental arithmetic tasks - that an audience of peers accidentally induces more stress on participants than even an adversarial, screaming audience.

Fire team members should be afforded annual live burn training as they - unlike their Civil Defence and Municipal Firefighting compatriots - have only infrequent experience of real fire situations.? Training should be conducted in accordance with NFPA 1403 Standard on Live Fire Training Evolutions and made available annually if possible.

EVALUATION

And, finally, during the drill wash-up, it is important for everyone to discuss how they individually responded to the simulation.? Did you feel yourself momentarily lose control?? Were you hyperventilating?? Were your hands shaky?? If the education step has been done effectively then participants will know that there is no shame - only acclaim - in sharing the negative effects that stress had on them during the drill.? Everyone should record their own responses and then monitor how these responses evolve across subsequent drills as they come more and more inoculated to the effects of stress.

Key takeaways

Practicing for major emergencies is an essential component of managing any facility with major accident hazards, but these simulations frequently lack the realism needed to truly familiarise participants with the levels of stress, fear and tension which arise in the midst of a serious incident.? As Brasidas of Sparta put it nearly two thousand years ago, “Fear makes one forget, and skill that cannot fight is useless.”

Stress inoculation is a concept which emphasises the need to add obstacles, distractions and elements of realism into these emergency drills in order to get personnel acquainted with the chaos and pressure which inevitably rise up during an incident. When we design simulations which catch participants off guard it will help them learn to anticipate and work through disorder. We need to learn to not lose our heads when things go awry. Things will go wrong, and they will go wrong at the worst time possible. So be prepared.