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Nickson training for stress 20170720
- 1. TRAINING FOR STRESS LEARNINGTO TAKE THE HEAT Chris Nickson FACEM FCICM Intensivist, The Alfred ICU
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- 3. Objectives 1. Discuss acutestress and the effects on performance 2. Discuss strategies and techniques for maintaining performance in stressful situations
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- 7. The Stress Response Anevolved stereotypical response with physiological and psychological effects
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- 10. In a lakethere is a patch of lily pads Every day, the patch doubles in size If it takes 48 days for the patch to cover the lake… How long would it take for the patch to cover half the lake?
- 11. How is thestress response triggered?
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- 14. situation > resources =THREAT resources > situation = CHALLENGE
- 15. Stress can bepositive!
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- 17. acute + chronicstress > resilience + resources
- 18. How can wetrain for stress?
- 19. “We don't riseto the level of our expectations, we fall to the level of our training.” Archilochus
- 20. Stress Inoculation Training StressExposure Training (1) Conceptualisation (2) Rehearsal (3) Application
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- 24. Mental practice Visualisation andMental Practice
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- 31. Reflect and recoverafter stress
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- 33. Team check Imbibe &ingest Equipment resupply Debrief
- 35. The stress response isnormal
- 36. The stress responseis physical and psychological
- 37. The stress response ismodifiable
- 38. We can modify ourperceptions
- 39. We can prepare forstress
- 40. We can reset ourresponses in real-time
- 41. We can reflect andrecover
- 42. We need to trainfor stress
- 43. Beat The Stress, Fool! BREATHETALK SEE FOCUS Inspired by Mike Lauria
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Editor's Notes
- #5 This is Mr T saying “Beat The Stress, Fool!” If you only remember one thing from this talk, remember this… We will come back to it at the end, but it might make more sense and be more memorable if you know who Mr T is - here he is playing “Clubber Lang’ - Rocky Balboa’s nemesis in Rocky 3:
- #9 physiological effects: “fight or flight or freeze” result from activation of the limbic system and hypothalamus - anterior hypothalmus stimulates the ANS resulting in adrenaline release from the adrenal medulla - ACTH release from the pituitary gland stimulates glucocorticoid release from the adrenal cortex manifestions: tachycardia perspiration and clammy skin tachypnea dry mouth urination and even defecation - “scared shitless” the physical effects may compound the psychological effects, in particular they tend to optimise gross motor function at the expense of fine motor control (e.g. tremor may worsen performance of technical skills) In Grossman’s cult book, ‘On Combat’ he popularises the idea of degrees of stress - condition white, yellow, red, grey, black - correlates with the stress reaction and that there are certain thresholds for degree of impairment I think this should be taken with a grain of salt, the correlation with heart-rate is imperfect and how stress manifests differs in different people and in different circumstances However, the take home is that excessive arousal from an acute stress response can have catastrophic effects on performance. This is important because doctors are notorious for under-estimating the effects of stress on our performance
- #36 We’ve discussed