FIght, flight, freeze -- somewhat related to the Eisenhower quote

[xiphias]

Lis and I were listening to a news story about how FEMA is rethinking their recommendations of how to handle a mass-casualty event. The current thinking is that first responders such as firefighters and EMTs are supposed to stay out of the area until the area is secured. The logic is, if danger is still ongoing, sending more people in is just sending in more potential casualties.

However, FEMA is rethinking that, and considering the notion of a "warm zone" -- not clearly actively dangerous, but not secured, either. The danger MIGHT be over, but that's not certain. And they're now suggesting that EMTs and firefighters go in at that point -- when the active threat APPEARS to be over, but security and police are still making sure. They're looking at what went right in the Boston Marathon bombing response, and trying to figure out how to replicate it. As I've mentioned before, the Boston Marathon bombing response was the most successful disaster response in recorded history, because of both excellent skill and planning, and because of just plain dumb luck: having an instantaneous and non-ongoing mass casualty event right in front of a whole bunch of trained medical personnel is the best way a worst thing could have happened.

What that highlighted was just how critical response time is. And we see the same thing in combat medicine -- military medics don't wait for the battle to be over before starting to stabilize the wounded; they are taking just as much fire as everyone else, and they do amazing work.

EMTs are NOT combat medics, and this would require rethinking what the job of an EMT is. But FEMA is more willing to recommend that firefighters put themselves into potential harms' way by entering "warm zones", since, as they point out, running into burning buildings is already probably MORE dangerous. Their job already is "risk my life to save other people".

Their suggestion is that non-combat first responders enter as soon as the apparent immediate danger is over, and limit themselves to stopping bleeding, while armed first responders simultaneously handle the job of securing the area.

Anyway, what I actually wanted to talk about was the OTHER part of FEMA's suggestions. They believe that, besides rethinking the role of first responders, they also want to start talking to everybody in general about what to do in people-attacking-type emergencies -- fight, if you're equipped to do so; get the heck out of there; or hide.

At Thanksgiving, my brothers-in-law, both former police officers, were talking about how folks just don't know what to do in emergencies, so the idea of spending some time teaching people to do so seems like it would be a good idea.

Basically, higher organisms like us have three basic instinctive reactions to danger: fight, flight, and freeze. People talk about the "fight or flight" response, but "freeze" is ALSO a valid response in some cases. The thing is -- for organisms of our size, we need to re-train ourselves that, instead of "freeze", we "hide".

On the whole, your best move is to "flee", if possible. Getting out of the situation means that you aren't a target; you're improving the situation by not being there. As Mr Miyagi said, "Best defense is not be there." Successfully fleeing requires situational awareness: knowing where you are, where threats are, where escape routes are. So, step one of what FEMA wants people to do is to pay attention to where they are and what's going around them.

If there isn't a route out of there, you also have the option of "hiding". Not as good as getting out of there, but still better than being a target out in the open. Again, situational awareness is all: you need to be thinking about How Not To Be Seen, and how to get to that spot. Your natural response with how to hide is to freeze; we need to rethink that enough to "get somewhere at least marginally safer, and THEN freeze".

"Fight" is a last-ditch option. If you're trained and equipped for the situation... well, "retreat" or "hide and wait for backup" are STILL probably better choices than "attack on one's own". And if you're NOT trained or equipped for it, "fight" is a TERRIBLE option. But it's still on the list. It's better than "do nothing."

So that's what I was thinking. "Fight, flight, freeze" are our natural responses. But in order for them to be useful, we need, ideally, training in how to do them effectively, or, at the very least, to have given some thought to how to do it.

Comments

[nellorat.livejournal.com]

There have been some interesting books on how to survive (or not) in many kinds of emergencies; I have a documentary on that in my Netflix streaming queue. Most people do just freeze in ways that are counterproductive.

The addition of "hide" makes perfect sense to me. For instance, a number of students who survived school shootings did it that way. Similarly, advice for hostages--blend into the crowd of other hostages, don't stand out in any way--is an equivalent while you still have to be literally visible. I can see the advice causing most problems when you don't know if the problem is a human attack or a natural disaster.

[xiphias.livejournal.com]

Yeah, hiding from earthquakes doesn't tend to be very effective.

On the other hand, SHELTERING from aftershocks MIGHT be. But yes, the optimal reaction to an earthquake would seem to be "get away from things that might fall on you," which seems to be the opposite of "get toward things that you can hide behind."

[nellorat.livejournal.com]

I was also thinking about 9/11 in NYC. I taught a memoir course at Gotham Writers' workshop that Fall, and predictably (although I in no way predicted it) many people signed up to write about their experiences on 9/11. My biggest revelation was the huge confusion over not only the cause but also what actually happened--sounds and tremors in the building were interpreted multiple ways at the time. (some people did, including one of my students, think a bomb or bombs had been set off, a fact now used by so-called truthers, but it was just one of many attempts to explain the unprecedented chaos.) It's sometimes even tough to figure out where the damage is, to flee from it. Still, even misguided attempts to flee or hide probably are no worse than just freezing.

[shmuelisms.livejournal.com]

The primary problem, is that freeze, fight and flight are instinctive reflexes, pretty much at the lizard-brain level. The amount of training, deep programming really, needed to create a serious behavioral change at that level, is non-trivial and repetitive. This is pretty much what a large component of what martial-arts (and related rescue/military) training is: Creating deeply ingrained "body knowledge" that overrides these reflexes. To get the person to "react" without really thinking too much about it. So getting the general public to take that type of training upon itself is probably non-doable without a major cultural change.

Culture itself is a major component of how people react. Take the crazy Israelis, for instance, who typically run TOWARDS the site of an attack.

BUT I refuse to accept the basic premise of the "problem" that FEMA is addressing, without seeing some hard studies: What percentage of "mass-casualty" events are actually "ongoing" past the initial event. In how many cases was their, in retrospect, an actual NEED to secure the area? Or is this just typical pussy-footing?

[xiphias.livejournal.com]

Well, that's precisely the point, isn't it? If you're sitting around waiting for an all-clear for a thing that ISN'T ongoing, you're letting people die unnecessarily. If there are people with rifles and grenades shooting people, that's one thing. If it's a bombing, well, waiting around for someone else to check for bombs while people are bleeding -- that's what FEMA wants to stop doing.

Although I do remember one bit from the London bombings: the bomb that went off accidentally on the top of the double-decker bus went off right outside a medical research facility, filled with doctors -- doctors who had been in research for the past few decades of their careers, but still doctors. They were about to rush out to help -- and one of them told them to wait for the SECOND explosion. He'd started his career in the military, and his expectation was that terrorists would set off one bomb, wait for the medical people to respond, and then set off another one... as it turned out, of course, that didn't happen there, but it IS a consideration.

It's just LESS of a risk than NOT going in.

[shmuelisms.livejournal.com]

I'm saying that even their reevaluation is too conservative and risk aversive.

And while yes, terrorist attacks HAVE done the double-attack trick here as well, those are a tiny subset of a small set of the total events.

[navrins]

I have very mixed feelings about this.

On the one hand, sure, having planned and trained and practiced for how to respond to being attacked with mass-casualty weapons will help more people survive those events. I find that entirely believable and even likely. And yes, those events do happen.

However, they happen very, very rarely. I'm pretty sure that most Americans who don't intentionally enter a risky profession (police, military, firefighting) will never experience a single one. And I really do not want us all to be taught that we need to be constantly scared, looking for where attackers or safe places might be. That's what people with PTSD do, and when you're not actually in a situation of imminent danger it is not healthy - there are reasons why it's called posttraumatic stress DISORDER. I don't think our society benefits by teaching us all to behave like people with PTSD, even if it does save a few lives every year.

[dianavilliers.livejournal.com]

Indeed. In a cold blooded analysis of money spent vs human misery avoided, any time, effort and money spent on this would probably be better used on defensive driving or hospital hand-washing campaigns or something.

[xiphias.livejournal.com]

If situational awareness keeps people from being hit by cars and slipping on ice, leaves, and in puddles, then it will be statistically useful.

[shmuelisms.livejournal.com]

Being [more] aware (situational awareness) of your surroundings is HARDLY the same as being hyper-vigilant (as typical of PTSD). Nor directly connected to being constantly scared. I've lived with hyper-vigilance (not fun) and mild PTSD. I also live in Israel, were situational awareness is a way of life.

[xiphias.livejournal.com]

Following up a little on what Shmuel is saying, and also what my brothers-in-law were saying: one of them is now a high-school teacher, and what he meant by "lack of situational awareness" was "walking around with headphones in and head down texting." There's something in between that and PTSD hyper-vigilance. I don't want people scared, either, or overestimating danger, or thinking that they're more danger from terrorists than trans-fats.

But I wouldn't mind if people would watch where they are going, not walk in front of trucks, and so forth. And being aware of what is around you and what you can use it for is part of that. Not because of terrorists specifically, but because it's just plain useful. Which way would you jump if a bicycle wiped out in front of you and was about to hit your knees? Situational awareness means that you're aware that there's a wall to the left of you, and someone's walking pretty close behind you, but if you jump to the right, you'll be okay.

That dog over there -- it looks nervous. Maybe don't crowd it so much, so it doesn't snap at you?

It's all part of the same thing. Not being SCARED of your world, but being AWARE of it.

[navrins]

Sure, that I can agree with. No problem. I'd rather put it in terms of "this is how to avoid stopping cars with your body and breaking your electronics by hitting them with floors" than "this is how to survive a terrorist attack," but it's an entirely reasonable goal.

It's also not what your post seems to be talking about.

[xiphias.livejournal.com]

It's not what the post is talking about, but it's the same solution for both. The post is talking about how FEMA would like people to learn to react to emergencies.

I think that a sentence or two about terrorist attacks, in the context of a larger class on "how to deal with emergencies" would be reasonable, although a WHOLE class about it would be less-than-helpful. But "here's how to tell if someone's having a stroke; here's the really basic form of CPR; if there's an active shooter, either run away or hide unless you've got no other choice than fight, in which case fighting is better than doing nothing; here's how to make a splint and here's a tourniquet; if your car breaks down in the snow in the wilderness, stay with the car instead of wandering off to freeze to death while looking for help; put up road flares behind your car if you break down at night so that people don't just drive into you" -- something like that seems like it would make sense.