1. presented by Ken L. Hendricks, Ed.S.,CC/NREMT, PI, NCEE, presented by Ken L. Hendricks, Ed.S.,CC/NREMT, PI, NCEE, Tactical Paramedic

2. Advanced techniques are the basics mastered. unknown unknown

3. At the conclusion of Physiocology you will have been exposed to: o Definition of Physiocology o Performance vs. Stress Level o Performance vs. Physical Endurance Level o Solutions to Lessen Negative Physiocology o OODA Loop o Mind Candy

4. The Real Focus of This Program o A Warrior’s Perspective o How Stress Can Effect a Warrior o How A Warrior Copes o Do We Deal With Warriors? o Does Data Effect the Average Warrior ?

5. “One of the biggest reasons for failure in the field of battle is not what to do next... this is the result of not having been trained thoroughly in what to expect on the battlefield.” General Orlando Ward, 1954

6. Isaiah 6:8 “Then I heard the voice of the Lord saying, Whom shall I send? And who will go for us? And I said here I am. Send me!” The Warrior

7. Physiology - the science of the functioning of living systems. In physiology, the scientific method is applied to determine how organisms... carry out the chemical or physical function that they have in a living system Psychology - is an academic and applied discipline which involves the scientific study of human mental functions and behaviors.

8. PHYSIO - study of the how the body physically works + COLOGY – the study of the thinking, behaviors, and emotions. Hence PHYSIOCOLOGY is the study of how the mind and body interact under various physical and emotional situations.

9. Learning can be defined as a behavioral change that meets two criteria: it results from an experience it results from an experienceand it endures over time. it endures over time. Schneider and Tarshis, 1986 Schneider and Tarshis, 1986.

10. The Learning Cycle Need ToLearn MotivatesPractice CreatesCompliance Leads ToConfidence

11. Quite some time ago Remsberg (1986) noted the importance of mental training and preparation for police work. When considering factors that decided the outcome of a critical encounter, the factors that decided an officer’s “destiny,” he suggested the following: In the mentally unprepared officer, physical factors accounted for 5%; psychological factors accounted for 5%; shooting skills accounted for 15%; and LUCK accounted for 75% of the outcome. In the mentally prepared officer, mental factors accounted for 75% of the outcome, luck fell to 5% and the other factors remained the same. The importance of mental preparation has been acknowledged from training in sport, with Yogi Berra (a better player and coach than mathematician) being famous for saying: Baseball is 90% mental, and the other half is physical. Mentally Prepared

12. The Amygdala is a source of anger, fear and sadness. Triggers the Sympathetic Nervous System (SNS). It can be readily conditioned but not so readily unconditioned, so much so that Neuroscientist Joseph LeDoux says that "we are all imprisoned by the Amygdala". LeDoux calls the fast acting route of response through the Amygdala- "the quick and dirty route" Amygdala Amygdala Slow Is Fast when the Amygdala is in control

13. Inverted – U Hypothesis The Inverted U-hypothesis expresses that too much stress or too little stress results in a lack of performance. A moderate amount of stress results in an optimal amount of arousal, which is needed to perform at maximum potential. Every individual is different when defining how much stress is needed to create a specific amount of arousal. This explains why anxious people perform better under little stress and calm people perform best with more stress

16. Homeostasis/All Is Good 60 bpm 115 bpm 145 bpm 220+ bpm Individual Optimum Survival and Performance Level Hypervigilance/Irrational Behavior/Collapse Fine Motor Skill Deteriorates Perceptional Narrowing Cognitive Processing Deteriorates Complex Motor Skill Deteriorates

17. Heart RateHighLow High Performance White Yellow Red Gray Black 115 BPM145 BPM175 BPM Copyright 2002 Dave Grossman

18. ... So the Question Is:... So the Question Is: * Are the Warriors ready for the spontaneous event? Because : * as oxygen levels decline - cognitive and physical abilities diminish: fear & confusion sets in In Fact: While it is suspected that Medics medication errors are significantly increased, Police Officers and Fire Fighters are 4 times more likely to die from a heart attack,

19. It is our performance that grants us the respect of courage, not the lack of fear Dr. Paul Whitesell, 1989

20. PEAK PERFORMANCE Exercise Intensity (% of max. power output)

21. PEAK PERFORMANCE Means: You are at your max for 0 to 5 seconds You Lose ~70 % of your best effort at 90 seconds (30% left) How much of what we do is done in 90 seconds?

22. Approximate Heart Rate-Rhythm Escalation & Performance Deterioration Part 1 Homeostasis Part 2 Optimum Part 3 Collapse (cell death) Performance/Odds of Survival Decrease Heart Rate

23. Strategy is the science of making use of space and time. I am more jealous of the latter than the former. We can always recover lost ground but never lost time. Field Marshall Gneisenau 1761 Field Marshall Gneisenau 1761

24. Solutions and Abatements 1. Confidence in the Results 2. Breathing – Sniper Breathing 3. Exercise – Conditioning - Sleep 4. Education to Increase Confidence – Mental Preparation 5. Simulation – Visualization – Experience – OODA Looping

25. Solutions and Abatements Confidence in the Results Confidence in the ResultsorOutcome

26. Solutions and Abatements Survival Mind Set In many cases, when a Warrior is injured or killed, they would are/be surprised. The Warrior attains the ability to concentrate in the presence of death and act reflexively without hesitation. In many cases, when a Warrior is injured or killed, they would are/be surprised. The Warrior attains the ability to concentrate in the presence of death and act reflexively without hesitation.

27. Solutions and Abatements 1. Breathing 2. Exercise 3. Education 4. Simulation 4 Count Sniper Breathing Hold 4 seconds Inhale 4 seconds Exhale 4 seconds Hold 4 seconds At least 2 sets

28. Solutions and Abatements 1. Breathing 2. Exercise (conditioning) 3. Education 4. Simulation Aerobic – Cardio. Anaerobic Resistance/Strength.Sleep

29. Solutions and Abatements 1. Breathing 2. Exercise 3. Education 4. Simulation Research indicates when firefighters/paramedics/officers were educated to recognize and predict the effects of stress, how traumatic events can effect personnel, and management of traumatic stress through stress reduction techniques, individuals were more likely to enjoy a higher level of physical and psychology wellness. Which also translates into less absenteeism and higher morale. Mark C. Shantz Eastern Michigan University Ypsilanti Mi. School of Fire Staff and Command Fourth Class An applied research project submitted to the Department of Interdisciplinary Technology as part of the School of Fire Staff and Command Program. William Dangler August, 2002

30. Solutions and Abatements 1. Breathing 2. Exercise 3. Education 4. Simulation Practice does not make perfect, perfect practice makes perfect. It's the quality of your practices that is ultimately responsible for how much your warriors get from practice tune and how well they handle highly pressured situations. Dr. Alan Goldberg Rehearsal – Imagery

31. Summary Solutions and Abatements Confidence Confidence 1.Breathing 2. Exercise 3. Education 4. Simulation

32. OODA-LOOP The OODA Loop (for observe, orient, decide, and act) is a concept originally applied to the combat operations process often at the strategic level in both the military operations.combat operations processstrategic It is now also often applied to understand commercial operations and learning processes. The concept was developed by military strategist and USAF Colonel John Boydmilitary strategistUSAFJohn Boyd

33. Observe-Orient-Decide-Act In order to win, we should operate at a faster tempo or rhythm than our adversaries--or, better yet, get inside [the] adversary's Observation-Orientation- Decision-Action time cycle or loop.... Such activity will make us appear ambiguous (unpredictable) thereby generate confusion and disorder among our adversaries--since our adversaries will be unable to generate mental images or pictures that agree with the menacing as well as faster transient rhythm or patterns they are competing against.

34. OODA Loop OBSERVE ORIENT DECIDE ACT OBSERVE : You see the threat or possible threat appear. ORIENT : You recognize the threat and process possible courses of action. DECIDE : You select the best course of action. ACT : You execute the selected course of action

35. “An army of tigers led by a sheep, will always be beaten by an army of sheep, led by a tiger.” Be A Leader

36. “Men are not afraid of death, they are afraid of dying.” Lord Moran, 1967

37. Can you hear the SNS at work in this actual recording of a police shoot out? This recording has vulgar language throughout. If you are offended you may leave at this time.

38. 'Get over it ' or 'Deal with it ' has been replaced with training on how to get over it or how to deal with it.”

39. Resources The art, practice and science of Feldenkrais® Director: Robert J. Burgess BEd, PT, PhD, Feldenkrais Practitioner Sharpening The Warriors Edge, The Psychology and Science of Training – Bruce Siddel Wikipedia Rescue Human Factors – Bruce Siddle, David Grossman, Sean McKay the applied science, and study of the interface between human psychological and physiological reactions under stress and the critical performance parameters of casualty management. On Killing and On Combat – LtCol. David Grossman

40. * Are the Warriors now better prepared for the spontaneous event that will eventually happen? Because : You now are aware that the key to being prepared focuses on: CONFIDENCE Breathing Exercise - Conditioning Education Simulation Thank you for your attention