Stress levels associated with huet - Opito

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Stress due to exits OPITO Anxiety This is experienced by the majority of passengers in an emergency situation and may impair their performance of actions that are novel and difficult (HUET training aims to reduce the novelty of the situation). Disorientation In a helicopter this results from a reduction in visibility, in-rushing water and the change in orientation following capsize. This will increase levels of anxiety and may result in a failure to locate an exit. Depersonalisation Witness reports from life-threatening events indicate that the passage of time seems to slow. This is thought to be as a result of people detaching themselves from the actual situation in order to think and respond more effectively. Panic It is thought that true instances of panic amongst passengers in accidents are rare and are usually due to feelings of being confined. Behaviour in accidents that might be regarded as panic can be interpreted as a rapid series of rational responses. Inaction It is thought that between 10 and 25% of people do little or nothing to escape from danger. Evidence from accidents seems to indicate that there are many more instances of behavioural inaction than panic. Inaction or 'freezing' is of great concern in the helicopter emergency situation. This may add to the anxiety of an individual who is not seated next to an exit, facing the prospect that the person seated next to the exit will not make a rapid escape and will effectively block the exit. Leach (2004) suggested that 'freezing' could be accounted for by time constraints on the cognitive processing of information in a rapidly unfolding, real-time environment. The main aims of training must therefore be to reduce the likelihood of these behaviours. This can be achieved through familiarisation with likely scenarios, familiarisation with the equipment that might be used and the procedures that must be followed, thereby generating confidence, coping skills and a positive outcome expectancy. 4.2 EFFECTS OF PSYCHOLOGICAL AND PHYSIOLOGICAL STRESS ON PERFORMANCE Performance in a threatening situation will depend upon the level of perceived threat, the coping abilities of the individual and the resultant level of stress experienced. It has been reported that lack of control over a stress condition can result in higher levels of reported helplessness, tension, anxiety and physiological activation of the HPA axis (Breier et al, 1987). Whilst low levels of anxiety can be experienced without any significant decrement in performance (see Idzikowski & Baddeley, 1983) there is a large amount of literature showing that higher levels of stress result in cortisol release that is known to affect cognitive function. Much of the focus on the effects of stress on performance has thus focussed on the effects of cortisol on the body and its role in the stress response. Cortisol is known to be produced in response to both psychological and physiological stressors, although there is a wide variability in cortisol response between individuals. Cortisol levels have been linked both to defence and to coping (see Harris, 1995 for review). It is also known that glucocorticoids (such as cortisol), secreted in response to stress, have an affect on cognitive performance by impairing declarative memory recall, defined as the conscious recollection of learned material (Elzinga et al, 2005; Kirschbaum et al, SC/MD/OPITO/063301 10.11.2006 Page 8 of 31
Stress due to exits OPITO 1996; Sauro et al, 2003). Anticipation of a stressful event has been shown to play a more significant role than the actual stressor in impairing declarative memory (Lupien et al, 1997). However, whilst declarative memory was impaired, the study by Kirschbaum et al (1996) showed no impairment in a procedural memory task. This suggests that those experiencing stress and anxiety may find it more difficult to remember instructions during the training, but the process of learning the physical actions or tasks required to complete the escape exercises may not be affected by stress. In a study of the effects of acute stress on immune and cognitive performance during emergency response training, Robinson (2005) found no changes in short-term working memory but did show some impairment of declarative memory in the period prior to HUET training. Robinson cites several reports of survival experiences where individuals have failed to carry out life-saving behaviours requiring procedural memory. She found some impairment in working and procedural memory during the impact stage of training, whilst poor decision-making was observed during the recovery phase. Caution should be taken in interpreting the effect on procedural memory as the test used was a word task and did not involve a physical task. Her overall conclusion was that "cognitive performance is very robust and dysfunctions were, on the whole, difficult to elicit" (Robinson, 2005; p227). She considered that the impact stage (HUET exercises) was the part of the threatening situation when the individual was most susceptible to cognitive impairment. Thus, anything that can be done to reduce the perception of threat during the HUET exercises should help to improve procedural memory, learning and hopefully, retention of that learning. 4.3 STUDIES OF STRESS DURING OFFSHORE EMERGENCY RESPONSE TRAINING An early study of HUET training of US navy personnel (using a prototype breathing device) showed a decrease in anxiety over the course of three days of training (Ryack et al, 1986), leading to a recommendation in support of HUET training for all crew members. The first major study of the psychological and physiological effects of helicopter underwater escape training was conducted by Hytten et al (1989) in Norway. Overall, most of the 78 trainees developed a positive response outcome expectancy and increased confidence in flying. Anxiety levels were low in those with earlier similar experience. Higher levels of anxiety were found in those who perceived the ditching as more demanding than expected. The authors considered that high anxiety levels prevent the development of a positive response outcome expectancy by interfering with the cognitive functions needed during training. A more individualised approach to training was recommended. Work in Canada looked at the potential benefits of using an emergency breathing system (EBS) to aid underwater escape (Bohemier, Chandler & Gill; 1990). They found that use of EBS was beneficial in helping subjects to deal with more difficult seat positions (crosscabin escapes) and resulted in an improved probability of making a successful escape over a sequence of 7 exercises. Both with and without EBS, subjects showed an increasing ability to cope with disorientation as experience in the simulator was gained. A comprehensive study of stress during all aspects of offshore survival training, conducted from 1991 to 1994 1 , Harris, Coleshaw & MacKenzie (1996) found the highest levels of anxiety at the time of enrolment onto the course and prior to HUET training. Pre-course 1 Five day combined (basic) course; three day refresher (further) course. SC/MD/OPITO/063301 10.11.2006 Page 9 of 31
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Page 6 and 7: GLOSSARY Stress due to exits OPITO
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Page 41 and 42: APPENDIX 1 QUESTIONNAIRES Appendix
Page 43 and 44: HUET TRAINING OFFICER QUESTIONNAIRE
Page 45 and 46: Appendix 1 9. Please list the facto
Page 47 and 48: BACKGROUND Date: ………………
Page 49: Questionnaire for delegates OPITO E

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