1. Plano, Texas Fire - Rescue
CDM . . .
Critical Decision Making
Bill Peterson
Fire Chief
Plano, Texas Fire - Rescue
> = Advance to next bullet or slide.
>References

2. CDM References
An adaptation of human factors issues from the following aviation sources:
AC Aeronautical Decision Making
(from gov/avr/afs)
ADA Aeronautical Decision Making for Student and Private Pilots (from National Technical Information Service Library, )
You will need: AC Aeronautical Decision Making available in ATP navigator and ADA (DOT/FAA/PM-86/41) Aeronautical Decision Making for Student And Private Pilots available from National Technical Information Service.
Handouts require copying Appendix 5. Life Events Stress Test from AC60-22 and Self Assessment of Hazardous Attitudes pg from ADA
12 years of research development and testing concept is valid for other dynamic high risk industries such as nuclear, medicine, orrshore oil and gas….
Also considers: critical thinking skills
emotional intelligence
Not a complete training system or component support other than training and serve as a catalyst for further study.
>Aeronautical Decision Making.

3. Critical Decision Making
CDM is a systematic approach to the mental process used by fire fighters to consistently determine the best course of action in response to a given set of circumstances.
Enables a person to make an intelligent determination in recognizing risk factors such as structural collapse, available resources, recency of experience, environment, and scene stress management.
Employs concepts of Critical Thinking
Recognizes “Iceberg” effect, that in dynamic situations we only know a portion of the whole picture.
Also notes that most human decisions are made by the SCM and not the conscious mind (CM).
>Good Judgment.

4. Critical Decision Making
Essential To Incident Scene Safety
Special Emphasis Item
Careful Evaluation Throughout
Practical Test
> A majority of fatal accidents are the result of decisional behavior, also known as cognitive judgment.
> CDM considers sound judgment and decision making to be an area most critical to incident scene safety.
> Does not have to be shown under Task to be evaluated but if shown in the Objective it will receive special emphasis.
>Critical Decision Making.

5. Good Judgment
Once believed to be gained only as a natural by-product of experience.
Good judgment can be taught.
Is harder to acquire if previous bad decisions did not result in failure.
>You’ve heard the statement, “Every fire provides the opportunity to learn.” You’ve heard fire fighters telling stories of surviving errors in judgment (Near Miss Incidents). What you don’t hear are fire fighters telling stories of fatal errors in judgment.
>Pilots who received CDM training in conjunction with the standard training curriculum made 10 to 50% fewer judgment errors than those who had not.
> Fire fighters should expect similar results.
Beware of not falling in the “Experience” trap. Experience is good, only if we fully understand the total environment of each experience. One can play “Russian Roulette” and statistically, each time you pull the trigger, you have about a 83% chance of surviving the experience. But IF YOU GET ENOUGH EXPERIENCE, sooner or later you will die.
>CDM

6. Builds upon the foundation of conventional decision making . . .
CDM
Builds upon the foundation of conventional decision making . . .
By enhancing the process to decrease the probability of human error by providing a structured, systematic approach to analyzing changes that occur and how these changes might affect the incident’s safe outcome.
CDM process addresses all aspects of decision-making on an incident scene and identifies the steps involved in good decision-making.
>Conventional Decision Making Process.

7. Conventional Decision Making Process
Firefighter
Equipment
Environment
Operation
SITUATION
Select
Response
Type
Skills/Procedures
Headwork
Required
Change/Event
Occurs
Recognize
Change
Inadequate
MISHAPS!
Recognition of change or lack of expected change is critical to modifying the situation or selecting an appropriate response.
Situational awareness is critical to successful and safe decision-making.

8. Steps For Good Decision Making
Identifying personal attitudes hazardous to safe incident scene operations.
Learning behavior modification techniques.
Learning how to recognize and cope with stress.
Developing risk assessment skills.
Using all resources in a multi-crew situation.
Evaluating the effectiveness of one’s CDM skills.
The CDM process addresses all aspects of decision making at the incident and identifies the steps in good decision making
>Identifying personal attitudes that are hazardous to individual/crew safety.
>Learning behavior modification techniques.
>Learning how to recognize and cope with stress.
>Developing risk assessment techniques.
>Using all resources.
>Evaluating effectiveness of one’s CDM skills.
>Critical Decision Making Process.

9. Critical Decision Making Process
Firefighter
Incident
Environment
Operation
SITUATION
Select
Response
Type
Skills/Procedures
Attitude
Management
Stress
Crew (if present)
Headwork
Process
Critique
Actions
Risk
Event
Change
Required
Expands conventional decision-making.
CDM enhances the process with an awareness of the importance of attitudes in decision-making.
Search for and establish the relevance of all information.
Choose and execute actions which assure safety in a compressed timeframe.

10. Operational Pitfalls
All experienced fire fighters have fallen prey to, or have been tempted by, one or more of these dangerous patterns of tendencies or behavior in their fire service careers.
There are a number of classic behavioral traps into which fire fighters have been known to fall.
Fire fighters, as a rule, always try to:
Complete an incident as planned
Please those involved with them.
Meet desired outcomes
Demonstrate they have the “right stuff”
The basic drive to demonstrate the “right stuff” can have an adverse effect on safety and can impose an unrealistic assessment of fire fighting skills under stressful conditions.
These tendencies ultimately may lead to practices that are dangerous and often against SOP’s, and may lead to a mishap.
These dangerous tendencies or behavioral patterns which must be identified and eliminated, include: >Peer Pressure.

11. Peer Pressure
Poor decision making based upon emotional response to peers rather than evaluating a situation objectively.
>Mind Set.

12. Mind Set
The inability to recognize and cope with changes in the situation different from those anticipated or planned.
Tunnel Vision
>Get-In-There-It is.

13. “Get-in-there-itis”
Clouds the vision and impairs judgment by causing a fixation on the original goal of aggressive interior attack - combined with a total disregard for any alternative course of action.
>1 Minute More Syndrome.

14. “Just One More Minute” Syndrome
Tendency to continue an interior attack after the low air warning sounds on the SCBA.
Based on a belief that there is a built in “fudge” factor.
An unwillingness to admit defeat and exit the structure before extinguishing the fire.
Often occurs when IC calls for evacuation of interior crews.
>Getting behind the operation. Better to get out 5 minutes early than 5 seconds too late.

15. Getting Behind the Operation
Pushing the fire fighter and crew capabilities to the limit by trying to maintain interior operations under rapidly deteriorating conditions.
>Deteriorating Interior Conditions. This is a loser.
Interior fire fighting tactics:
Developed in the 1960’s and early 1970’s.
Different environment than today.
Hotter, faster burning fuel package.
Lightweight building construction.

16. Deteriorating Interior Conditions
Often leads to spatial disorientation and eventually loss of direction and situational awareness.
Even more dangerous when operating alone or without a hose line or safety line.
>Getting Behind The Incident.

17. Getting Behind the Incident
Allowing events or the situation to control your actions rather than the other way around.
Constant “catch up” mode of operation.
>Loss of Situational Awareness.

18. Loss of Situational Awareness
Another case of getting behind the incident which results in . . .
not knowing where you are,
an inability to recognize deteriorating circumstances, and
the misjudgment of the rate of deterioration.
>Operating Without Adequate Air Reserves.

19. Operating W/O Adequate Air Reserves
Ignoring minimum air reserve requirements is generally the result of overconfidence, lack of incident action planning, or ignoring Standard Operating Procedures.
>Failure to follow standard operating procedures.

20. Failure To Follow SOP’s
Actions made up “on the fly”, under stressful conditions, are typically made with inexact or incomplete data and are prone to fail.
Iceberg theory.
>Operating Outside The Envelope.

21. Operating Outside the Envelope
Unjustified reliance on the (usually mistaken) belief that the crew’s performance capability meets the demands imposed by the most experienced (usually overestimated) member’s skills.
>Neglect of Incident Action Planning, Pre-Plan Information, SOP’s.

22. “OOPS!” The “Oops” Factors”. . .
Neglect of Incident Action Planning, pre-plan documentation, or standard operating procedures
Unjustified reliance on the fire fighter’s short and long term memory, regular suppression skills, repetitive and familiar incidents, etc.
Next will be Hazardous Attitude Inventory. Pass out attitude assessment test.
Depending on time available you may choose to have audience do test now or assign for self study later. In either case the instructions should be covered.
>Hazardous Attitudes.

23. Hazardous Attitudes Anti-authority (don’t tell me!).
Impulsivity (do something quickly!).
Invulnerability (it won’t happen to me).
Macho (I can do it).
Complacency ( just another routine response).
There are five hazardous attitudes that can affect a fire fighter’s judgment, and have an impact on safety.
> Antiauthority: Found in people who do not like anyone telling them what to do. They may be resentful of having someone tell them what to do or may regard rules, regulations, and procedures as silly or unnecessary. It is always your prerogative to question authority if you feel it is in question.
>Impulsivity: The need to do something-anything-immediately. They do not stop to think about what they are about to do, do not select the best alternative, and do the first thing that comes to mind.
>Invulnerability: Accidents happen to others, but never to them. They know accidents can happen and anyone can be affected. They never really feel or believe they will be personally involved. More likely to take chances and increase risk.
>Macho: Fire fighters who are always trying to prove that they are better than anyone else are thinking I can do it - I’ll show them. Will try to prove themselves by taking risks in order to impress others. Thought to be a male characteristic, women are equally susceptible.
>Complacecy: Fire fighters who think, “I’ve done this 100 times before”, do not recognize that every fire they respond to is different, the flammability of contents is greater than it was 20 years ago, and buildings are being engineered to: “barely withstand the forces of gravity and nature.” Sometimes will go along with unreasonable requests just to be a “nice guy”.
Hazardous attitudes which contribute to poor fire fighter judgment can be effectively counteracted with an appropriate action.
antidote thought.>

24. The Five Antidotes . . . HAZARDOUS ATTITUDE ANTIDOTE
Anti-authority: “Don’t tell me.”
“Follow the rules. They are usually right.”
Impulsivity: “Do something quickly.”
“Not so fast. Think first.”
Invulnerability: “It won’t happen to me.”
“It could happen to me.”
Macho: “I can do it.”
“Taking chances is foolish.”
Complacency: “Another routine response.”
“Every fire is different.”

25. Antidote Recall Exercise . . .
Hazardous Thought
Antidote
Antiauthority:
Impulsivity:
Invulnerability:
Macho:
Complacency:
Anti-authority: Follow the rules. They are usually right.
Impulsivity: Not so fast, think first.
Invulnerability: It could happen to me.
Macho: Taking chances is foolish.
Complacency: Every fire is different.

26. Stress And Firefighting
The demands on a fire fighter can range from unexpected structural collapse during an interior attack to a lost wallet. Numerous physical and physiological conditions in a fire fighters personal and professional life as well as the nature of fire suppression itself can hamper the ability to perform at his/her optimum level and make decisions to the best of his/her ability.
> How much stress is in your life?

27. Stress And Firefighting
Stress is a term used to describe the body’s nonspecific response to demands placed on it, whether those demands are pleasant or unpleasant in nature.
The demands on a fire fighter can range from unexpected structural collapse during an interior attack to a lost wallet. Numerous physical and physiological conditions in a fire fighters personal and professional life as well as the nature of fire suppression itself can hamper the ability to perform at his/her optimum level and make decisions to the best of his/her ability.
> How much stress is in your life?

28. How Much Stress Is In Your Life?
Major and minor stressors have a cumulative effect which constitutes your total stress-adaptation capability which can vary from year to year.
Hand out copy of appendix 5 Life Events Stress Test.
Use the life change profile questionnaire to enhance your awareness about the sources of stress in your life.
Place a check in the happened column if you have experienced the event described in the last 12 months and total the number of checks at the end.
The more changes you have, the more likely you are to suffer a decline in health. As a rule of thumb, if you score over 20 checks, mostly in the top half of the checklist, you have an 80% chance of a serious health change.
If you have about 20 checks distributed over the checklist, you have about a 50% chance of illness in the near future.
Each of us have personal stress-adaption limitations. When we exceed this level, stress overload may lead to poor health or illness.
> Is Stress Bad?

29. Is Stress Bad?
Stress is an inevitable and necessary part of life that adds motivation to life and heightens a fire fighter’s response to meet any challenge.
Stress is a response to a set of circumstances that induces a change in a fire fighters current physiological and/or psychological patterns of functioning forcing the fire fighter to adapt to these changes.
In fact, performance of a task will generally improve with the onset of stress, but will peak and then begin to degrade rapidly as stress levels exceed a fire fighter’s adaptive abilities to handle the situation.
>Handling Stress In Fire Fighting.

30. Handling Stress In Fire Fighting
Accidents often occur when fire fighting task requirements exceed an individual (least qualified or experienced) crew member’s capabilities.
A superior fire fighter uses superior judgment to avoid stressful situations which might call for use of superior skills.
The difference between fire fighter capabilities and task requirements is the margin of safety.>

31. Firefighter Capabilities
The Margin Of Safety . . .
Pre-Incident
Low Air Alarm
Rehab
Enroute
Initial Attack
Task Requirements
Firefighter Capabilities
Effort
Margin of Safety
At Scene
Time

32. Handling Stress In Fire Fighting
Stress is insidious
Stress is cumulative
> Stress has a gradual and cumulative effect that develops slowly, so slowly that stress can be well established before becoming apparent. A fire fighter may think that he/she is handling everything quite well, when in fact there are subtle signs that the person is beyond his/her ability to respond appropriately. Core body temperature increases also impact decision making.
> A generalized stress reaction can develop as a result of accumulated stress. There is a limit to a fire fighter’s adaptive nature. This limit, the stress tolerance level, is based on a fire fighter’s ability to cope with the situation. If the number or intensity of the stressors becomes too great, the fire fighter is susceptible to an environmental overload. At this point, a person’s performance begins to decline and judgment deteriorates.
> Signs of Inadequate Coping.

33. Signs Of Inadequate Coping
Emotional
Physical
Behavioral
The indicators of excessive stress often show as three types of symptoms. These symptoms differ depending upon whether aggression is focused inward or outward.
>Individuals who typically turn their aggressive feelings inward often demonstrate the emotional symptoms of depression, preoccupation, sadness, and withdrawal.
>Individuals who typically take out frustrations on other people or objects exhibit physical symptoms.
>On the other hand, emotional symptoms may show up as overcompensation, denial, suspicion, paranoia, agitation, restlessness, defensiveness, excess sensitivity to criticism, argumentativeness, arrogance, and hostility.
>Life Stress Management.

34. Life Stress Management
Become knowledgeable about stress.
Take a realistic assessment of yourself.
Take a systematic approach to problem solving.
Develop a lifestyle that will buffer against the affects of stress.
Practice behavioral management techniques.
Establish and maintain a strong support network.
There are many techniques available that can help reduce the stress in your life or help you cope with it better. Not all of these ideas may be the solution, but some of them may be effective for you.
>Become knowledgeable
>Take a realistic assessment
>Take a systematic approach
>Develop a lifestyle
>Practice behavioral management
> Establish and maintain a strong support network
>Fireground Stress Management.

35. Fireground Stress Management
Avoid situations that distract you from controlling the operation.
Reduce your workload to reduce stress levels.
If an emergency does occur, be calm!
Maintain proficiency of your knowledge/skills.
Know and respect your own personal limits.
Do not let little mistakes build into a big thing.
Don’t let fire fighting add to your stress.
Good fireground stress management begins with good life stress management.
Many life stress management techniques are not usually practical at an incident. Rather, you must condition yourself to relax and think rationally when stress appears. The following checklist outlines some thoughts on fireground stress management.
>Avoid distracting situations.
>Reducing workload will create a proper environment in which to make good decisions.
>Think for a moment, weigh the alternatives, then act.
>Proficiency builds confidence with your situation, its component systems (crew and equipment), and emergency procedures.
>Know and respect your own personal limits.
>Wait until after you complete the operation, then “debrief” and analyze past actions.
>If fire fighting is adding to your stress, either take a break from fire fighting or seek professional help to manage your stress within acceptable limits.
>Personal Go/No Go Checklist.

36. Personal “Go/No-Go” Checklist
Do I feel well?
Have I taken any medication in the last 12 hours?
Have I had as little as one ounce of alcohol in the last 12 hours?
Am I tired?
Am I under undue stress?
Have I eaten a sensible meal?
Am I dehydrated?
Do I have proper personal protective equipment?
The fire fighter should not only pre-plan the emergency incident, but also himself/herself on each and every shift. Ask yourself, “Could I pass my personal checklist right now?” If you cannot answer with an absolute “yes,” then you should not place yourself or your crew at added risk.
>Is there anything wrong with me at all?
>Any medication that would cause problems?
>Any alcohol?
>Did I get a good nights sleep?
>Am I emotional right now?
>Taken in a good load of protein? Protein snacks available?
>Do I need to take noncarbonated liquids such as water, Gatorade or fruit juices?
>Gloves, hood, PPE, full SCBA?
>Risk Management.

37. RISK MANAGEMENT
Risk management is the responsibility of everyone involved in fire fighting.
The Incident Commander who is faced with the decision of just how hard to push a crew, becomes a party to risk management. It is understandable from a “mission” point of view that the emergency situation must be handled effectively.
This question “Is the success of the task worth the risk?” must always be kept in mind during decision making.
>The Decide Model.

38. The Decide Model Detect that change has occurred.
Estimate the need to react to the change.
Choose a desirable outcome for operation.
Identify actions which control the change.
Do take the necessary action.
Evaluate effect of action on the change.
The Decide Model is intended to provide the fire fighter with a logical way of approaching decision making.The six elements represent a continuous loop decision process which can be used to assist the fire fighter in the decision making process when he/she is faced with a change in a situation that requires judgment.
Primarily focused on the intellectual component, it can also have an impact on the motivational component of judgment as well.
>Detect
>Estimate
>Choose
>Identify
>Do
>Evaluate
>Identifying The Enemy.

39. Identifying The Enemy
Most preventable accidents have one common factor - human error, rather than an equipment malfunction.
Fire fighters who are involved in serious accidents generally know what went wrong. Very often, the fire fighter was aware of the possible hazards when the decision was made that led to the wrong course of action. In the interest of expediency, peer pressure, self-gratification, or other often irrelevant factors, the incorrect course of action was chosen. Each incident, involving decisions on strategy, tactics, alternatives, occupancy, fire volume, building size, and offensive/defensive operations, is a sequence of choices with certain milestones in the incident sequence that require particular determination and discretion.
>Fire Fightng Is Rapidly Changing.

40. Fire Fighting Is Rapidly Changing
CDM is designed to reduce the extremely long and sometimes painful process of learning how to make good judgment decisions based on experience alone.
Mistakes in judgment can be fatal.
Fire fighting is rapidly changing from a physical to a mental task. Initial instruction to perform fire suppression operation takes only a few months. Training to safely conduct / manage fire suppression operations involves a decade or two of experience and periodic recurrent training.
>CDM can reduce the long process of learning how to make good judgment decisions.
>Mistakes in judgment can be fatal.
>Personal Checklist

41. Personal Checklist
Fire Fighting while under the influence of alcohol or drugs is a never.
Fire Fighting with a known cardiac medical deficiency is never expedient.
Fire Fighting outside Standard Operating Procedures is never safe.
Fire Fighting with less than the required minimum air supply is never reasonable.
One essential decision point before a incident is the checklist of basic principals that cannot be compromised. This personal checklist should include the fundamental principles applicable to every incident.
Once a fire fighter decides what not to do, the decision on what needs to be done becomes clear. Consider the following never’s as factors that contribute significantly to unsafe incident.
>Several drinks will influence thought and reaction for approximately 24 hours while heavy drinking will have lingering effects for up to 36 hours. Effects from the use of marijuana remain in the system for at least a week. The side effects and duration of prescription drugs are well documented and available.
>Fire fighting with a known medical deficiency.
>Following Standard Operating Procedures will maximize the necessary level of safety for the individual and the crew.
>Don’t expect your equipment to protect you from stupidity!.
>Continued.

42. Personal Checklist, Cont.
Interior Attack under deteriorating conditions is never justified.
Free Lancing is never justified.
Casual neglect of any applicable standard operating procedure is never justified.
Fatality accident statistics show that fire fighters should be conducting continuous evaluation on themselves as well as on the incident.
>Be aware of changing interior conditions and plan on contingencies.
>The only thing worse than no operating plan is multiple plans.
>A checklist may be larger or smaller, however certain standards should be established for all incidents so that the first decision point is whether or not to begin the operation at all.
> Fire Fighter impairment contributes to many more accidents than failure of equipment.
> The”I’M SAFE” personal checklist.

43. The “I’m safe” Checklist
Illness. Any Symptoms?
Medication. Prescription or OTC drugs?
Stress. Psychological, money, health, family?
Alcohol. Within 8 hours? Within 24 hours?
Fatigue. Adequately rested?
Eating. Proper foods for nourishment?
Contains all of the most common categories of fire fighter impairment and can be easily committed to memory.
>Do I have any symptoms?
>Have I been taking prescription or over the counter drugs?
>Am I under psychological pressure from the job? Do I have money, health, or family problems?
>Have I been drinking within 8 hours? Within 24 hours?
>Am I tired and not adequately rested?
>Have I eaten enough of the proper foods to keep adequately nourished during the entire incident?
> How To Be A Safe Fire Fighter.

44. How To Be A Safe Fire Fighter
A fire fighter does not have to be a genius to be a safe fire fighter.
>How To Be A Safe Fire Fighter.

45. How To Be A Safe Fire Fighter
A fire fighter should be an emotionally stable person.
An experienced, mature fire fighter will accept and follow the rules and procedures which will benefit the whole community.
Some fire fighters break rules simply for the gratification of some emotional need.
>A fire fighter should be an emotionally stable person who can accept the fact that he/she is not in possession of all facts or skills for all situations and be willing to accept the recommendations of those who specialize in evaluating, assessing, and administering fire service procedures.
>Even though the rules and procedures are designed to serve most of the people most of the time, a fire fighter can always argue for a different ways of doing things. The immature, emotionally unbalanced fire fighter has strong tendencies to satisfy a personal need regardless of the consequences.
>Even though the fire fighter may know that this emotional need is not considered a healthy habit (like smoking, speeding, overeating, etc.), the fire fighter is, nonetheless, driven by his or her own emotions.
>How To Be A Safe Fire Fighter

46. How To Be A Safe Fire Fighter
Existing rules would go a long way to remedy the accident rate.
Exhibiting one or more of the five hazardous attitudes or irrational behavior also exposes emotional weaknesses in personality.
>However, personality traits that cause irrational behavior also make fire fighters prone to disregard the rules that would assure safe operations.
>When a fire fighter exhibits one or more of the five hazardous attitudes or irrational behavior, that pilot may also be exposing any emotional weaknesses in his/her personality.
>Developing Good Decision Making Skills.

47. Developing Good Decision Making Skills
The development of good decision making skills is far more difficult than developing good fire fighting skills . . .
Developing Good Decision Making Skills
Good judgment may mean not fire fighting while under the influence of any medication, when it is too hot or cold, or refusing to expose personnel to unacceptable risk when it would require fire interior fighting under marginal conditions.
>Developing Good Decision Making Skills.
. . . but it CAN be done!

48. Developing Good Decision Making Skills
Many fire fighters fail to make proper decisions when they really want to do something.
Not following safety-oriented information is similar to not following the advice of a doctor or lawyer.
The most important decision a fire fighter will make is to learn and adhere to published rules, procedures, and recommendations.
Fire Fighting has reached a new plateau.
>Sometimes due to lack of knowledge, but too often the result of a human tendency to rationalize a situation until it appears justifiable. When a fire fighter really wants to do something (such as staying in the structure 1 more minute after his or her low air warning bell has sounded just to be the one that puts out the fire), the fire fighter can generally make himself/herself believe that it was all right to do it. A fire fighter can be his/her own worst enemy.
>In addition to following SOP’s there are some do’s and don'ts that can insure the prevention of most accidents. All this information is safety-oriented.
>Fire fighter’s, by learning and adhering to these published rules and procedures, can take most hazards out of fire fighting. When a fire fighter operates at an incident, human lives (most always the lives of other fire fighters) are held in balance and the fire fighter has a moral responsibility to operate in the safest possible manner.
>Acquiring fire service knowledge, fire fighting skills, and proficiency are relatively easy. Acquiring personal discipline and maturity to achieve the organization’s mission in a safe manner is much more difficult. Today’s progressive fire service organization requires leadership and administrative management and risk management oriented decision making skills as prerequisites for safety and efficiency.
>Questions?

49. In summary . . . CDM is critical to survival
Be aware of operational pitfalls
Be aware of hazardous attitudes
Understand impact of stress on firefighting
Embrace risk management
Follow the Personal Survival Checklist

50. Something to think about . . .
How are critical decisions being made on your fire scene?

51. QUESTIONS ?