Consider an Olympic sprinter. She spends hours every day training herself to automatically respond to the retort of the starter’s gun; training to think fast, act faster, and shave another millisecond off her start.
Like Pavlov and his dog, this sprinter is training her body to act in response to external stimuli.
While our hypothetical sprinter is training her body, she’s also training her brain. But which brain is she training?
Thinking fast and slow
In his book Thinking Fast and Slow, psychologist and economist Daniel Kahneman described two brains.
The reactive, or fast brain seemingly makes decisions for us. It reflexively draws on past experience to act automatically.
Simple tasks like how to breathe, or walk, or grab an object are actions of the fast brain. Have you ever driven a familiar route and realise you can’t recall the last ten minutes of the drive? That’s your fast brain as well.
Kahneman also talks about the reflective, or slow brain. This is the brain that takes its time, actively reasoning, weighing up options, and consciously deciding what to do next.
The slow, reflective brain is also our emotional brain. In their paper Amygdala Automaticity in Emotional Processing, R. J. Dolan and Patrick Vuilleumier found the section of our brain that processes threats, holds significant sway over our ability to act rationally in stressful situations.
No surprises there, right? This is the fight-or-flight response hardwired into us from the time when humanity was more prey than predator.
This reflex saved lives. Fast-forward to today, and it also prevents us from saving others.
First aid author and training expert John Haines told us how the fight-or-flight reflex actually prevents bystanders from helping in the event of a sudden cardiac arrest.
John knows even the best-trained people can freeze in the face of an emergency. It’s the panic response – “at times of anxiety or when we are uncertain about a situation, we tend to be completely irrational.”
Training the fast brain
CPR training starts by engaging the slow brain. The acquisition of knowledge – on for example, what happens to a body in sudden cardiac arrest – is a job for our reflective consciousness.
The aim of this training however, is to embed a series of physical actions that become rote. John Haines himself says his textbooks are useless in an emergency, if your body doesn’t know what to do in the moment.
There’s a reason CPR accreditation needs to be updated annually: it’s because the trainers know one session does not imbue a person with the reflex response to a sudden cardiac arrest.
Like our sprinter, training this reflex into ourselves takes constant practice.
Unlike our sprinter – who can just step outside for a run anytime she likes – opportunities to practice responding to an emergency are harder to come by.
There are other ways however, to snap a body into action when needs must.
Kahneman collaborator and Nobel Prize for Economic Sciences winner, Richard Thaler coined the idea of the Nudge. At its simplest definition, a nudge is a positive influence on actions and decision-making, that works most effectively when it’s engaging the reactive, fast brain.
Nudging is a theory of behavioural economics. What does this have to do with CPR training?
The British Heart Foundation used Nudging when it ran a public awareness campaign showing Stayin’ Alive by the Bee Gees can be used when performing CPR.
A great Nudge overcomes inertia, and prompts the fast brain into action. Mnemonic devices, like associating a popular song with the moves required to save someone’s life from sudden cardiac arrest, are an excellent example.
Another example of a mnemonic Nudge used in first aid training is DR ABC. This is an acronym describing the steps involved in responding to an emergency situation like a sudden cardiac arrest.
In fact, DR ABC spelt out – Danger, Response, Airway, Breathing, Circulation / Compressions / Call and ambulance – also describes the sudden cardiac arrest Chain of Survival (albeit in a different order).
These Nudges are an example of ways to help train yourself to overcome the fight-or-flight response to an emergency, and rapidly deliver aid.
Do you have other examples of Nudges used in CPR training? Leave a comment and let us know.
