Worst Case Scenarios: Our Best Training Ground

I have had CPR training of sorts for more than 30 years, going back to the time I was a Boy Scout, and culminating with a refresher course I took last year, yet I never thought I would really ever need it. In fact, I’ve asked instructors at times if they had ever used their CPR training and only a handful have, ( former EMTs or those currently in the medical field.) Yet I, along with two other training camp attendees, were thrust into this situation several weeks ago when we happened upon a cyclist, who had just crashed and was unresponsive. 

We quickly realized he was struggling to breathe, and as we attempted to unclip him from the bike and lie him flat, he stopped breathing. After several minutes of trying, we were unable to find a pulse, so we cleared the airway, began chest compressions, and ultimately did rescue breathing. But it was very different from what I'd expected from all the classes and courses I'd taken for years: It was chaotic and loud, the cyclist seemed to be semi-conscious, his body was contorted and tanked up in the bicycle, as I gave compressions his body made noise as air was forced out, it was hard to find his carotid and femoral arteries to get a pulse, rescue breathing was a challenge as his mouth was gaping open and he had significant facial hair, and on and on.... It was NOTHING like I'd practiced in all those classes. 

The paramedics arrived on scene 8-10 minutes later and took over using an AED, then continuing compressions for quite some time until his heart resumed beating and they were able to transport him to the hospital. The cyclist is still in the hospital and recovering, albeit very slowly. He still has a long road ahead and is certainly not out of the woods yet. However we were grateful to be in the right place and the right time to help this gentleman have a second chance at life.

It’s been about 3 weeks or so since this occurred, and I've relived the situation many times over in my mind, asking the questions; “Could we have done more?”, “Did we start compressions too late?” “Were those compressions deep enough?”, “Did we wait too long to start the rescue breathing?”, “Should we have done things differently?”. As I’ve been thinking about this  I’ve been kicking myself a bit- thinking, “I’ve been trained for this! Why wasn’t I better prepared?”. 

And that’s when I realized- all my training and instruction had been done as a ‘best case scenario’, with an instructor and a few other trainees in a quiet classroom, on ‘perfect-bodied’ mannequins, with zero other distractions. And that’s all fine and good, BUT THAT’S NOT HOW IT HAPPENED IN REAL LIFE! Now, I’m not going to immediately go on a crusade to reform CPR-First Aid classes, but I am going to remember this as it applies to our training (and, of course in life.) 

And here’s the lesson: 

We should train in the worst-case conditions and scenarios, not just in the best. 

Just like my CPR training was done in a relatively calm, controlled environment, many times our planning and preparation for training and racing is in a best-case scenario: We tend only to ride our bikes outside in good weather, not in the wind or rain. Cyclists practice changing a flat tire in our air conditioned living room with all our stuff laid out neatly on the floor, not after riding for two hours in 90 degrees, trying to use a CO2 cartridge with sweaty hands and squinting eyes. Runners make sure to run the route with the least amount of hills, or only run in the morning when it’s cool and not in the heat of the day. Triathletes swim open water only when it’s calm and not when there are swells, chop, or currents. 

If we train, prepare, and rehearse for races (and life) in only perfect scenarios, we will be left struggling when a situation arises where we need to perform under less than ideal circumstances. 

As we continue to go about our training, along with working hard during ideal, controlled training sessions, let’s not forget to throw a wrench in the works every once in a while. This can better condition us on how to respond when we need to perform under stressful, hectic, less than ideal circumstances. And hopefully it will be just a matter of how fast we cross a finish line and not a matter of life and death.