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Informed emergency responses through improved situation awareness
Pauls, J.; Groner, N.; Gwynne, S.; Kuligowski, E.; Meacham, B.; Proulx, G.;
Thomas, I.; Ripley, A.
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I nfor m e d e m e rge ncy re sponse s
t hrough im prove d sit uat ion
a w a re ne ss
N R C C - 5 1 3 8 8
P a u l s , J . ; G r o n e r , N . ; G w y n n e , S . ; K u l i g o w s k i ,
E . ; M e a c h a m , B . ; P r o u l x , G . ; T h o m a s , I . ;
R i p l e y , A .
J u l y 1 3 , 2 0 0 9
A version of this document is published in / Une version de ce document se trouve dans:
Proceedings of the 4th International Symposium on Human Behaviour in Fire (Robinson College, Cambridge, UK, July 13, 2009), pp. 531-542
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INFORMED EMERGENCY RESPONSES
THROUGH IMPROVED SITUATION AWARENESS
DISCUSSION PANEL
Jake Pauls (Convener and Moderator) Jake Pauls Consulting Services
Norman Groner
John Jay College of Criminal Justice Steve Gwynne
Hughes Associates, Inc. Erica Kuligowski
US National Institute of Standards and Technology Brian Meacham
Worchester Polytechnic Institute Guylène Proulx
National Research Council, Canada Ian Thomas
Victoria University, Australia Amanda Ripley Journalist and Author, USA
INTRODUCTION
A classic problem in emergencies is the need for information about what is happening and what to do about it. Thus much behaviour in emergencies is occupied with information seeking and, while this often delays the initiation of important behaviour such as evacuating via the exit stairs, it is essential to know what strategy is best and how to implement it. This is “Situation awareness.” For example, in the South Tower of the World Trade Center on 9-11, one of the three exit stairs was temporarily available through the impact zone—post jet impact—for limited egress.
On 24 June 2002, Beverly Eckert was recorded on video at a NIST hearing in New York City relating her final discussion on 9-11 with her husband, Sean Rooney, who worked for Aon Corporation on the 98th floor of World Trade Center South Tower, the second to be hit and the first to collapse on 9-11. He called her on the morning of the attacks, and they talked until there was a loud explosion and nothing more. Some of her recollections from the 2002 hearing: “I was on the phone with Sean for the last half hour of his life, beginning at 9:30 a.m. He described his situation, what escape routes he had tried and asked me for information based on what I was seeing on TV. He was calmly and rationally trying to assess his options. I reached 911 on another phone but a full half hour after the planes had struck they had no information to pass along. . . . Sean died because of failures in communication. . . . There are lessons to be learned from what he and so many others endured.”
Following 9-11, Beverly Eckert went on to serve as the co-chair of Voices of September 11th and was an active participant in the “families” advocacy for, among other things, understanding—situation
awareness—of what happened before, on and after 9-11. An especially moving photograph (by Kathy
Willens for Associated Press) of Beverly was taken in August 2006 as she listened to the emergency responder recordings made during 9-11, recordings that underlined how inadequate situation awareness was on the part of emergency responders. (The documentary videos shot by Jules and Gedeon Naudet in the lobby of the World Trade Center also show the woefully inadequate situation awareness of emergency responders at the site.)
Beverly Eckert died on 12 February 2009 in the crash of Continental Connection Flight 3407 (a 74-seat Bombardier Dash 8 Q400 with twin turboprop engines), while it was attempting to land at the Buffalo, New York, Airport. Situation awareness—or shortage thereof—apparently played a role in the crash.
This panel session is dedicated to Beverly Eckert and her eloquent contribution to our understanding of situation awareness in relation to 9-11. What happened in the World Trade Center on 9-11 was yet another example of failures in situation awareness. In this case there were numerous failures in situation awareness, some of which were instrumental in the loss of life, especially in the South Tower.
In this panel session, several perspectives on situation awareness will be briefly presented and discussed. For example, leading off the presentations is Norman Groner who has the perspective of a psychologist long involved with situation awareness in relation to human factors in fires. He has spoken and written extensively on this topic from a human factors (ergonomics) perspective and this Symposium on human behaviour in fire includes his paper, “A situation awareness requirements analysis for the use of elevators during fire emergencies.”
The fact that the field of human factors (ergonomics) has been the leading discipline for a
user-centered examination of the science of situation awareness and the application of insights in many
mission-critical situations, makes Dr. Groner an especially appropriate person to provide the introductory, scientific perspective on situation awareness. For this he draws, for example, on the leading work of ergonomist Mica Endsley and her colleagues who provided a full definition of situation awareness: “the perception of the elements in the environment within a volume of time and space, the comprehension of their meaning and the projection of their status in the near future.”1
Although “situational awareness” is sometimes used, grammatically, it is more correct to use “situation,” the noun, rather than “situational,” the adjective. The awareness is of a situation. Stated less formally, situation awareness is being aware of what is happening around you and understanding what that information means to you now and in the future—especially in relation to your actions. Note that the formal and informal definitions are appropriate for building fire events as they highlight the importance of not just making information available, but also the importance of understanding the significance of that information and predicting how events are likely to evolve.
Situation awareness is not new in the field of fire and human behaviour. It has been described long before the formal label became widely used. For example, paraphrasing Canter, Breaux and Sime: “Behavior in fires can best be understood as a logical attempt to deal with a complex, rapidly changing situation in which minimal information for action is available.”2 Generally the role of situation awareness is to improve the timing, quality, amount and usability of critically important information needed to carry out appropriate actions.
Within codes and fire/life safety standards there are longstanding requirements for systems and facilities that enhance situation awareness. Included are fire/smoke detection, alarm and communication systems plus the system status panels in emergency command centers; supervisory systems for various especially critical components (e.g., certain valves) of fire protection systems; water flow indicators; certain signs; and the availability of trained staff, notably in health care occupancies. Additional, nontraditional systems enhancing situation awareness could include video (and other system) monitoring of means of egress/escape. In the USA, the latter has been the subject of proposals for NFPA 101 and NFPA 5000 in recent years but these have not yet been adopted. Serious failures of situation awareness have been identified as central to unfortunate outcomes in various emergencies; for example, in the World Trade Center there was significant lack of awareness of the actual nature of the event and extent of damage to the building and its systems. Responses to natural hazards such as hurricane Katrina also exhibited major inadequacies in situation awareness.
Typical persons’ responses to developing fires also exhibit situation awareness problems as incorrect assumptions are made about the rapidity of fire growth or the effect of opening a door. Good situation awareness is critical to decision making which, in turn, is critical to performance during an emergency.
CONTRIBUTORS
Beyond these introductory remarks (by the panel convener) on situation awareness, and the perspective of human factors (ergonomics) authority, Norman Groner (from the John Jay College of Criminal Justice), the panel provides the opportunity for an international and multidisciplinary set of perspectives. They come from Steven Gwynne (UK and Hughes Associates Inc., USA); Erica Kuligowski (National Institute of Standards and Technology, USA); Brian Meacham (Worcester Polytechnic Institute, USA); Guylène Proulx (National Research Council, Canada); Ian Thomas (Victoria University, Australia); and Amanda Ripley (journalist and author, USA).
They provide perspectives on other aspects of human factors, fire, and situation awareness. With this panel coming at the end of the Symposium, we look forward to new ideas on how to put into practice what has been learned about human factors in fires in the several decades of research and multidisciplinary discussions of this topic since the early analysis of Professor John Bryan of behaviour at the Arundel Park Hall fire in Maryland in 1956.3
Complementing, in more ways than one, the many contributions of Professor Bryan, this paper includes the perspectives of journalist Amanda Ripley, author of the recent book, The Unthinkable.4 This book title is especially intriguing within the context of situation awareness. If an event is “unthinkable,” then how do we develop an awareness of what is happening and what to do about it? With her choice of the title, “Denial,” for Part One of her book, the disconnect with situation awareness is especially marked and provocative. (In addition to Amanda Ripley’s writings, one of her recent contributions as a journalist in the field is her videotaped discussion with Professor Bryan on February 27, 2009. This wide-ranging discussion spanned several decades of Professor Bryan’s involvement with human behaviour and fires beginning with his own response, as a youth, to incipient fires, his situation awareness and his response.)
NORMAN GRONER:
AN OVERVIEW OF SITUATION AWARENESS TOPICS RELATED TO EMERGENCY RESPONSES IN BUILDING
As noted in the introduction to this panel session, problems with achieving good situation awareness (SA) are frequently implicated in poor outcomes to building emergencies. My purpose here is a briefly describe several topics discussed in the human factors and cognitive ergonomics literature that seem relevant to emergencies in buildings.
Mr. Pauls quotes Mica Endsley’s seminal definition of situation awareness.1 The term as used in the technical literature differs from the way SA (and the associated term of “situational awareness”) is sometimes used by practitioners. I recall an interview with an emergency responder subsequent to his participation in the World Trade Center disaster where he explained that he had good situational awareness, although it proofed to be wrong. You cannot have good SA if it is “wrong.”
The Three Levels of Situation Awareness
The classic definition of SA provided by Mica Endsley 20 years ago has been developed into three generally recognized levels of SA. During emergencies, all three levels are necessary to achieve good SA. The situation where someone discovers a fire in their home provides a simple way to illustrate the importance of all three levels.
Level 1 – perception of the elements in the environment. In our example, this means that someone receives sensory input, for example, flames and smoke that they identify as a fire.
Level 2 – comprehension of the current situation. Level 2 comprehension depends on the goals of the perceiver. For example, discovering a fire in a fireplace has an entirely different meaning than discovering a fire that is burning on a stove or in an upholstered chair. A fire in a fireplace is associated with the goals of comfort and aesthetics, but a fire on the stove or a piece of furniture is likely to be associated with the goals of controlling the fire and saving lives and valued possessions. The meaning of the two fires is entirely different.
Level 3 – projection of future status. The importance of level 3 SA is apparent when someone encounters an unintended household fire. Persons with poor level 3 SA are unlikely to anticipate potential for the growth of the fire to rapidly accelerate, thereby greatly underestimating the time available to complete their goals.
Global Situation Awareness
Under conditions of stress, people experience attentional narrowing or tunneling. They tend to focus narrowly on immediate tasks, and less able and likely to notice anomalies and peripheral cues in the environment that indicate a change in the situation. This, in turn, inhibits their abilities to adapt when the situation changes in ways that are not accurately foreseen, that is, their level 3 SA is reduced. To circumvent this problem, people need to maintain a big picture or bird’s eye view of the situation. In the human factors and cognitive ergonomics literature, this has been labeled global situation awareness. In order to allow people to focus their attention on the task at hand, the task of maintaining global situation awareness can be allocated to other organizational structures, for example, the planning function in the Incident Command System used in the United States, or to computers that draw attention to special displays when situational parameter fall outside of set values.
Team and Shared Situation Awareness
Emergencies often involve teams where people in varying roles share common goals. During the time urgency and uncertainty of an emergency, and given that teams are comprised of people who are often geographically distributed, the problem of staying on the same page or having common ground is an important challenge. For example, during a building emergency, people in the roles of permanent occupants and visitors, building managers, facilities engineers, emergency team members, security personnel, and police, fire and emergency medical services all have interdependent roles but share the common goal of preventing casualties. Because their roles differ, people do not require, and should not be provided with the exact same SA. However, to the extent that their activities are interdependent, they do need to share a common understanding of the situation. Shared SA can be facilitated by sharing displays of information and by using the same mental models. For example, the Incident Command System is a shared mental model of how to manage an emergency response that helps all participants achieve good SA with respect to the activities of each other. The Situation Awareness Requirements Analysis described in my paper at this symposium is a means to achieve shared SA with regards to who needs to receive information from whom.
Stages in Designing for Good Situation Awareness
Fire safety engineering is about design, and I expect that the efforts of people in achieving good situation awareness will be an increasingly recognized and important design goal. The design process can be divided into three stages:
1. Figuring out the information requirements that people need to make good decisions
during emergencies. This stage is too frequently overlooked and should be subjected to
careful analysis, the subject of my paper in this symposium that presents a situation awareness requirements analysis for the use of elevator to evacuation occupants during building emergencies. Understanding the information needs of people in various roles is
especially important to achieving good shared SA during large scale emergencies involving people from many agencies in a variety of roles.
2. Figuring out the sources where the needed information can be acquired. While the engineering community understandable focuses on sensor technologies, a great deal of valuable information is also acquired from people. The phenomenon of “milling” identified by sociologists is of critical importance to people when they are trying to achieve situation awareness in ambiguous situations that are typical of the time-critical early stages of building emergencies.
3. Figuring out how that information can be presented in a way that best supports user
goals. Presenting information requires careful design to avoid requiring people to spend
unnecessary time deciphering information and to avoid information overload. A common mistake is to ask users what information they want displayed, because they often request too much data, much of which may not be relevant to their goals. For example, isomorphic displays that show the status of all sensors in a building can obscure the information that is most relevant to the goals of understanding the extent of fire growth relative to areas where people may require rescue, how a fire can best be approached for suppression activities, whether the ventilation system is compromising compartmentation, and so forth.
STEVEN M.V. GWYNNE:
THE ENGINEERING IMPLICATIONS OF SITUATION AWARENESS
Understanding situation awareness (SA) is critical to the understanding of human response in fire. Without this understanding, human response may be misinterpreted or seen as incomprehensible. This brief text will outline how can we embed our understanding of situation awareness in egress analysis and influence situation awareness through procedural design.
Given the pragmatic nature of this text, the simplest definition of SA is adopted: “knowing what is going on so you can figure out what to do.”5 It clearly outlines the process of SA: the need for information and its use to assess and decide upon a response. This is a simplification, given that the interpretation of external information and recall of experiences is highly dependent upon the individual’s cognitive abilities; however, the definition does capture the nature of the process.
It is important that SA is addressed in egress analysis. A number of methods are available to assess egress performance: i.e., to calculate the required safe egress time. These include engineering calculations, performing egress drills, and employing computational tools. To realistically represent human response during an incident, these models would have the SA process and subsequent response selection embedded within them. For instance, an individual is exposed to false alarms; on receiving an alarm signal, the individual then ignores it; the individual also ignores the information provided by the alarm: the individual then prolongs initiating their response to an event and has only a sub-set of the information available. This process is currently not fully represented.
Even the most basic of engineering methods need to represent three key behavioral responses and a basic emergent condition that limits the effectiveness of this response: the pre-response time (the time that it takes people to purposively respond to the incident); route selection (the routes selected during the response); movement speed (the speed at which evacuees might move during their response); and the flow constraints that emerge (the limitations placed on free movement). The impact of SA might crudely be represented within the three behavioral responses. Although little data exist linking SA to specific response components, engineering judgment can be used to link the differing levels of SA to the three behavioral responses highlighted above. (See table below.) This may then allow the impact of SA to be examined, if not the link between key factors influencing SA and the assessed outcome.
Situation Awareness
of Emergency Pre-Response Route Use Speed
None Infinite
(e.g., no cues, etc.)
n/a (e.g., no response, etc.) n/a (e.g., no response, etc.) Incomplete information / Inaccurate interpretation Extended
(e.g. late perception of cues, misinterpretation/ misunderstanding leading to underestimation of risk, etc.)
Selection not based on time constraints. Potentially based on a sub-set of routes (e.g., go out the way they came in, etc.)
Moderate
(e.g., casual walk – not moving as quickly as possible, not moving directly to safety, etc.)
Relatively Complete / Accurate
Reduced
(e.g., receipt and recognition of cues, etc.)
Selected according to time constraints (e.g., may use nearest route available if aware, etc.)
According to ability (e.g., move as quickly as possible, etc.)
Given this analysis, emergency procedures and practices can be implemented to manage SA. These fall into those that occur prior to incident (training and preparation), and those that are conducted during the incident (notification and management). Prior to the incident, the subject population can be made aware of the response required, the routes available and the procedural cues to look out for during the incident. They can be primed. This is not possible in all occupancies; i.e., those where populations are transient. During the incident, information can be provided (both via technology and staff) to manage SA and the behavioral response: the nature of the incident; that a response is required; and the nature of this response. This represents both an attempt to compensate for omissions in SA and coordinate the simultaneous use of SA to produce actions in the target population.
It is possible to crudely account for SA during egress analysis; it is possible to address SA during the application of emergency procedures. It is critical to acknowledge and understand SA in order to do either of these important activities.
ERICA KULIGOWSKI:
A SOCIOLOGICAL PERSPECTIVE ON SITUATION AWARENESS
As Dr. Groner notes, situation awareness (SA) consists of perception, interpretation of the situation, and the projection of future status, which then leads to decision-making and the performance of actions. What is not specifically included in the description of situation awareness is the interpretation of the risk that occupants develop in addition to their interpretation of the situation. Once an occupant receives cues, it is his/her interpretation of the situation and/or interpretation of risk which then leads to the decision to perform a certain set of protective actions, e.g., evacuation.6 In some cases, occupants develop an accurate assessment of an emergency, which increases their interpretation of risk, which ultimately influences them to begin evacuation. On the other hand, occupants with little or no understanding of the situation may receive cues that increase their level of risk which, in turn, influences them to evacuate anyway. An example of this is seeing others in the building evacuating and following suit, even without an understanding of the situation.
There are numerous factors that influence an occupant’s SA, i.e., their perception, interpretation of the situation, and interpretation of the risk to themselves and/or others in the building.7 The focus of this write-up is on the social factors, i.e., the factors that arise from the interaction of the occupants with others inside or outside of the building. Research shows that these social factors can include external cues presented to the individuals from other people and social behavior in which the occupant engages, i.e., milling behavior.
Research on human behavior in fires, community-wide disasters, and other types of emergencies has identified external social factors that influence the perception of a cue, the accuracy of the interpretation of the situation, and the level of risk defined. In the case of perception, the presence of others decreases the probability that a cue will be received by the occupant;8 whereas if the cue/information is provided by someone or some group that represents an official source (e.g., the fire department) the occupant is more likely to perceive or receive the cue.9-10 In the case of the interpretation of the situation, the social factors that increase the probability of an accurate interpretation of the event include seeing or hearing others in the building performing behaviors that are consistent with that interpretation,8-9 receiving information about the situation from someone or some group that represents an official source,11-12 and receiving information about the situation from someone or some group that is familiar to the occupant (e.g., friends, family, etc.).13-14 Last, both the presence of loved ones within a building15 and the presence of social cues that are consistent with an understanding of an emergency13 increase the likelihood of an occupant defining risk. These factors directly influence an occupant’s situation awareness.
In addition to these factors that influence the phases or levels of situation awareness (i.e., perception and interpretation), there are social behaviors in which the occupant engages that influence his/her situation awareness. In an emergency situation where other occupants are present, especially in new and/or ambiguous situations16 and times of urgency,17 occupants are likely to interact more intensely with others around them. This type of interaction, which is intensified in densely populated buildings, has been documented in a variety of different incidents18-19 as a means to establish what is going on, define the new situation at hand, and propose and adopt new appropriate norms for behavior.16-17 It is through this group-based reasoning strategy that occupants can begin to construct meaning from the cues that they perceive in fire situations. In these types of situations, leaders can emerge that suggest interpretations of the event and/or risk, which can then be incorporated into the occupant’s own situation awareness.
BRIAN MEACHAM:
INFORMING RESPONSES THROUGH IMPROVED SITUATIONAL AWARENESS —AN ENGINEERING PERSPECTIVE
Access to good information is a critical component of enhancing situational awareness, and is essential to informing decisions, especially under rapidly changing conditions. Real-time, relevant, and appropriate information can help the recipient adapt her response to the particulars of the event at hand, be it availability of egress paths or ice build-up on the wings of an aircraft.
However, not all information that is or can be made available is necessarily “good” with respect to the problem at hand and the decision that needs to be made, and “more” is not necessarily “better.” A challenge for enhancing situational awareness for better informed emergency responses is to better understand what information is needed, at what level of detail, in what format, and how this information will actually be used (or is capable of being used) to positively impact emergency responses. If the information being provided is not real-time, relevant and appropriate, one could envision making a bad situation even worse.
As other panelists have noted, most building codes now require audible and visual alarm notification equipment, typically at least two means of egress (which may include lifts), appropriate exit signage, and sufficient emergency lighting. In large, complex and high-rise buildings, alarm notification often includes voice communication. In most of these buildings, fire detection of some sort is available, as well as other fire protection systems, such as smoke control systems and compartmentation. These systems are available to provide information and safety in the event of emergencies, and are often mandated with this intent in mind.
In addition, advances in sensor technology, egress technology, communication technology and computational modeling offer the promise of more information and better safety by providing
real-time understanding of smoke and fire location, near real-real-time modeling of smoke and fire spread, the ability to control fire protection, signaling, communications and egress systems, and the ability to direct emergency responder actions. However, which of these technologies will actually help to improve safety and under what conditions, which may result in unintended consequences, and what advice is there for the design community? How do we balance adding new technology to better inform decisions with reducing potentially competing signals and egress options, which could cost precious decision making time: how do we choose between pre-determined evacuation schemes and adaptive approaches for a particular building use or population?
Currently, prescriptive regulation-based design of fire protection, signaling and egress systems generally assumes that occupants react immediately and make ‘rational’ decisions: that they immediately recognize a fire cue as such, move to the nearest emergency exit, and leave the building. Engineers know this is not true, and conceptually understand that a wide range of challenges exist, including those associated with occupant recognition, response and decision-making, learned irrelevance and exit selection, movement toward the familiar, and variability in movement times.20-22 Performance-based regulations and design approaches aim to allow these factors to be addressed; however, data for analysis and design are lacking, many computational egress models do not adequately account for the uncertainty and variability in occupant reaction, response, decision-making or movement, and perhaps most importantly, it is not always clear how to address these issues in actual building and systems design in such a way that the overall level of safety is being improved.
Although there are regulatory requirements which often specify certain system types, and building owners who push hard to lower costs, most fire protection engineers are truly aiming to provide a level of fire and life safety that is appropriate to the risk. Engineers can design more effective systems —if they know the parameters. By working across disciplines, we can all better understand the problems and potential solutions, and effect regulatory and design changes to achieve the levels of safety that are desired.
GUYLÈNE PROULX:
SITUATION AWARENESS IN APARTMENT BUILDING FIRES
Situation awareness is defined as being aware of what is happening around you, understanding what this information means for you now and in the near future. In an apartment building fire, situation awareness will depend on three factors, which compose the fire event: the occupant’s characteristics, the building features and the fire scenario. Depending on any one of these factors, the fire situation can remain minor or develop into a catastrophic event, which will influence the occupant’s situation awareness.
The occupant’s characteristics will have a substantial impact on their situation awareness. The state of the person asleep or awake at the time of the fire appears particularly important, as people asleep are unlikely to be awaken by smoke or smell of something burning. The smoke alarm, if present, might wake up the occupants although it is acknowledged now that not everyone can be awakened by the sound of an alarm. This particular vulnerability of occupants asleep is specific to the residential occupancy as well as hotels and motels.
Another important occupant’s characteristic is the presence of people with limitations. Occupants who have a hearing, visual or cognitive impairment are much less likely to be warned about the fire than a person who has no particular limitations. Understanding what is happening could also be a challenge for occupants of different age: the very young might not grasp the situation as well as some elderly who suffer from degenerative conditions.
The contribution of alcohol, medication or other drugs is also an issue that will influence the likeliness of occupants becoming aware of the situation and achieving an appropriate response. The residential occupancy is probably the type of building where this issue is more likely to be present;
coroners’ reports demonstrate that in the USA, half of the residential fire fatalities were under the influence of alcohol or other drugs.
The building features are meant to alleviate these problems and contribute to situation awareness in providing early detection and warning to occupants. The main means to provide warning is through the fire alarm system. Individual apartments will have a local smoke alarm to warn the occupants of that apartment that they have a problem in their unit. The building should also be equipped with a central alarm system that will emit a signal throughout the occupancy in case of an emergency. Many apartment buildings have these alarm sounders in the central corridors of the building, which does not guarantee that the sound will be perceived inside each apartment. This is an important drawback since occupants who do not get a warning are unlikely to develop a situation awareness while an emergency is actually unfolding. Provision of sounders in every apartment is necessary for alarm audibility. A few apartment buildings have a voice communication system that could tremendously help occupants with their situation awareness. Unfortunately, apartment buildings rarely have a person designated to provide information through these means, and it is often expected that arriving firefighters will issue information. By the time firefighters provide information, precious minutes will have been wasted. If audibility of the alarm signal is essential, no less essential is the intelligibility of the messages issued through the voice communication system. Obtaining timely information through the voice communication system can help occupants considerably with their situation awareness. The fire scenario, its location, what is burning, how its burning, etc., will have an impact on the potential detection of this fire by mechanical systems or direct perception by the occupants. A fire that is burning outside the building or several floors above the location of an occupant can go unnoticed for a long period of time.
Occupants who are awake and without limitation located in the apartment of fire origin are likely to rapidly form a relatively clear situation awareness. They will directly perceive the danger, e.g. smell of burning, see smoke or flames, as well as hear their smoke alarm or being warned by other occupants of the apartment. Situation awareness is much more complex for occupants who are not in the apartment that is on fire. The information available to occupants of the other apartments is often limited and ambiguous. Situation awareness is a real challenge when all the information offered is the beeping of a fire alarm, as nuisance alarms are prevalent in many apartment buildings, it is to be expected that in the initial moment the situation will be misunderstood. An area of great concern is that occupants will delay their evacuation response due to a lack of situation awareness. Starting evacuation too late during a fire event can result in injuries and fatalities. It is paramount that information be provided for occupants to take accurate and prompt action. Once occupants understand that there is a problem in the building it is essential to maintain the environment into an emergency status; so the alarm should continue ringing and information on the situation should continue to be transmitted to the occupants as long as the situation is not under complete control.
Providing timely and precise information to occupants is crucial. This is the basis of situation awareness, which in turn will allow better-informed decision-making during a fire in an apartment building.
IAN THOMAS:
SITUATION AWARENESS AND RAPIDLY ADVANCING BUSHFIRES IN AUSTRALIA
In considering situation awareness we need to view the incident (fire or other emergency) from the perspectives of:
• each person involved in the incident, particularly those least likely to be able to deal with it (obtainable from records of those killed or injured in previous incidents);
We also need to recognise that all of these people will be stressed by the situation and will have different relevant knowledge, experience, capabilities and attitudes, and these will influence their perception of the incident and their ability to absorb and use the information they receive.
I recently had experience of situation awareness through being involved in a very severe fire and this experience has given me an insight into the needs of a person involved in a fire. The fire my wife and I were involved in was not a building fire, but the February 7, 2009 “Black Saturday” bushfire in Victoria, Australia in which 173 people died. I am sure that many aspects of the experience were very similar to those experienced by people involved in fires in buildings, particularly large buildings. Many aspects of this situation awareness experience were similar to, but more severe than, those we had previously experienced when threatened by three nearby bushfires during the previous five years. Earlier experience acting as chief warden in a building (fortunately only during minor emergencies) also provided an insight into the needs and difficulties experienced as the person with the role of supplying information and instructions.
We were well aware that the bush and grassland on February 7 was extremely dry and that the weather conditions were extremely dangerous. Although we had monitored the radio station that works with the emergency services to supply information and the emergency services web sites for most of the day, we were unaware of the approaching fire until it was almost upon us. It had begun during the afternoon over 50 km away but it, and another fire about 20 km away, did not seem relevant to us as there was no indication they were moving at all, or heading in our direction. We were surprised when a neighbour drove in and asked to use our telephone as their power had gone off (as had ours), saying they were evacuating because they had received a call telling them Kinglake (a town about 10 km away) was burning and the fire was headed our way. There was still nothing on the radio or on the web. When we walked outside as they were leaving it was quite dark (when it should have been bright sunlight) making burning embers falling around us clearly visible in the descending smoke – we began to realise this was really serious. The neighbours drove off but quickly telephoned to say the nearby paddocks they were driving past were on fire and it was headed our way. We rushed outside to see that it was even darker and the fire was rapidly approaching.
So began eight hours of fighting the fire, defending the house, and exhausting activity and decision making – and three days of uncertainty, exhausting activity and emotional turmoil for us and our families due to failed communications. We learned from this experience that what is needed is:
• good preparation and planning, practiced and tested under the most adverse conditions imaginable;
• from others, information that is clear, concise, current, accurate, relevant and local.
Such information needs to be repeated periodically because all of the intended recipients may not be able to hear it or assimilate it at any one time. If information provided does not fulfil all of these criteria it adds to the confusion and/or becomes “noise” and reduces the capacity of those involved to act rapidly and in the most appropriate way. The information needs to be:
• clear and concise because, under the stress of adverse and time critical conditions, lack of clarity, ambiguity and unneeded information cannot be tolerated;
• current because old information is likely to be inaccurate and useless, or even worse, misleading; • accurate: inaccuracy may lead to confusion, delays and/or an inappropriate course of action; • relevant: irrelevant information is useless, and worse may lead to confusion, delays and/or an
inappropriate course of action;
• local, because it needs to be specific to the situation faced by the recipient. Non-specific information may lead to uncertainty, delays, confusion and/or an inappropriate course of action. In our case, for most of the time, the information available failed several of these criteria.
I doubt that these criteria can be reliably satisfied in building fires or in bushfires. Any assertion or expectation that such information will be provided might also lead to greater delays, confusion or uncertainty.
AMANDA RIPLEY:
THE ROLE OF PRIOR EXPERIENCE
I am not an academic or an expert of any kind. My only real function is as a storyteller. So I accept Jake Pauls’ kind invitation to contribute to this paper with all the expected caveats. I can only hope to be a messenger (an imperfect one) for the many disaster survivors and researchers I have interviewed over the years.
People who have lived through bombings, shipwrecks or hurricanes tell me that they perceived what was happening to them by fitting the situation into everything that had happened to them before. Usually, this meant that they tried (very creatively) to find a benign explanation for the threat— because, in part, they had few other options in their heads.
Most often, this process manifests itself as a form of disbelief. Captain Chesley Sullenberger, the pilot who successfully landed US Airways Flight 1549 in the Hudson River in January 2009, described his immediate response to the engine failure this way to CBS: “My initial reaction was one of disbelief. ‘I can’t believe this is happening. This doesn’t happen to me.’… I had this expectation that my career would be one in which I wouldn’t crash an airplane.”
This is how the brain works. The brain loves patterns, and it processes the present by fitting it into everything that has come before. Why is this important? Because most of us don’t have a pre-existing pattern for a fire. So this “normalcy bias” will often translate into not only pre-evacuation delay—but ongoing censorship of environmental and social cues in order to fit what is happening into the patterns we do have.
Ideally, the design of a structure and the communication of information in a crisis should overwhelm this denial response. (Many flight attendants are now trained to shriek at passengers to “Get out! Get out!” of a burning airplane.) But that is a bit too late, I would argue.
What really helps broaden the brain’s awareness is having experienced something relevant before. If the brain is a database, then there needs to be good data in there before anything goes wrong. In other words, everyone in a building should have muscle memory for going down the stairs in a realistic, surprise fire drill. That will imbed a highly useful pattern in the brain for use in a real emergency. That asset, I would argue, may be much more valuable than many other engineering improvements to the building or the alarm system.
Sullenberger had good, realistic training, and he actively pushed through the denial phase. Manuel Chea, who worked on the 49th floor of Tower 1 of the World Trade Center, had experience. After the plane hit the building, many of his colleagues began to talk to each other and gather up belongings. Chea jumped up from his cubicle and ran to the closest stairwell. When I asked him why he had moved so fast, Chea offered several theories. He knew where the stairway was because he used it all the time to go to the cafeteria. (Unlike most Trade Center occupants, who had never entered the stairwells before.) So he was familiar with the escape route, a huge advantage. Also, he had experience with fire. The previous year, his house in Queens, New York, had burned to the ground. He had escaped, blinded by smoke. His brain had useful patterns for what was happening, and it helped broaden his awareness.
In one recent study, Erica Kuligowski and her colleagues found that standard engineering parameters only explained about 13 percent of the differences in evacuation speeds.23 I would humbly suggest that some of the remaining variance may be due to the different set of available patterns in the minds of the occupants.
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