A first-aid backpack on the ground in a forest setting with mountains in the distance. Used as a metaphor for applying the principles of Dr ABC to managing high-pressure decisions at work

The Dr ABC of Managing High-Pressure Decisions – an Emergency Response Guide

A while ago in preparation for some volunteering, I took one of the best training courses I’ve ever experienced, the Outdoor First Aid course at the UK’s national outdoor centre at Plas y Brenin.

Amongst other things, we learnt the Dr ABCDE structure of first aid.

And during a recent coaching session we used that structure to help manage a seriously high-pressure decision that my client was facing.

First, here’s a reminder of my notes from that course:


  • Danger: Ensure safety for yourself, bystanders, and the casualty from further harm.
  • Response: Check if the casualty is responsive or unconscious.
  • Airway: Check if the casualty’s airway is open and clear.
  • Breathing: Monitor if they are breathing normally.
  • Circulation: Look for signs of life such as pulse, movement, or coughing.
  • Disability: Check again for unconsciousness, possibly caused by a neurological injury or condition (e.g. check pupil response).
  • Exposure: Expose and examine them for other hidden injuries, and ensure they are not getting cold.

If you need to manage a high-pressure decision at work, here’s my first-aid guide, using the principles of Dr ABC and applying them to great leadership:

D – Danger – assess first before acting:

  • Assess the situation and potential risks before taking action.

R – Responsiveness – ask others for their response, seek allies and advice:

  • Seek input, feedback, and advice from others to gather different perspectives and insights.

A – Airways – open up your choices about how to deal with the high-pressure situation:

  • Explore a wide range of options and possibilities before narrowing down choices.

B – Breathing – monitor the progress and vitality of the decision-making process:

  • Continuously assess the progress, outcomes, and indicators of the decision to ensure it is on the right track.

C – Circulation – take decisive action and stay committed to the chosen course:

  • Follow through with the decision, implement it effectively, and dedicate the necessary resources and effort to make a significant impact.

D – Disability – evaluate the potential drawbacks and unintended consequences of the decision:

  • Assess and monitor the potential negative effects or limitations of the decision, and be prepared to address them proactively. Learn from what’s happening.

E – Exposure – identify hidden risks and protect against unfavourable external influences:

  • Be aware of potential risks or obstacles that may not be immediately apparent, and take measures to mitigate or avoid them. Protect the decision-making process from unfavourable external factors.

What else comes up for you, when you’re faced with managing a high-pressure decision at work? What do you need to take into account?

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