The Yips

The "Yips" are a well-known feature of sports. Can they impact sudden cardiac arrest as well?

The Yips
A new trend in my community, getting "Flocked" for special events. 

Good morning and Happy Memorial Day! Just a short introductory post today, as the week's been packed for me with a return from Montana and holiday events with the family.

Moving on from the relatability argument and some ethical arguments, we have to look at other reasons people wouldn't perform CPR when it mattered most. In the ideal world, where everyone had access to regular and high quality training, what would cause this to happen?

My answer took me back to a tweet from January 16th, 2023

Even one of my favorite all-time NHL goalies, Marc Andre Fleury, has been a victim of the dreaded "Yips."[1]

The idea that the "Yips" would only impact athletes seems silly to me. Those nerves, the pressure to perform, the sudden "fumbly-ness" that takes place among disciplines, especially in medicine, would suggest that the yips can strike anywhere.

Peak Sports, in an article on the yips, listed two bullets that I think are especially relevant in bystander SCA response.

You can’t stop thinking about the outcome or messing up.

You overthink how to do a skill and confuse your body with too many signals.[2]

Now, while winning a sports game may not be as important as the critical life and death nature of helping something in an arrest, the fact that performance can be impacted by mental blocks in either scenario is important.

The "Yips" don't happen in isolation either. Our bystanders bring their own mental headspace to an emergency response and, bad news, we're all pretty anxious these days. [3].

What can happen? One author described it as a "triple trouble pattern."[4]

  1. You don’t feel confident about your coping abilities
  2. You feel anxious when you face difficult situations
  3. You procrastinate on coping.

Even mentally doubting your skills when assessing a pulse, or if the patient's gasp is normal breathing, can trigger an unintended consequence when time is of the essence.

Only recently have we recognized that bystander mental health, with "one out of three bystanders showing signs of pathological psychological processing weeks after the incident."[5]

With post-care health being such a new field, perhaps it's important to consider how we condition people to beat the "Yips" in our CPR training and even in telephone CPR. Building confidence, relating to people's true anxieties, and acknowledging that "doing your best" in-the-moment is all we can ask can go a long way. Recognizing and planning for mental blocks can help us in post-care response for bystanders too, which hopefully has positive impacts on the number of people willing to respond in an emergency.

In the coming weeks, we'll explore a bit more on overcoming self-doubt and the mental health challenges surrounding bystander response. For now, I wish you and your favorite sports teams a good "Yip-free" performance as you enjoy the holiday and start of summer.

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