Klar denken, stark handeln – wenn alles auf dem Spiel steht. Mentale Stärke entscheidet
in der Notfallmedizin über Sekunden, Gesundheit und langfristige Exzellenz. Der Beitrag
zeigt, wie das Verständnis für unsere Neurobiologie, das Erlernen kognitiver Kontrolle
und das Training von Selbstwirksamkeit und Selbstregulation unter Druck wirken – und
warum Resilienz, Kultur in Hochleistungsorganisationen und Erholung trainierbare Schlüsselressourcen
sind.
Abstract
In emergency medicine, peak performance under extreme pressure is not an exception
– it’s the standard. Yet while technical skills are systematically trained, the ability
to maintain cognitive clarity, emotional control, and decision-making capacity under
stress remains underemphasized.
This article explores the psychological and neurobiological mechanisms of pressure,
the impact on cognition, stress response and the phenomenon of cognitive overload
and freezing.
Drawing from high-performance fields such as aviation and elite sports, it outlines
mental strategies – such as breath control, reframing, self-talk, cognitive offloading,
and the application of different models —to maintain operational capacity in high-stakes
situations. Through real-world case studies, the article emphasizes the need for structured
training in self-regulation, emotional resilience, and team-based mental models. Long-term
strategies for sustainable performance – including the COTE framework
(Confidence, Optimism, Tenacity, Enthusiasm), physiological regeneration, psychological
safety, and leadership-driven cultural change – are also discussed. Mental competence
is framed not as a luxury, but as a core professional skill essential for safety,
effectiveness, and personal well-being in the high-pressure environment of emergency
care.
Schlüsselwörter
Entscheidung - Notfallmedizin - Extremsituation - Resilienz - mentale Kompetenz
Keywords
decisions - emergency medicine - extreme situation - resilience - mental competence