In this conversation, we will examine the challenges of exposure to high-stress situations, the principle of ‘psychological stunning’ and how to deal with the concepts of ‘amygdala highjack’. We will reflect with Tash on a seminal case that she experienced and her reflections on it. We will also reflect on how to harness and control these psychological and physiological stressors in practice to get the best out of yourself in a situation such as this. We will also look at the cognitive switches that Tash uses to de-escalate from the stress of the shift and finally how she approaches self-care within her practice.  Natasha Adams is a Senior Critical Care Paramedic (CCP) with the Queensland Ambulance Service, working on the Woodridge CCP POD and with the High Acuity Response Unit (HARU).  Her clinical interests include progressive out-of-hospital care clinical education, and leadership development. Natasha is currently working on a project with graduate paramedic induction programs but will soon progress into a full review of Queensland Ambulance Services' clinical education and operational areas. In the conversation, we examine: The case & reflections on the case  Why and how a ‘state of startle & overwhelm’ occurs.  The senses that shut down – hearing, vision, spatial awareness, concept of time     Mental imagery and rehearsal    Metacognition on the scene (thinking about thinking and mental awareness on the scene)  The trajectory of the HPT when the rails are coming off  Cognitive triggers (end of shift cognitive switching – going home mindset)  The hot debrief – contextualising the scene and emotions – permission to exhale  Nuances of NTS – permission to fail/miss information (self and crew)  Reflection on care and Self-care  My thanks to Tash for an engaging and insightful interview.