IMHO, based upon real-time experience in life and death emergencies in ER's, adrenaline does not help me function effectively, Training helps. Equipment helps. Being part of a team that has done this stuff before helps. Adrenaline makes my hand shake, and I miss the IV start. Adrenaline makes me respond to the obvious and apparent injuries without checking for the hidden, more serious problems. Nurses and soldiers and LEO's and fire fighters practice and equip and train and rehearse so that they will not have to rely on adrenaline to succeed, and not have to suffer for adrenaline induced errors in judgment. Adrenaline is not a solution to survival situations, it is an additional problem with which to cope. The less a life and death situation seems like a life and death situation, the more likely it will turn out to be a life situation.