How do I handle the hardest, highest stakes rescues?

You handle most rescues now, which means your training has become instinct. What still tests you are the rare ones where the stakes are highest and nothing goes to plan. Those are supposed to be hard. If they felt easy, you would be missing how much is riding on them. The pressure you feel is respect for the moment, and that is right. In the worst situations, no one holds the whole thing in their head at once. The people who stay steady break the chaos into the next single action, and only that. What is the one thing that must happen right now? Do it. Then ask again. Complex rescues are just many small, clear decisions made in a row under weight. After your next hard call, take a few minutes to walk back through it, honestly, while it is fresh. Not to punish yourself, but to learn what you would do sooner next time. That quiet review, done again and again, is how the high-stakes ones slowly stop testing you.