Planned actions, as prescribed in protocols and trained in exercises, help frontline responders take action under enormous pressure. Yet, these same actions are often hard, if not impossible, to implement during crises, either because the specific situation was not anticipated and there are no plans in place or because prepared plans do not produce the desired results. As a consequence, frontline responders will need to improvise and adapt their activities to crisis situations. Yet, improvisation under extreme stress is very difficult and may be inefficient or even dangerous to responders. The resulting dilemma for responders is how to choose the right course of action. This requires a view of both action patterns as complementary and even mutually conducive, as most crises will demand a combination of plans and improvisation. Reflective acting helps frontline responders to find the right balance and define adequate response activities.