EM SAQs · Resuscitation team leadership and CRM
Lead the arrest — CRM principles and the debrief
ACEM-style SAQ on resuscitation CRM, closed-loop communication, fixation defence and plus-delta debrief.
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Establish leadership. State clearly "I am the team leader," stand at the foot of the bed if hands are free, stop freelancing, and allocate roles: airway, compressions, defibrillator, drugs, timer/scribe, runner. Start a visible timer and demand high-quality CPR with compressor rotation.
Shared mental model. Every two-minute cycle, summarise aloud: rhythm, last shock/drug, reversible causes being checked, next priority. This aligns the team and invites corrections.[1]
Closed-loop communication. Direct orders to a named person; require read-back; confirm completion. No floating orders into the air. [5]
Fixation defence. Actively solicit dissenting information ("what are we missing?"); use graded assertiveness (CUS/PACE) culture; if airway concern raised, verify ETCO₂/ultrasound/view rather than dismiss hierarchy. Cognitive forcing: scan Hs/Ts checklist. [5]
Debrief. Hot plus-delta immediately: what went well, what to change; later cold debrief for system issues; support second victims.[5]
References2ShowHide
- [1]Greif R, et al. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation, 2020.PMID 33098918
- [5]Gaba DM Crisis resource management and teamwork training in anaesthesia. Br J Anaesth, 2010.PMID 20551023