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Problems for clinical judgement: 3. Thinking clearly in an emergency
M J Schull1, L E Ferris, J V Tu
1Division of Emergency Medicine, University of Toronto, Toronto, Ont. mjs@ices.on.ca
Summary
Improving patient resuscitation in emergencies requires enhanced training and teamwork. Implementing crisis resource management principles and clear roles can lead to better clinical decision-making and patient outcomes.
Area of Science:
- Emergency Medicine
- Critical Care Medicine
- Anesthesiology
Background:
- Resuscitating critically ill patients is a highly stressful and often disorganized medical event.
- Effective management of patients in extremis is crucial for improving survival rates.
Purpose of the Study:
- To review existing literature on improving clinician and team performance during critical patient resuscitation.
- To identify strategies for enhancing the response to medical emergencies.
Main Methods:
- A review of selected studies from anesthesia, emergency medicine, and critical care.
- Analysis of factors influencing individual and team performance in high-stress medical situations.
Main Results:
- Individual performance can be improved through increased emergency exposure during training and incorporating teamwork, communication, and crisis resource management.
- Team performance benefits from personality assessments for personnel selection, defined roles, shared team culture, and regular debriefings.
Conclusions:
- Systematic responses, rather than over-reliance on technology or instinct, are essential.
- Enhanced training and robust teamwork foster clearer thinking, enabling effective action and improved patient outcomes in critical care settings.