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Related Concept Videos

Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Assessment of Airway, Skin Color, and Use of Accessory Muscles01:30

Assessment of Airway, Skin Color, and Use of Accessory Muscles

A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
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The initial evaluation of a patient's respiratory system...
Administering Oxygen by Mask01:30

Administering Oxygen by Mask

Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
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Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
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Related Experiment Video

Updated: May 23, 2026

Emergency Undocking in Robotic Surgery: A Simulation Curriculum
06:48

Emergency Undocking in Robotic Surgery: A Simulation Curriculum

Published on: May 20, 2018

Crew resource management: using aviation techniques to improve operating room safety.

Michael A Ricci1, John R Brumsted

  • 1Fletcher Allen Health Care, Burlington, VT, USA. Michael.Ricci@vtmednet.org

Aviation, Space, and Environmental Medicine
|April 3, 2012
PubMed
Summary

Implementing surgical crew resource management (CRM) training significantly reduced operating room errors like wrong-site surgeries and retained foreign bodies. Sustained results require ongoing reinforcement and refresher training for a safer surgical environment.

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Area of Science:

  • Patient Safety
  • Surgical Quality Improvement
  • Healthcare Management

Background:

  • The Institute of Medicine highlighted significant patient harm from medical errors, prompting a focus on error reduction in healthcare.
  • Hospitals and surgical teams are increasingly adopting strategies to minimize preventable adverse events.
  • Crew Resource Management (CRM) principles, adapted from aviation, offer a framework for improving teamwork and communication in high-risk environments.

Purpose of the Study:

  • To evaluate the impact of implementing a surgical Crew Resource Management (CRM) program on patient safety metrics.
  • To assess the effectiveness of aviation-based safety techniques in reducing surgical errors within an academic medical center.
  • To determine the influence of CRM training on malpractice claims and associated costs.

Main Methods:

  • A mandatory surgical Crew Resource Management (CRM) program was implemented for all operating room (OR) personnel in an academic medical center performing 19,000 procedures annually.
  • Aviation-derived techniques, including pre-operative checklists and briefs, post-operative debriefs, and standardized communication protocols, were introduced.
  • Key performance indicators monitored included compliance with pre-operative briefings, rates of wrong-site surgeries, retained foreign bodies, and malpractice claims data.

Main Results:

  • Pre-operative briefing compliance rapidly increased from 6.7% to 99% within four months of training.
  • Incidents of wrong-site surgeries and retained foreign bodies decreased from seven in 2007 to zero in 2008.
  • Following a 14-month period without refresher training, these errors recurred, rising to five in 2009. Malpractice expenses dropped from $793,000 (2003-2007) to zero post-implementation.

Conclusions:

  • Surgical Crew Resource Management (CRM) training demonstrably reduced the incidence of critical surgical errors, such as wrong-site surgeries and retained foreign bodies.
  • Sustained improvements in patient safety necessitate continuous reinforcement and regular refresher training for CRM programs.
  • While CRM is not a singular solution, its implementation fosters a cultural shift towards enhanced safety and error prevention in the operating room.