Cliff Reid from Resus.me gave this talk at Essentials of Emergency Medicine in Las Vegas today.
He discusses mastering your team, yourself and the patient. He advocates training in resus for resus, having systems to manage stress like RSI checklists
Here’s the one we use in Whanganui:
It looks complicated – because it’s a complicated process – and there is a lot to prepare and do right to make sure it goes smoothly. It also provides great documentation of what actually happened when.
Sneaky little screen shot of Cliff’s causes of shock:
[Hmm. Still gotta get sepsis, anaphylaxis and toxins in there some where.]
We need to encourage our teams to help us / challenge us / remind us of things we may have forgotten or when we are heading down the wrong track. The team leader should keep their hands off the patient and avoid becoming task focused.
Control the environment. Don’t allow the environment to control you.
We need to control the mob of helpers. Get everyone on the same page by regularly verbalising assessments and plans. We need to ask individuals to do tasks not just float a request out into the room. Different teams will be focused on their “bits” eg the surgeons on the belly. We need to keep the over view. We need to learn graded assertive techniques and to learn the science of human persuasion. Cliff sagely notes this doesn’t work well at home. Give annoying people a job eg ask the surgeon to do a cut down (while one of your team puts in the IO in a fraction of the time) 😉
We need to be comfortable with allowing patients to die with dignity when this is appropriate.
We need to learn from the cases that don’t go well. Weingart: “A good resuscitationist agonises.”
Ah, a man after my own heart.