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Trauma resuscitation: can team behaviours in the prearrival period predict resuscitation performance?
  1. Lillian Su1,
  2. Seth Kaplan2,
  3. Randall Burd3,
  4. Carolyn Winslow2,
  5. Amber Hargrove2,
  6. Mary Waller4
  1. 1Division of Critical Care Medicine, Children's National Health System, Washington, District of Columbia, USA
  2. 2Department of Psychology, George Mason University, Fairfax, Virginia, USA
  3. 3Division of Trauma and Burn Surgery, Children's National Health System, Washington, District of Columbia, USA
  4. 4Schulich School of Business, York University, Toronto, Ontario, Canada
  1. Correspondence to Dr Lillian Su, 750 Welch Road, Stanford University, Palo Alto, CA 94304, USA; lisu{at}stanford.edu

Abstract

Background Optimising team performance is critical in paediatric trauma resuscitation. Previous studies in aviation and surgery link performance to behaviours in the prearrival period.

Objective To determine if patterns of human behaviour in the prearrival period of a simulated trauma resuscitation is predictive of resuscitation performance.

Design Twelve volunteer trauma teams performed in four simulation scenarios in a paediatric hospital. The scenarios were video recorded, transcribed and analysed in 10-second intervals. Variation in the amount of utterances per team member in the prearrival period was compared with team performance and implicit coordination during the resuscitation.

Key results Coders analysed 18 962 s of video. They coded 5204 team member utterances into one of eight communication behaviour categories. Inter-rater reliability was excellent (an average of 83.1% across all four scenarios). The average number of communications occurring during the prearrival period was 18.84 utterances, with a range of 2–42 and a SD of 9.55. The average length of this period was almost 2 minutes (mean =117.30 s, SD=39.20). Lower variance in team member communication during the prearrival better was associated with better implicit coordination (p=0.011) but not team performance (p=0.054) during the resuscitation.

Conclusion Patterns of communication in the prearrival trauma resuscitation period predicted implicit coordination and a trend towards significance for team performance which suggests further studies in such patterns are warranted.

  • teamwork
  • resuscitation
  • trauma
  • simulation

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Footnotes

  • Twitter Follow Lillian Su @lilliansu

  • Contributors LS participated in the design of the study and wrote the background, results and discussion section. She also edited the final version of the study prior to submission and is responsible for the overall content. SK participated in the design of the study, analysed the results and edited the manuscript. He also supervised the data collection of CW and AH. CW collected data from the videos, wrote the methods section and edited the manuscript prior to submission. AH collected data from the videos, wrote the methods section and edited the manuscript prior to submission. RB conducted the simulations, and edited the manuscript prior to submission. MW participated in the design of the study, analysed the results and edited the manuscript.

  • Funding The project described was supported by Award Number UL1RR031988 from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Center for Research Resources or the National Institutes of Health.

  • Competing interests None declared.

  • Ethics approval Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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