Medical EducationPrehospitalResuscitationSMACCStructured teaching of Crisis Resource Management CRM

Structured teaching of Crisis Resource Management CRM by Cliff Reid

Cliff Reid educates the audience on structured teaching of crisis resource management.

Cliff works for Sydney HEMS in extreme conditions. The environment tries to kill them and the patients try to die.

He works in a big team, with a lot of the doctors never having worked in prehospital care. The team covers a huge area, completing many missions every year on both fixed wing and rotary wing platforms as well as road ambulances.

Every case is scrutinised, both formally and informally. When things go wrong, it is rarely due to the clinical factors alone and often due to non-technical skills. These skills are discussed often but not taught in a structured way.

Cliff presents the Zero Point Survey. A magical window before touching the patients where planning can start for when things go wrong and what can be done about it.

It is as simple as STEPUP: Self, Team, Environment, Patient, Update and Prioritise.

Self –

Get you head in the zone. Checklist’s can be useful for both physical and psychological safety and preparedness. Training also plays a crucial part to ensure that a situation is perceived as a challenge and not a threat, enabling high level performance.

Team –

Make sure everyone is on the same page. Assign roles and tasks as they are the key to smooth team flow through the mission. Have a plan for dealing with disruptive individuals.

Environment –

Control and mitigate any safety hazards and create a safe workspace. Own your resuscitation real estate. This means adequate space, sufficient light, appropriate heat, control noise and crowd.

Patient –

Gather information ahead of time to start planning a course of action.

Update and Prioritise –

Throughout the mission, use constant communication and a standard operating procedure to regroup and update priorities. The simple strategy of the Zero Point Survey gives structure for both performing and debriefing resuscitations and simulations in crisis resource management.

Structured teaching of Crisis Resource Management CRM by Cliff Reid

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Cliff Reid

Involved in providing and teaching critical care in and out of the hospital. Fascinated by human factors.