EDcare Skills Training

Human Factors in Resuscitation

While the ABCDE structure of Airway, Breathing, Circulation, Disability, Exposure suggests a linear process to the assessment and management for the seriously ill patient, in clinical practice resuscitation follows a more “horizontal” pathway where multiple tasks are being handled concurrently by the members of the resuscitation team. This adds a layer of complexity as multiple processes are occurring simultaneously, often at different rates and undertaken by staff with different levels of skill, knowledge and experience. In recent years a deeper understanding of the process of resuscitation has prompted the recognition of the critical role that human factors play in the successful management of the critically ill patient. In the first topic below we explore some of the insights and concepts that are developing in relation to the role of human factors in resuscitation, highlighting in particular the importance of leadership, communication, situational awareness and cognitive factors including shared mental models and critical thinking.

Management of Burn Injury

The second topic builds on the workshop focusing on Burns and considers the assessment and management of the patient with burn injury. It is evident that in the patient presenting with burn injury priority should be given to ensuring completion of a primary survey and where required institution of resuscitation. It is easy for staff to be distracted by the burn injury, the degree of patient distress and emotional issues that may occur in the setting of burns and as a consequence delay the assessment of the patient’s vital organ functions. The clinical case simulation explores the red flags that suggest airway injury, the central role of fluids in the patient with major burns, the immediate management of burn injury and highlights the importance of avoiding hypothermia. The case also explores the assessment and treatment of burn injury as well as the role of ADT, consideration of other injuries and the possibility of toxic gas exposure (carbon monoxide).