ACRM Principles

Question 1

Define “crisis”

Answer 1

time of intense difficulty or danger that involves making difficult yet important decisions

Question 2

4 ways we learn prevention and management skills of anesthesia crises:

Answer 2

1) repeated exposure to clinical experiences
2) natural emergence
3) didactic instruction
4) simulation

Question 3

2 most dominant aspects of the clinical environment

Answer 3

1. dynamic
2. complex

Question 4

Why are NTS relevant to ACRM?

Answer 4

• human factors play a role in 80% of anesthesia-related complications
• poor communication is involved in 70%
• joint comm lists NTS in their RCA of sentinel events annually
• cognitive skills or social skills contribute to70-80% of medical errors

Question 5

Define NTS

Answer 5

• cognitive & mental skills: planning, decision-making, situational awareness
• social & interpersonal skills: teamwork, leadership, communication

Question 6

4 frameworks of NTS:

Answer 6

1) ACRM
2) ANTS
3) emotional intelligence
4) team cognition (knowledge/skills/attitudes)

Question 7

6 categories of ANTS:

Answer 7

• task management
• team work
• leadership
• situational awareness
• decision-making
• managing fatigue & coping with stress

Question 8

5 key principles of team cognition / TeamSTEPPS

Answer 8

1) team structure
2) communication
3) leadership
4) situational monitoring
5) mutual support

Question 9

5 tenets of emotional intelligence

Answer 9

1) self-awareness
2) motivation
3) empathy
4) social skills
5) self-regulation

Question 10

6 ways in which anesthesia and aviation parallel one another:

Answer 10

1. dynamic
2. time pressure
3. intensity
4. complexity
5. uncertainty
6. risky

Question 11

Where did medicine adopt its CRM from? What else?

Answer 11

aviation
in addition to…
- written checklists/algorithms
- established procedures
- simulation
- safety language models

Question 12

5 ACRM principles:

Answer 12

1) situational awareness
2) team leadership/role clarification
3) communication
4) error anticipation strategies
5) use of resources

Question 13

3 hallmarks of situational awareness:

Answer 13

• anticipate and plan
• know the environment
• use all information available

Question 14

Describe an effective leader:

Answer 14

• respectful assertiveness
• decisiveness
• calm, rational leadership & decision-making

Question 15

3 kinds of fixation errors

Answer 15

1) this and only this
2) everything but this
3) everything is OK

Question 16

Most important factor r/t calling for help:

Answer 16

must be done early enough to make a difference