Lecture 12 Human Factors 2

Question 1

Name some examples of the technical skills required for resuscitation.

Answer 1

Physiological monitoring
Ventilation 
Intubation
Chest compressions 
Medication administration

Question 2

Name some non-technical skills required for resuscitation.

Answer 2

Situation awareness
Leadership
Communication 
Role allocation
Anticipation and planning
Back- up behaviour

Question 3

What can 72% of adverse effects be attributed to in the resuscitation of neonates?

Answer 3

Teamwork breakdown

• communication barriers
• poor situation awareness
• not factoring in human error

Question 4

What does CRM stand for? and what are some of the principles within NRP? (Neonatal resuscitation program)

Answer 4

Crisis Resource Management. 
Know your environment.
Anticipate and plan.
Assume the leadership role.
Communicate effectively. 
Delegate workload.
Allocate attention wisely.
Use all available information. 
Use all available resources. 
Call for help when needed. 
Maintain professional behaviour.

Question 5

What percentage of neonates need assistance breathing? And how many of these need extensive resuscitation?

Answer 5

10%

<1%

Question 6

What are some issues that are faced when implementing CRM?

Answer 6

Lacks specificity (ambiguity of principles)
Team variables not factored (skill mix and team size) 
Task variables not factored (prepardedness and infant variables) 
Lacks standardisation (content and delivery)

Question 7

What did Nadler et al (2011) test and find in the Mater mothers hospital?

Answer 7

Looked at the period between nov 2008-2009. Motion activation video recordings captured the resusicitation process in neonates. Furthermore weekly anonymous and voluntary debriefing sessions were offered. Recordings of the first and last 4.5 months were analysed. Found that weekly debriefings with recorded resuscitations improved teamwork. However no improvement of clinical procedure and intubation deterioated. Issues with exp control: attendees names not recorded and not all attendees were participants.

Question 8

What did nadler and mcLanders do and find when analysing retrospective video recordings?

Answer 8

They looked at the different time stamps
On the intubation process. Looked at end face-mask ventilation, laryngoscope in and laryngoscope out, decision of correct or incorrect tube placement and recommencment of ventilation. The outcome was rated as withdrawn, failed or successful. Found that time without ventilation was up to 2.6 x more than the laryngoscope in-out duration should be. Concluded that more attention should be paid to the effects of the patient not the clinical procedure.