Non-technical Skills in Resuscitation Flashcards
What are non-technical skills?
- Cognitive, social & personal skills
- That complement technical skills
- Lead to safe & efficient task performance
Things that affect our personal performance
What are 4 key elements of non-technical skills?
1. Situational awareness
2. Decision-making
3. Team-work including leadership
4. Task Mx
What is situational awareness?
- Awareness of what is happening in the current environment
- Understanding of how your actions may impact on future events
3 key areas needed in Situtational awareness:
- Information gathering
- Interpretation
- Future planning
3 key areas needed in Situtational awareness - Information gathering - What is important?
- Location of arrest
- Info on events leading up to arrest
- Actions taken
- Who is present - name, skills, roles, team leader
3 key areas needed in Situtational awareness - Interpretation - What is important?
- Confirm Dx of arrest
- Check monitors attached to interpret rhythm
- Determine necessary actions
3 key areas needed in Situtational awareness - Future Planning - What is important?
- Consider impact of interventions
- Plan next steps
Situational awareness - What info needed early into resus?
- Hx - Info about events leading up to arrest
- Dx - Confirm cardiac arrest
- Team - Who is present & what skills they have
- Action - Identify priorities & implement immediate necessary actions
What is the essence behind Decision making?
- Choosing the right interventions
- At the right time
Examples of Decision making needed during resus:
- Confirming cardiac arrest
- Calling for help
- Starting CPR
- Choosing shock energy
- Choosing drugs to be given
- How long to resus for
Examples of good team-work:
- Knowing the names of the team
- Supporting each other in their roles
- Communicating clearly - asking for help & raising concerns.
Characteristics of good team member:
- Competence
- Commited
- Communicates well
- Creative
- Supportive
- Accountable
- Prepared to admit when help is needed
- Participates in feedback
A good team leader has several important attributes such as:
- Knowledge, skills and experience
- Good role model
- High level of situational awareness
- Strong communication skills
- Stays calm
- Empathetic towards team
- Ability to delegate to team members
Role of team leader during resus:
- Follow guidelines
- Consult with team or other seniors if unsure themselves
- Allocate roles & tasks
- Plan tasks in advance
- Play to strengths of team
- Consider safety of team
- Thank team
- Support relatives
- Complete documentation
Who is responsible for task Mx?
- Team leader
Examples of task Mx at a cardiac arrest:
- Prioritise team’s actions correctly
- Making sure that everyone is safe before a shock is delivered
- Mx team conflict
- Observing the team for fatigue & stress (changing for compressions)
What does SBARD stand for?
1. Situation
2. Background
3. Assessment
4. Recommendation
5. Decisions
SBARD - How to describe Situation?
- Introduce yourself
- Check you are speaking to the correct person.
- Identify the pt. you are talking about (who and where).
- Say what you think the current problem is
- State what you advice you need
Hi, I’m Dr Smith the medical F2.
I am calling about Mr Brown on acute medical admissions who I think has a severe pneumonia and is septic.
He has an oxygen saturation of 90% despite high-flow oxygen and I am very worried about him.
SBARD - How to describe Background?
- Background info/demographics about pt.
- Reason for admission
- Relevant PMH
He is 55 years
Previously fit & well.
He has had fever and a cough for 2 days.
He arrived 15 minutes ago by ambulance.
SBARD - How to describe Assessment?
- Use ABCDE approach
- Include specific observations & vital signs values
- Include early warning score
He looks very unwell and is tiring
Airway – he can say a few words
Breathing – RR is 24, he has bronchial breathing on the L side. His O2 sats is 90% on high-flow O2. I am getting a blood gas & CXR
Circulation – his PR is 110, his BP is 110/60
Disability – he is drowsy but can say a few words
Exposure – he has no rashes
SBARD - How to describe Recommendation?
- State exactly what you want the person you are calling to do
I am going to start the following treatment; is there anything else you can suggest?
I don’t think I can do anymore; I would like you to see the patient urgently.
I am getting ABx ready and he is on IVF. I need help – please can you come & see him straight away.
SBARD - How to describe Decisions?
- Summarise what has been decided
We have agreed that you will come & R/V the pt. straight away.
In the meantime I will repeat the BP reading.
What resus team should do at start of their duty?
- Introduce themselves
- ID skills & experience
- Allocate team leader
- Allocate roles
- R/V any high risk pt’s
