Abstract
A worker in a printshop attempts to remove a foreign object from moving print cylinders. During a brief moment of inattention, the cylinders catch the sleeves of his shirt and both of his arms are drawn into the machine. Despite a nearly instantaneous shut down of the equipment by one of his colleagues, both arms are trapped up to the elbows. Because of the unusual circumstance, EMS dispatch decides to send a physician to the scene along with the ambulance. When the emergency physician, a senior resident in emergency medicine, arrives at the scene with two paramedics, he finds a patient with a reduced level of consciousness standing in front of the print cylinders. The worker’s colleagues are supporting him in a standing position. With the help of the paramedics, the physician places a large-bore peripheral IV line in a vein of the dorsal foot and starts volume resuscitation. With repetitive small boluses of ketamine and midazolam, the patient receives adequate analgesia and sedation, while the two paramedics with help from two workers construct a small temporary platform adjacent to the print cylinders. Assessment of the situation by the machine technician reveals a difficult and protracted disassembly. Since the printshop is not far from the local hospital, the emergency physician contacts the operating room and requests a surgeon and anesthesiologist to come to the scene. Because the patient is young and an amputation would impose severe risks, the emergency physician and surgeon decide not to amputate the patient’s extremities. Meanwhile, the fire department arrives and, after the anesthetist has deepened the analgesia and sedation, help the machine technician with the difficult task of disassembling the press. Two hours later, both arms are freed from the printing machine. Sudden pulsating bleeding is stopped by the inflation of upper extremity tourniquets that the paramedics had placed on both arms before they were released from the machine. The patient is intubated on site and transferred to the operating room. Due to the rapid and coordinated rescue and surgical intervention, both extremities are saved with a good degree of functionality.
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References
AHRQ (2008) TeamSTEPPS. Strategies and tools to enhance performance and patient safety. AHRQ Pub. No 06-0020-2
Badke-Schaub P (2000) Wenn der Gruppe Flügel fehlen: Ungeeignete Informations- und Entscheidungsprozesse in Gruppen [Inadequate decision-making and information processing in groups]. In: Mey H, Lehmann Pollheimer D (eds) Absturz im freien Fall oder Anlauf zu neuen Höhenflügen. Vdf, Zürich, pp S 113–S 130
Barrett J, Gifford C, Morey J, Risser D, Salisbury M (2001) Enhancing patient safety through teamwork training. J Healthc Risk Manag 21:57–65
Brown MS, Ohlinger J, Rusk C, Delmore P, Ittmann P (2003) Implementing potentially better practices for multidisciplinary team building: creating a neonatal intensive care unit culture of collaboration. Pediatrics 111:482–488
Burke CS, Salas E, Wilson-Donnelly K, Priest H (2004) How to turn a team of experts into an expert medical team: guidance from the aviation and military communities. Qual Saf Health Care 13(Suppl 1):i96–i194
Cannon-Bowers JA, Salas E, Coverse S (1993) Team mental models in expert team decision making. In: Castellan N (ed) Individual and group decision making. Lawrence Erlbaum, Hillsdale, pp 221–246
Cole E, Crichton N (2006) The culture of a trauma team in relation to human factors. J Clin Nurs 15:1257–1266
Darley JM, Latane B (1968) Bystander intervention in emergencies: diffusion of responsibility. J Pers Soc Psychol 8:377–383
Dev P, Youngblood P, Heinrichs WL, Kusumoto L (2007) Virtual worlds and team training. Anesthesiol Clin 25(2):321–336
Driskell JE, Salas E (1992) Collective behavior and team performance. Hum Fact 34:227–288
Firth-Cozens J (2004) Why communication fails in the operating room. Qual Saf Health Care 13:327
Fleishmann E, Zaccaro S (1992) Toward a taxonomy of team performance functions. In: Swezey R, Salas E (eds) Teams: their training and performance. Ablex, Norwood, pp 31–56
Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R (2003) Anaesthetists’ Non-Technical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth 90(5):580–588
Flin R, Fletcher G, McGeorge P, Sutherland A, Patey R (2003a) Anaesthetists’ attitudes to teamwork and safety. Anaesthesia 58:233–242
Flin R, Lynne M, Goeters KM, Hörmann J, Amalberti R, Valot C, Nijhuis H (2003b) Development of the NOTECHS (non -technical skills) system for assessing pilots’ CRM skills. Hum Fact Aeros Safet 3(2):95–117
Flin R, Yule S, McKenzie L, Paterson-Brown S, Maran N (2006) Attitudes to teamwork and safety in the operating theatre. Surgeon 4:145–151
Guise JM, Segel S (2008) Teamwork in obstetric critical care. Best Pract Res Clin Obstet Gynaecol 22(5):937–951
Healey AN, Undre S, Vincent CA (2004) Developing observational measures of performance in surgical teams. Qual Saf Health Care 13(Suppl 1):i33–i40
Helmreich R, Schaefer H (1994) Team performance in the operating room. In: Bogner M (ed) Human error in medicine. Erlbaum, Hillsdale, pp 225–253
Howard SK, Gaba DM, Fish KJ, Yang G, Sarnquist FH (1992) Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents. Aviat Space Environ Med 63(9):763–770
Hunt EA, Shilkofski NA, Stavroudis TA, Nelson KL (2007) Simulation: translation to improved team performance. Anesthesiol Clin 25(2):301–319
Jain M, Miller L, Belt D, King D, Berwick DM (2006) Decline in ICU adverse events, nosocomial infections and cost through a quality improvement initiative focusing on teamwork and culture change. Qual Saf Health Care 15:235–239
Janis I (1972) Groupthink. Psychological studies of policy decisions and fiascos. Houghton − Mifflin, Boston
Kaissi A, Johnson T, Kirschbaum MS (2003) Measuring teamwork and patient safety attitudes of high-risk areas. Nurs Econ 21:211–218
Katzenbach JR, Smith DK (1993) Teams. Der Schlüssel zu Hochleistungsorganisationen [Teams. The key to high-performance organizations]. Redline Wirtschaft, Vienna
Kogan N, Wallach MA (1969) Risk taking. Holt, New York
Kriz WC (2000) Teamkompetenz. Konzepte, Trainingsmethoden, Praxis [Team competence. Concepts, training methods, practice]. Vandenhoeck and Ruprecht, Göttingen
Leonard M, Graham S, Bonacum D (2004) The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care 13(Suppl 1):i85–i90
Lingard L, Espin S, Whyte S, Regehr G, Baker GR, Reznick R, Bohnen J, Orser B, Doran D, Grober E (2004) Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care 13:330–334
Makary MA, Sexton JB, Freischlag JA, Holzmueller CG, Millmann EA, Roven L, Provenost PJ (2006) Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. J Am Coll Surg 202:746–752
Manser T (2009) Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand 53:143–151
Matera P (2003) The power of teamwork. J Emerg Med Serv 28:26
Mickan S, Rodger S (2000) Characteristics of effective teams: a literature review. Aust Health Rev 23:201–208
Morey JC, Simon R, Jay GD, Wears RL, Salisbury M, Dukes KA, Berns SD (2002) Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res 37:1553–1581
Murray WB, Foster PA (2000) Crisis resource management among strangers: principles of organizing a multidisciplinary group for crisis resource management. J Clin Anesth 12:633–638
Ohlinger J, Brown MS, Laudert S, Swanson S, Fofah O (2003) Development of potentially better practices for the neonatal intensive care unit as a culture of collaboration: communication, accountability, respect, and empowerment. Pediatrics 111:471–481
Orasanu J, Salas E (1993) Team decision-making in complex environments. In: Klein G, Orasanu J (eds) Decision-making in action: models and methods. Ashgate, New York, pp 327–345
Paris CR, Salas E, Cannon-Bowers JA (2000) Teamwork in multi-person systems: a review and analysis. Ergonomics 43:1052–1075
Reader T, Flin R, Lauche K, Cuthbertson BH (2006) Non-technical skills in the intensive care unit. Br J Anaesth 96:551–559
Rice MM (2009) Teams and teamwork in emergency medicine. In: Croskerry P, Cosby KS, Schenkel SM, Wears RL (eds) Patient safety in emergency medicine. Lippincott Williams & Wilkins, Philadelphia, pp 177–180
Risser DT, Rice MM, Salisbury ML, Simon R, Jay GD, Berns SD (1999) The potential for improved teamwork to reduce medical errors in the emergency department. The MedTeams Research Consortium. Ann Emerg Med 34:373–383
Risser DT, Simon R, Rice MM, Salisbury ML (2000) A structured teamwork system to reduce clinical errors. In: Spath PL (ed) Error reduction in health care. A system approach to improving patient safety. AHA, Chicago, pp 235–278
Salas E, Dickinson TL, Converse SA, Tannenbaum SI (1998) Toward an understanding of team performance and training. In: Swezey RW, Salas E (eds) Teams: their training and performance. Ablex, Norwood, pp 3–30
Salas E, DiazGranados D, Klein C (2008) Does team training improve team performance? A meta-analysis. Hum Factors 50:903–933
Schaefer HG, Helmreich RL, Scheidegger D (1995) Safety in the operating theatre, part 1: interpersonal relationships and team performance. Curr Anaesth Crit Care 6:48–53
Schmutz J, Manser T (2013) Do team processes really have an effect on clinical performance? A systematic literature review. Br J Anaesth 110:529–544
Schulz S, Frey D (1998) Wie der Hals in die Schlinge kommt: Fehlentscheidungen in Gruppen [Erroneous decision-making in groups]. In: Ardelt-Gattinger E, Lechner H, Schlögl W (eds) Gruppendynamik. Anspruch und Wirklichkeit der Arbeit in Gruppen [group dynamics – ideal and reality of work in groups]. Verlag für Angewandte Psychologie, Göttingen, pp S 139–S 158
Sexton JB (2004) The better the team, the safer the world: golden rules of group interaction in high risk environments: evidence based suggestions for improving performance. Swiss Re Centre for Global Dialogue Rüschlikon/Gottlieb Daimler Karl Benz Foundation, Switzerland/Ladenburg
Sexton JB, Makary MA, Tersigni AR, Pryor D, Hendrich A, Thomas EJ, Holzmueller CG, Knight AP, Wu Y, Pronovost PJ (2006) Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel. Anesthesiology 105:877–884
Sherwood G, Thomas E, Bennett DS, Lewis P (2002) A teamwork model to promote patient safety in critical care. Crit Care Nurs Clin North Am 14:333–340
Stout RJ, Cannon-Bowers JA, Salas E, Milanovich DM (1999) Planning, shared mental models, and coordinated performance: an empirical link is established. Hum Factors 41:61–71
Sundar E, Sundar S, Pawlowski J, Blum R, Feinstein D, Pratt S (2007) Crew resource management and team training. Anesthesiol Clin 25(2):283–300
Theodoropoulos A, Kneebone R, Dornan B, Leonard R, Bello F (2007) Development and evaluation of a virtual intensive therapy unit – VITU. Stud Health Technol Inform 125:467–469
Thomas EJ, Sexton JB, Helmreich RL (2003) Discrepant attitudes about teamwork among critical care nurses and physicians. Crit Care Med 31:956–959
Thomas EJ, Sherwood GD, Mulhollem JL, Sexton JB, Helmreich RL (2004) Working together in the neonatal intensive care unit: provider perspectives. J Perinatol 24:552–559
Ummenhofer W, Amsler F, Sutter PM, Martina B, Martin J, Scheidegger D (2001) Team performance in the emergency room: assessment of inter-disciplinary attitudes. Resuscitation 49:39–46
Undre SN, Sevdalis AN, Healey S, Darzi A, Vincent CA (2006) Teamwork in the operating theatre: cohesion or confusion? J Eval Clin Pract 12:182–189
Urban J, Bowers C, Monday S, Morgan B (1995) Workload, team structure and communication in team performance. Mil Psychol 7:123–139
Weaver SJ, Dy SM, Rosen MA (2014) Team-training in healthcare: a narrative synthesis of the literature. BMJ Qual Saf 23(5):359–372
Wheelan SA, Burchill CN, Tilin F (2003) The link between teamwork and patients’ outcomes in intensive care units. Am J Crit Care 12:527–534
Xiao Y, Hunter WA, Mackenzie CF, Jefferies NJ, Horst R (1996) Task complexity in emergency medical care and its implications for team coordination. Hum Factors 38:636–645
Youngblood P, Harter PM, Srivastava S, Moffett S, Heinrichs WL, Dev P (2008) Design, development, and evaluation of an online virtual emergency department for training trauma teams. Simul Healthc J Soc Simul Healthc 3(3):146–153
Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D (2006) Development of a rating system for surgeons’ non-technical skills. Med Educ 40(11):1098–1104
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St.Pierre, M., Hofinger, G., Simon, R. (2016). The Key to Success: Teamwork. In: Crisis Management in Acute Care Settings. Springer, Cham. https://doi.org/10.1007/978-3-319-41427-0_11
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