Su Lillian, Kaplan Seth, Burd Randall, Winslow Carolyn, Hargrove Amber, Waller Mary
Division of Critical Care Medicine, Children's National Health System, Washington, District of Columbia, USA.
Department of Psychology, George Mason University, Fairfax, Virginia, USA.
BMJ Simul Technol Enhanc Learn. 2017 Jul 6;3(3):106-110. doi: 10.1136/bmjstel-2016-000143. eCollection 2017.
Optimising team performance is critical in paediatric trauma resuscitation. Previous studies in aviation and surgery link performance to behaviours in the prearrival period.
To determine if patterns of human behaviour in the prearrival period of a simulated trauma resuscitation is predictive of resuscitation performance.
Twelve volunteer trauma teams performed in four simulation scenarios in a paediatric hospital. The scenarios were video recorded, transcribed and analysed in 10-second intervals. Variation in the amount of utterances per team member in the prearrival period was compared with team performance and implicit coordination during the resuscitation.
Coders analysed 18 962 s of video. They coded 5204 team member utterances into one of eight communication behaviour categories. Inter-rater reliability was excellent (an average of 83.1% across all four scenarios). The average number of communications occurring during the prearrival period was 18.84 utterances, with a range of 2-42 and a SD of 9.55. The average length of this period was almost 2 minutes (mean =117.30 s, SD=39.20). Lower variance in team member communication during the prearrival better was associated with better implicit coordination (p=0.011) but not team performance (p=0.054) during the resuscitation.
Patterns of communication in the prearrival trauma resuscitation period predicted implicit coordination and a trend towards significance for team performance which suggests further studies in such patterns are warranted.
优化团队在儿科创伤复苏中的表现至关重要。先前在航空和外科领域的研究将表现与到达前阶段的行为联系起来。
确定模拟创伤复苏到达前阶段的人类行为模式是否可预测复苏表现。
12个志愿者创伤团队在一家儿科医院的四个模拟场景中进行操作。对场景进行录像、转录，并以10秒为间隔进行分析。将到达前阶段每个团队成员的话语数量变化与复苏期间的团队表现和默契协调进行比较。
编码人员分析了18962秒的视频。他们将5204条团队成员的话语编码为八个沟通行为类别之一。评分者间信度极佳（在所有四个场景中平均为83.1%）。到达前阶段的平均沟通次数为18.84次话语，范围为2至42次，标准差为9.55。此阶段的平均时长近2分钟（均值 = 117.30秒，标准差 = 39.20）。到达前阶段团队成员沟通的较低方差与复苏期间更好的默契协调相关（p = 0.011），但与团队表现无关（p = 0.054）。
到达前创伤复苏阶段的沟通模式预测了默契协调以及团队表现的显著趋势，这表明对此类模式进行进一步研究是有必要的。
