PT  - JOURNAL ARTICLE
AU  - Michael J. Schull
AU  - Lorraine E. Ferris
AU  - Jack V. Tu
AU  - Janet E. Hux
AU  - Donald A. Redelmeier
TI  - Problems for clinical judgement: 3. Thinking clearly in an emergency
DP  - 2001 Apr 17
TA  - Canadian Medical Association Journal
PG  - 1170--1175
VI  - 164
IP  - 8
4099  - http://www.cmaj.ca/content/164/8/1170.short
4100  - http://www.cmaj.ca/content/164/8/1170.full
SO  - CMAJ2001 Apr 17; 164
AB  - THE RESUSCITATION OF A PATIENT IN EXTREMIS is frequently characterized by chaos and disorganization, and is one of the most stressful situations in medicine. We reviewed selected studies from the fields of anesthesia, emergency medicine and critical care that address the process of responding to a critically ill patient. Individual clinicians can improve their performance by increased exposure to emergencies during training and by the incorporation of teamwork, communication and crisis resource management principles into existing critical care courses. Team performance may be enhanced by assessing personality factors when selecting personnel for high-stress areas, explicit assignment of roles, ensuring a common “culture” in the team and routine debriefings. Overreliance on technology and instinct at the expense of systematic responses should be avoided. Better training and teamwork may allow for clearer thinking in emergencies, so that knowledge can be translated into effective action and better patient outcomes.