From The Intensive Care Network – another podcast from the SMACC 2013 conference. This is Dr Karel Habig, Medical Director of the Greater Sydney Area HEMS, discussing how experience from aeromedical retrieval can improve medical practice.
Click HERE for the audio (right click to open it in a new tab), accompanying slides are below:
Following a spate of aviation accidents in the 1980’s and 1990’s, Transport Canada and the aviation industry came up with the aviation ‘Dirty Dozen’ – human factors in aviation maintenance that commonly lead to errors.
Consider these in the context of your prehospital or emergency service:
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(thanks to Tim Leeuwenburg at KIdocs.org for this one!)
The importance of effective communication
A recent study published in the May-June 2013 edition of Air Medical Journal analyzed a randomly selected group of quality assurance reports looking for communication errors. Quality assurance reports examined had been submitted in circumstances of issues, adverse events, or simply high risk activities (for example patient requiring intubation, or scene times exceeding 20 minutes)
Of 278 reports analysed, 58 (21%) were found to involve communication errors. Communication errors were categorised according to Clark’s Communication Level Hierarchy:
Level 1: CHANNEL – establishing a means of communication between people – e.g verbal communication, digital communication
Level 2: SIGNAL – the transmitted data, for example the sound in a verbal communication or the text in a digital communication
Level 3: INTENTION – the semantic meaning derived from the content within the data
Level 4: CONVERSATION – the joint activitiy that is understood between people communication (e.g. shared mental model)
Of 65 communication errors found (from 58 reports), less than a third had been identified by staff as communication errors. Communication errors occurred most commonly at level 1 (42/64) followed by level 4 (21/64). Level 2 and 3 failures were rare.
The most common communication issue was failure to communicate change in plan or status.
The authors concluded that current quality and safety reporting systems may lack the sensitivity to identify communication errors, and that improvements to the ontology of quality and safety reporting systems, user interfaces, and staff education on reporting of communication errors could enhance the safety of air medical transport services.
Read the full article HERE (secure area limited to ADHB staff only – ADHB has subscription access to this journal via the Philson Library at the University of Auckland School of Medicine)
With thanks to Russell Clarke
There is currently a huge amount of interest in lessons that medicine can learn from aviation, including concepts like CRM and the use of checklists. Efforts are being made to select and integrate these concepts into a form specific to emergency medicine – Andy Buck’s blog Resus Room Management is a great example of this, and is well worth a read.
Joe Novak, an emergency physician who is a former F15 pilot (!) feels that due to its chaotic nature emergency medicine is analogous to combat aviation! These concepts are discussed in a lecture presented on Scott Weingart’s emcrit.org
Click HERE for the show notes and podcast
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In combat aviation:
In EM & Critical Care:
Auckland HEMS 