• Factors Affecting Team Size and Task Performance in Pediatric Trauma Resuscitation

    by Alan Batt. Last modified: 01/04/14

    trauma

    Summary

    • Review of video-recorded resuscitations of pediatric trauma patients
    • Average bedside team ranged from 2.7 to 10.0 member
    • Fewer people were present during activations without prearrival notification
    • Fewer people were present during activations at night
    • Maximum number of tasks was performed by teams with 7 people at the bedside – there is a nonlinear association between number of team members and completed tasks.

    [/PMID]24651216[/PMID]

    Abstract

    Objectives

    Varying team size based on anticipated injury acuity is a common method for limiting personnel during trauma resuscitation. While missing personnel may delay treatment, large teams may worsen care through role confusion and interference. This study investigates factors associated with varying team size and task completion during trauma resuscitation.

    Methods

    Video-recorded resuscitations of pediatric trauma patients (n = 201) were reviewed for team size (bedside and total) and completion of 24 resuscitation tasks. Additional patient characteristics were abstracted from our trauma registry. Linear regression was used to assess which characteristics were associated with varying team size and task completion. Task completion was then analyzed in relation to team size using best-fit curves.

    Results

    The average bedside team ranged from 2.7 to 10.0 members (mean, 6.5 [SD, 1.7]), with 4.3 to 17.7 (mean, 11.0 [SD, 2.8]) people total. More people were present during high-acuity activations (+4.9, P < 0.001) and for patients with a penetrating injury (+2.3, P = 0.002). Fewer people were present during activations without prearrival notification (-4.77, P < 0.001) and at night (-1.25, P = 0.002). Task completion in the first 2 minutes ranged from 4 to 19 (mean, 11.7 [SD, 3.8]). The maximum number of tasks was performed at our hospital by teams with 7 people at the bedside (13 total).

    Conclusions

    Resuscitation task completion varies by team size, with a nonlinear association between number of team members and completed tasks. Management of team size during high-acuity activations, those without prior notification, and those in which the patient has a penetrating injury may help optimize performance.

    References

     
    1.

    Kelleher DC1, Kovler ML, Waterhouse LJ, Carter EA, Burd RS. Factors Affecting Team Size and Task Performance in Pediatric Trauma Resuscitation. Pediatr Emerg Care. 2014 Mar 19. PMID: 24651216.

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    Alan Batt

    Alan Batt

    Paramedic, educator, researcher
    Alan is a critical care paramedic, paramedic educator and prehospital researcher, currently working around the world as an educator and researcher. He has previously worked and studied across Europe, North America and the Middle East. He holds a Graduate Certificate in Intensive Care Paramedic Studies, and an MSc in Critical Care. His main interests are in care of the elderly, end-of-life care, patient safety, professionalism (including role and identity), and paramedic education.

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