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SYMPOSIUM
Year : 2010  |  Volume : 3  |  Issue : 4  |  Page : 389-394

Human factors in resuscitation: Lessons learned from simulator studies


1 Medical Intensive Care Unit, University Hospital Basel, Basel, Switzerland; Silverman Institute for Health Care Quality and Safety and the Department of Medicine, Beth Israel Deaconess Medical Center, Boston; and Harvard Medical School, Boston, MA, USA
2 Department of Psychology, University of Neuchâtel, Switzerland
3 Department of Psychology, University of Bern, Bern, Switzerland
4 Silverman Institute for Health Care Quality and Safety and the Department of Medicine, Beth Israel Deaconess Medical Center, Boston; Harvard Medical School, Boston, MA, USA; and Department of Psychology, University of Neuchâtel, Switzerland
5 Medical Intensive Care Unit, University Hospital Basel, Basel, Switzerland

Correspondence Address:
S Hunziker
Medical Intensive Care Unit, University Hospital Basel, Basel, Switzerland; Silverman Institute for Health Care Quality and Safety and the Department of Medicine, Beth Israel Deaconess Medical Center, Boston; and Harvard Medical School, Boston, MA, USA

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.70764

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Medical algorithms, technical skills, and repeated training are the classical cornerstones for successful cardiopulmonary resuscitation (CPR). Increasing evidence suggests that human factors, including team interaction, communication, and leadership, also influence the performance of CPR. Guidelines, however, do not yet include these human factors, partly because of the difficulties of their measurement in real-life cardiac arrest. Recently, clinical studies of cardiac arrest scenarios with high-fidelity video-assisted simulations have provided opportunities to better delineate the influence of human factors on resuscitation team performance. This review focuses on evidence from simulator studies that focus on human factors and their influence on the performance of resuscitation teams. Similar to studies in real patients, simulated cardiac arrest scenarios revealed many unnecessary interruptions of CPR as well as significant delays in defibrillation. These studies also showed that human factors play a major role in these shortcomings and that the medical performance depends on the quality of leadership and team-structuring. Moreover, simulated video-taped medical emergencies revealed that a substantial part of information transfer during communication is erroneous. Understanding the impact of human factors on the performance of a complex medical intervention like resuscitation requires detailed, second-by-second, analysis of factors involving the patient, resuscitative equipment such as the defibrillator, and all team members. Thus, high-fidelity simulator studies provide an important research method in this challenging field.


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