Effects of designated leadership and team-size on cardiopulmonary resuscitation: The Basel-Washington SIMulation (BaWaSim) trial.
Journal article

Effects of designated leadership and team-size on cardiopulmonary resuscitation: The Basel-Washington SIMulation (BaWaSim) trial.

  • Hunziker S Medical Intensive Care Unit, University Hospital Basel, University of Basel, Switzerland; Medical Communication and psychosomatic medicine, University Hospital Basel, University of Basel, Switzerland. Electronic address: Sabina.Hunziker@usb.ch.
  • O'Connell KJ Children's National Medical Center, Washington, DC, United States.
  • Ranniger C Clinical Learning and Simulation Skills (CLASS) Center, The George Washington University, Washington, DC, United States.
  • Su L Children's National Medical Center, Washington, DC, United States.
  • Hochstrasser S Medical Intensive Care Unit, University Hospital Basel, University of Basel, Switzerland; Medical Communication and psychosomatic medicine, University Hospital Basel, University of Basel, Switzerland.
  • Becker C Medical Communication and psychosomatic medicine, University Hospital Basel, University of Basel, Switzerland; Department of Emergency Medicine, University Hospital Basel, University of Basel, Switzerland.
  • Naef D Medical Intensive Care Unit, University Hospital Basel, University of Basel, Switzerland; Medical Communication and psychosomatic medicine, University Hospital Basel, University of Basel, Switzerland.
  • Carter E Children's National Medical Center, Washington, DC, United States.
  • Stockwell D Patient Safety and the Pediatric Intensive Care Unit, Children's National Medical Center, Washington, DC, United States.
  • Burd RS Children's National Medical Center, Department of Surgery, Washington, DC, United States.
  • Marsch S Medical Intensive Care Unit, University Hospital Basel, University of Basel, Switzerland.
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  • 2018-09-03
Published in:
  • Journal of critical care. - 2018
English OBJECTIVE
During cardiopulmonary resuscitation (CPR), it remains unclear whether designating an individual person as team leader compared with emergent leadership results in better team performance. Also, the effect of CPR team size on team performance remains understudied.


METHODS
This randomized-controlled trial compared designated versus emergent leadership and size of rescue team (3 vs 6 rescuers) on resuscitation performance.


RESULTS
We included 90 teams with a total of 408 students. No difference in mean (±SD) hands-on time (seconds) were observed between emergent leadership (106 ± 30) compared to designated leadership (103 ± 27) groups (adjusted difference - 2.97 (95%CI -15.75 to 9.80, p = 0.645), or between smaller (103 ± 30) and larger teams (106 ± 26, adjusted difference 3.53, 95%CI -8.47 to 15.53, p = 0.56). Emergent leadership groups had a shorter time to circulation check and first defibrillation, but the quality of CPR based on arm and shoulder position was lower. No differences in CPR quality measures were observed between smaller and larger teams.


CONCLUSIONS
Within this international US/Swiss trial, leadership designation and larger team size did not improve hands-on time, but emergent leadership teams initiated defibrillation earlier. Improvements in performance may be more likely to be achieved by optimization of emergent leadership than increasing the size of cardiac arrest teams.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.rero.ch/global/documents/111187
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