An integrated ABCDE approach to managing medical emergencies using CRM principles

Abstract

Background: There is increasing recognition of the vital role of non-technical skills in managing medical emergencies. An ABCDE approach has been very successful in training healthcare professionals in technical skills. Using a similar structure is likely to enhance successful application of their non-technical counter parts in clinical practice whether it is in the hospital or pre-hospital setting. Aim and Methods: To further promote safe patient care, teaching and learning aids currently used to implement crisis resource management skills, non-technical skills and human factors were identified and grouped in a way that facilitates memorisation. Results: Tools are available in the form of lists, tables and algorithms to identify behavioural markers of different components of non-technical skills and aspects of crisis resource management (CRM) and human factors. They require the need to memorise a list of items or a checklist. We have successfully used a visual aid representing these key CRM principles as a radial diagram, combined with a flow chart representing ABCDE approach for technical skills. Grouping them together in a format to embed in memory, combined with a visual aid representing the application nature of the principles, is likely to complement the existing tools in matching the learning style of more healthcare professionals. This inherently promotes the more widespread use of the principles, and hence has the potential to enhance patient safety. Conclusions: The proposed radial diagram, alongside the mnemonic alphabetical grouping, can be used to introduce the CRM principles and to provide effective feedback. This mnemonic is likely to help embed the CRM principles and enable recall in clinical practice to increase patient safety. The effectiveness of this aid could be tested using simulation of medical emergencies while training multiprofessional teams.