Critical Communication

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Inadequate communication is a potential cause for adverse incidents.  It is particularly important in the dynamic, emotionally charged and information dense environment of the resuscitation room

Elements of good communication include being:


Not ‘Please get the monitoring on’

But ‘I want the Sats, BP and ECG monitor on.  And call out the first BP reading within 2 minutes’ 

Not ‘Start compressions’

But ‘Sam.  Start compressions.  Luke.  Be on standby to takeover in 5 minutes’


Not ‘I think I can feel a pulse’

But ‘I am not confident I can feel a pulse.  Can you check for me?’


Not ‘We are just finishing up a case in theatre and need to clean it down first before we are ready’

But ‘The theatre will be ready in 15 minutes’


Not ‘I want you to do a FAST scan’

But ‘Once the monitoring is on, lines are in, fluids connected, we will do the CXR and I will give you 5 minutes to do an eFAST.  Everyone gown up now.  After that we will finish the trauma series whilst continuing fluid resuscitation’

Not ‘At some point we are going to need a CT’

But ‘I would like the patient ready for CT in 10 minutes.  Can you get ready for that’


Not ‘Let’s give some blood’

But ‘Give 2 units of blood and reassess the situation in 10 minutes.  I am targeting a SBP over 100’

Anticipate multiple contingencies

Not ‘Let’s give a bag of saline’

But ‘If one litre of saline doesn’t bring the BP over 100 or the HR down then we will commence blood’

Not ‘we might go straight to theatre instead’ 

But ‘If he remains stable over the next 5 minutes we will go to CT.  Make preparations now’.  ‘If he destabilises here or in CT we will abandon the procedure and go straight to theatre’

Pre-notifies all stakeholders

Not ‘He might be a candidate for embolisation’

BUT ‘Can you put the interventional radiologist on standby now and inform he we have an haemodynamically unstable severe pelvic trauma who we are currently resuscitating’

Confirms understanding (read-back)

Not ‘OK. Team leader’

But ‘Yes Team Leader.  We are getting the transport monitor and calling the PSA now’


Reflect on how many ways in which you can sharpen up your communication both in critical and non-critical situations so that the message gets across and acted on in timely fashion

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