Importance of leadership in cardiac arrest situations: from simulation to real life and back

Abstract

The 2010 American Heart Association guidelines now recommend leadership training in Advanced Cardiac Life Support courses. In this review we provide a comprehensive summary of data derived from clinical studies that investigated the importance of leadership in cardiopulmonary resuscitation (CPR). Only a few, mostly observational, studies have been conducted under real-life conditions because of the high heterogeneity of the situations, difficulties in capturing the initial phase of CPR, and ethical issues. Well-controlled studies in the human simulator can fill existing gaps and provide important insights. High-fidelity video-assisted simulator studies from different research groups have shown that a prolonged process of teambuilding is associated with significant shortcomings in CPR, whereas effective leadership improves team performance. In addition, randomised controlled studies have provided evidence that medical students receiving leadership training subsequently showed improved CPR performance, which was sustained after a follow up of 4 months. In addition, leadership is influenced by gender and other factors such as emotional stress. Future studies are needed to investigate cultural differences and how findings from the simulator can be transferred to real-life situations.

Can Simulation Based-Team Training Impact Bedside Teamwork in a Pediatric Intensive Care Unit?

“…[1][2][3][4] Specific teamwork skills such as communication, team leadership, and role assignment are essential during a clinical crisis such as trauma in the emergency room or resuscitation in ICUs. [4][5][6][7][8] The importance of training healthcare professionals to achieve optimal team performance has been supported by postintervention period. This study was implemented to evaluate the impact of a single SBTT on team performance during real emergency events in a single pediatric ICU.…”

Strategies to Improve Out-of-Hospital Cardiac Arrest Outcomes in the Pre-Hospital Environment – Part B: Non-Pharmaceutical Strategies

“…As such, recent literature has a heavy focus on the importance of achieving optimal CPR (28)(29)(30)(31)(32)(33)(34) and therefore, it is unsurprising that studies identified in this review with protocols promoting and maintaining optimal CPR, showed positive results. There has also been recent focus on optimising the use of factors promoting the efficiency of teams in clinical circumstances, such as leadership and the use of non-technical skills, to improve outcomes (35,36). A pivotal study to this concept in the out-of-hospital environment was TOPCAT2 (37), which presented a specialist second-tier response to OHCA to focus on non-technical skills (more specifically leadership, communication and clinical decision making), with goals closely aligned to that of a pit crew approach.…”

Liderança na educação médica

“…O contexto de aplicabilidade desta competência é amplo, não só contemplando circunstâncias diárias do atendimento ambulatorial, da gestão hospitalar e da saúde pública, 3 mas também incluindo momentos de risco de vida como o atendimento a uma parada cardiorrespiratória. 4 Dessa forma, devido ao papel central que o médico exerce pela natureza de suas atividades profissionais, é imprescindível o desenvolvimento de liderança.…”