TY - JOUR
T1 - Effects of designated leadership and team-size on cardiopulmonary resuscitation
T2 - The Basel-Washington SIMulation (BaWaSim) trial
AU - Hunziker, Sabina
AU - O'Connell, Karen J.
AU - Ranniger, Claudia
AU - Su, Lillian
AU - Hochstrasser, Seraina
AU - Becker, Christoph
AU - Naef, Daryl
AU - Carter, Elizabeth
AU - Stockwell, David
AU - Burd, Randall S.
AU - Marsch, Stephan
N1 - Funding Information:
SH was supported partly by an unrestricted research grant from the University of Basel ( DMS_2211 ), Switzerland, and by the Office of Medical Education , Undergraduate Medical Education Research Grant, FY12 Medical Education Grant ; The George Washington University School of Medicine and Health Sciences . Children's National Medical Center ; University Hospital, Basel, Switzerland; PIs: Karen O'Connell, MD and Sabina Hunziker, MD.
Funding Information:
SH was supported partly by an unrestricted research grant from the University of Basel (DMS_2211), Switzerland, and by the Office of Medical Education, Undergraduate Medical Education Research Grant, FY12Medical Education Grant; The George Washington UniversitySchool of Medicine and Health Sciences. Children's National Medical Center; University Hospital, Basel, Switzerland; PIs: Karen O'Connell, MD and Sabina Hunziker, MD.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/12
Y1 - 2018/12
N2 - 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.
AB - 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.
KW - Cardiopulmonary resuscitation
KW - Leadership
KW - Team behaviour
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U2 - 10.1016/j.jcrc.2018.08.001
DO - 10.1016/j.jcrc.2018.08.001
M3 - Article
C2 - 30172964
AN - SCOPUS:85052455187
SN - 0883-9441
VL - 48
SP - 72
EP - 77
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -