The "pit crew" concept in cardiac arrest

While the drivers and owners may get most of the credit a good "pit crew" is essential for team success in NASCAR.

 

 

So what makes a good pit crew?

Leadership

A good pit manager will ensure that the pit crew is ready and that all the necessary resources are in place. That includes ensuring that the appropriate number of people have been assigned to critical tasks, and that equipment is organized in a logical manner.

Skills and Competencies

Individual team members should possess all of the skills and competencies to perform their functions quickly, efficiently, and accurately. For example, the tire replacement crew should know when the tires need to be replaced, where the tires are kept, and whether wet or dry tires are required. Similar skills are required of the team members responsible for refueling and repairing mechanical breakdowns.

Teamwork and Communication

Fluency in communication can make the difference between winning and losing. This is where precious seconds can be lost or gained. Good communication is what leads to coordination and problem solving. Lack of communication leads to errors and loss of situational awareness.

Best Practices

Doing something because "that's the way it's always been done" or because "that's how a real pit crew operates" is short-sighted if the end result is losing the race. A good pit crew learns from its mistakes (and the mistakes of others) and will not hesitate to amend its procedures when another pit crew demonstrates a way to do it better. The outcome drives the process. Not tradition. Not ego.

Rehearsal

A good pit crew doesn't "make it up the day of the race" and neither does any other high-performance team (Navy SEALs, surgical team at Johns Hopkins, NFL football team). It takes practice. Lots of practice. It also takes a commitment to excellence which is the motivation. It has to start with the desire to win and be the best.

Applying these lessons

Firefighters with Hilton Head Island Fire & Rescue discuss
the "lessons learned" from a recent cardaic arrest.

Are you familiar with the latest evidence based guidelines for the care of cardiac arrest patients?

Have you bothered to find out how the top EMS systems in the country are doing it?

When's the last time you practiced working a cardiac arrest with a fully clothed 175 pound mannequin found face-down between a toilet and a bathtub?

When's the last time you practiced using your own real equipment (as opposed to the equipment laid out on the table at your last ACLS class)?

When's the last time you sat down with your crew and choreographed exactly who would do what during a cardiac arrest?

Are you like a "pit crew" when you arrive on scene? Or do you "do the best you can" and hope for the best?

Who would you want showing up to save a member of your family?

Photo credit: Wake County EMS blog

See also:

Why you need to strengthen your community's chain-of-survival

Tom Bouthillet and Jamie Davis discuss cardiac arrest and the chain-of-survival

Cardiac arrest – Anatomy of a System Failure

Cardiac arrest – Are you ready to save one of our own?

65 year old male CC: Cardiac arrest on the tennis court

57 year old male CC: Cardiac arrest

1 Comment

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
CC
80 Year Old Male: Fall
You know.. the story says "suddenly he found himself on the ground, which he attributes to tripping on the runner rug in the hallway." If you want to look at the patient first… an unwitnessed fall with that kind of EKG (long qt in particular) in an 80 year old male who has been on…
2014-08-13 04:02:10
David Baumrind
"Treat the patient not the monitor?"- Redux
Jason, thank you for your comments!
2014-08-11 18:21:02
The LITFL Review 141 - LITFL
Pit Crew CPR – The Explicit Details
[…] CPR? Read about it in a brief post by Tom Bouthillet of the EMS 12-Lead Blog. Tom also outlines the entire pit crew CPR model in this post. […]
2014-08-11 02:36:15
Jason
"Treat the patient not the monitor?"- Redux
David- I agree with your post to a point. I wholeheartedly agree with your frustration at those who post the catch phrase in question when we are discussing ekg's on line in a learning environment. This website has no room for the phrase. Give it your best attempt and read what others have to say.…
2014-08-10 17:45:09
The LITFL Review 135 - LITFL
Revisiting Transcutaneous Cardiac Pacing
[…] familiar with the various presentations of false capture while engaging in the procedure? Check out this detailed post from the EMS 12-Lead Blog. […]
2014-08-10 17:14:07

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