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

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Jewel
53 Year Old Male: Severe Leg Pain
Hmm it appears like your site ate my first comment (it was extremely long) so I guess I'll just sum it up what I wrote and say, I'm thoroughly enjoying your blog. I as well am an aspiring blog writer but I'm still new to the whole thing. Do you have any helpful hints for…
2014-08-31 17:51:28
David Baumrind
All that wiggles isn’t Wellens’
@Gary, by all means, nitpick all you like. I agree with your assessment, and the post has been modified. Thank you for the feedback!
2014-08-30 17:28:16
Gary Huntress
All that wiggles isn’t Wellens’
Not to nitpick but is this really a "slightly leftward axis"? I and AVF are both positive. I put it at about +20 degrees, not leftward.
2014-08-30 11:49:35
Handsome Robb
87 YOM COMPLAINING OF CHEST DISCOMFORT AND DYSPNEA
CHF. 12-lead shows a sinus Tachycardia in the 120s with PACs, besides the anterior leads there's diffuse ST depression, the STE in the anterior leads can be explained by the LBBB, axis is good as well. I wish they posted the EtCO2 waveform so we could see but I'm assuming it's non-obstructive. The elevated EtCO2…
2014-08-30 08:08:22
Christopher Watford
“Bad heartburn” – 82 y.o. female without chest pain.
Brooks, Firstly, thank you for the warm welcome to the club. Secondly, the Glasgow algorithm's only published sens/spec for AMI is 51.6%/97.6% respectively (Tuscon STEMI Database). I've not been able to find any other publications. The GE Marquette 12SL algorithm has been widely studied, but is much older, and ranges in sensitivity from 48% to…
2014-08-29 16:50:14

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