Calling for Help: From Situational Awareness to Effective  Communication in Critical Anesthesia Situations

Tarinee  Buasuk; Tachawan  Jirativanon

Authors

Tarinee Buasuk Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Tachawan Jirativanon Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

Keywords:

call for help, communication, critical situation, effective escalation, non-technical skill, situation awareness

Abstract

In the dynamic environment of the operating room, the provision of safe and effective anesthesia care necessitates not only technical proficiency but also a robust foundation of non-technical skills. These skills, encompassing aspects such as situation awareness, decision-making, task management, communication, and teamwork. Effective communication within anesthesia teams is highlighted as a critical factor in preventing errors, improving coordination, and enhancing overall patient care. Strategies for fostering a culture of open communication and proactive collaboration are explored, along with the importance of timely escalation of concerns. The decision to call for help in critical anesthesia situations is examined, considering factors such as provider experience, situational awareness, and cultural influences. Training initiatives aimed at developing non-technical skills in anesthesia providers are discussed, emphasizing the importance of communication training and simulation-based experiences. The integration of non-technical skills into anesthesia practice represents a fundamental commitment to patient-centered care and continuous quality improvement.

References

Flin RH, O’Connor P, Crichton M. Safety at the sharp end: a guide to non-technical skills. Great Britain, Bodmin, Cornwall, Ashgate Publishing, Ltd., 2008.

Flin R, Patey R, Glavin R, Maran N. Anaesthetists’ non-technical skills. Br J Anaesth. 2010;105:38-44.

Sidi A. Challenges in learning and assessing anesthesia cognitive and non-technical skills of anesthesiologists and residents in anesthesia. Harefuah. 2020;159:432-9.

Raksamani K. Situation awareness in anesthesia. Thai J Anesthesiol. 2019;45:171-5.

Vannucci A, Kras JF. Decision making, situation awareness, and communication skills in the operating room. Int Anesthesiol Clin. 2013;51:105-27.

Schulz CM, Krautheim V, Hackemann A, Kreuzer M, Kochs EF, Wagner KJ. Situation awareness errors in anesthesia and critical care in 200 cases of a critical incident reporting system. BMC Anesthesiol. 2016;16:4.

Weinger MB, Slagle J. Human factors research in anesthesia patient safety: techniques to elucidate factors affecting clinical task performance and decision making. J Am Med Inform Assoc. 2002;9(Suppl1):S58-63.

Wacker J, Kolbe M. Leadership and teamwork in anesthesia-making use of human factors to improve clinical performance. Trends Anaesth Crit Care. 2014;4:200-5.

Odell M. Human factors and patient safety: changing roles in critical care. Aust Crit Care. 2011;24:215-7.

Gautam B, Shrestha BR. Critical incidents during anesthesia and early post-anesthetic period: a descriptive cross-sectional study. J Nepal Med Assoc. 2020;58:240-7.

Vlassakova BG, Sinnott SM, Askins N, et al. The anesthesia perioperative “Call for Help”-experience at a quaternary pediatric medical center: analysis of 67,564 anesthesia encounters. Anesth Analg. 2018;127:126-33.

Adler AC, Chandrakantan A. STAT calls: real data could improve anesthesia staffing models. Anesth Analg. 2018;127:21-2.

Langerman A, Angelos P, Siegler M. The “call for help”: intraoperative consultation and the surgeon-patient relationship. J Am Coll Surg. 2014;219:1181-6.

Bielka K, Kuchyn I, Frank M, et al. Critical incidents during anesthesia: prospective audit. BMC Anesthesiol. 2023;23:206.

Szczurek L. When to ask for help. In: Yoon-Flannery K, Fisher C, Neff M, eds. A surgeon’s path: what to expect after a general surgery residency. Cham: Springer International Publishing. 2018;p179-80.

Matern LH, Gardner R, Rudolph JW, Nadelberg RL, Buléon C, Minehart RD. Clinical triggers and vital signs influencing crisis acknowledgment and calls for help by anesthesiologists: a simulation-based observational study. J Clin Anesth. 2023;90:111235.

Lee H, Woodward-Kron R, Merry A, Weller J. Emotions and team communication in the operating room: a scoping review. Med Educ Online. 2023;28:2194508.

Stubbings L, Chaboyer W, McMurray A. Nurses’ use of situation awareness in decision-making: an integrative review. J Adv Nursing. 2012;68:1443-53.

Burnard P, Naiyapatana W. Culture and communication in Thai nursing: a report of an ethnographic study. Int J Nurs Stud. 2004;41:755-65.

Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13(Suppl1):i85-90.

Bertrand B, Evain JN, Piot J, et al. Positive communication behaviour during handover and team-based clinical performance in critical situations: a simulation randomised controlled trial. Br J Anaesth. 2021;126:854-61.

Dirks JL. Effective strategies for teaching teamwork. Crit Care Nurse. 2019;39:40-7.

Raksamani K, Jirativanont T, Sareenun P. Correlation of medical knowledge and non-technical skills assessment in anesthesia residents. Siriraj Med J. 2020;72:483-7.

Hayes MM, Chatterjee S, Schwartzstein RM. Critical thinking in critical care: five strategies to improve teaching and learning in the intensive care unit. Ann Am Thorac Soc. 2017;14:569-75.

Parab SY, Ranganathan P, Shetmahajan M, Malde A. Role of simulation-based training in thoracic anaesthesia. Indian J Anaesth. 2024;68:58-64.

Yee B, Naik VN, Joo HS, et al. Nontechnical skills in anesthesia crisis management with repeated exposure to simulation-based education. Anesthesiology. 2005;103:241-8.

Sameera V, Bindra A, Rath GP. Human errors and their prevention in healthcare. J Anaesthesiol Clin Pharmacol. 2021;37:328-35.

Cotter JM, Ziniel S, Lockwood J, Reese J. Care escalation: teaching residents how to effectively communicate patient care concerns. MedEdPORTAL. 2019;15:10833.