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The process of teambuilding delays cardiopulmonary resuscitation


Health-care workers summoned to help at a cardiac arrest arrive at different times. Providing of life support and the process of teambuilding have to take place simultaneously. The aim of this study was to test the hypothesis that the process of teambuilding impairs the quality of cardiopulmonary resuscitation during its early phase.


The study took place in a high-fidelity patient simulator. A scenario of a witnessed cardiac arrest due to ventricular fibrillation was used that occurred after a uneventful period of 2 min. Twenty-four teams, each consisting of three physicians, were randomly assigned to one of two versions of the scenario: version R (reality) mimics reality in that the arrest occurs in the presence of one physician and the remaining two physicians are summoned to help; in version A (all present) all three physicians were present at the moment of the arrest. The performance of the teams was rated using videotapes recorded during simulations. The first meaningful measure (FMM) was defined as either precordial thump, ventilation, cardiac massage, or defibrillation. Completion of the initial phase (CIP) was defined as three countershocks, initiation of mask ventilation and cardiac massage, and injection of epinephrine.


Both groups differed significantly in the timing of important measures (Table 1).

Table 1


The present study was designed to unmask the additional burden of teambuilding during the very early phase of an emergency situation. Teams that were able to form prior to the cardiac arrest performed significantly better than teams that had to form during the cardiac arrest. Thus, the process of teambuilding is associated with a significant delay in crucial measures in cardiopulmonary resuscitation. Further research is necessary on how to improve teambuilding in the settings of medical emergencies.

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Marsch, S., Hunziker, P., Mueller, C. et al. The process of teambuilding delays cardiopulmonary resuscitation. Crit Care 8 (Suppl 1), P297 (2004).

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