1. The effect of random leader
role assignment on task and
team performance during
resuscitation
Shashikanth Reddy Ambati
Northshore-LIJ (New York, NY) Pediatric Critical Care Fellow
INSPIRE @ IMSH 2014: San Francisco, CA,USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. Background
• Human factors influence quality
and outcomes of CPR.1
• One of the most consistent human
factor limitations is failure to identify
leader
International Network for Simulation-based Pediatric Innovation, Research and Education

3. Background
Lack of a defined leader role delays
care and impairs communication in
resuscitation.2
International Network for Simulation-based Pediatric Innovation, Research and Education

4. Hypotheses
1. Identified leader role will improve the
effectiveness of medical response and
team performance
2. Profession of the leader(Physician or
Nurse) will affect team performance
International Network for Simulation-based Pediatric Innovation, Research and Education

5. PICO Question
• P : Resuscitation caregivers
• I : Identified leader role (physician or
nurse)
• C: No Identified leader role
• O: Time to BVM; Time to Compressions;
Time to IV medications; Team
Performance3
International Network for Simulation-based Pediatric Innovation, Research and Education

6. Approach / Design
• Scenario: Infant in respiratory distress.
• Randomization: 4-person
resuscitation team to Intervention or
Control
• Intervention- identified leader
• Control- no identified leader
International Network for Simulation-based Pediatric Innovation, Research and Education

7. Approach/Design
• Time line: q1 month simulations × 24
months@ local sim center
• The scenarios will be video recorded.
• Data collection: observed times, scores
on team performance scale3
International Network for Simulation-based Pediatric Innovation, Research and Education

8. Outcomes
1. Primary Outcome: Time to BVM
2. Secondary Outcomes: Time to
compressions, time to IV medications
and team performance
International Network for Simulation-based Pediatric Innovation, Research and Education

9. 3 Questions to improve study
1. Feed back on the design.
2. Looking to make into a multicenter
study.
3. For possible granting agencies.
International Network for Simulation-based Pediatric Innovation, Research and Education

10. Contact Information
• Shashikanth Reddy Ambati
• CCMC, North Shore LIJ
Hospital
• shashiambati@gmail.com
International Network for Simulation-based Pediatric Innovation, Research and Education

11. References
1.
S.Hunziker, F.Tschan. NK Semmer, Howell, S.Marsch. Human factors in
resuscitation: Lessons learned from simulator studies. J Emerg Trauma
Shock. 2010 Oct; 3(4):389-94.
2.
Fernandez Castelao E, Russo SG, Riethmüller M, Boos M. Effects of team
coordination during cardiopulmonary resuscitation: A systematic review of the
literature. J Crit Care. 2013 Aug;28(4):504- 21.
3.
Nicholas Allen Hamilton, Alicia N. Kieninger, etal. Video Review Using
Reliable Evaluation Metric Improves Team Function in High-Fidelity Simulated
Trauma Resuscitation. Journal of Surgical Education volume 69/Number 3
May/June 2012.
4.
Elizabeth A. Hunt, MD, Allen R. Walker, MD, Donald H. Shaffner, MD, Marlene
R. Miller, MD, Peter J. Pronovost, MD. Simulation of In-Hospital Pediatric
Medical Emergencies and Cardiopulmonary Arrests: Highlighting the
Importance of the First 5 Minutes. Pediatrics. 2008 Jan; 121(1):e34-4.