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Randomized Controlled Trial
. 2018 Dec:48:72-77.
doi: 10.1016/j.jcrc.2018.08.001. Epub 2018 Aug 12.

Effects of designated leadership and team-size on cardiopulmonary resuscitation: The Basel-Washington SIMulation (BaWaSim) trial

Sabina Hunziker  1 , Karen J O'Connell  2 , Claudia Ranniger  3 , Lillian Su  2 , Seraina Hochstrasser  4 , Christoph Becker  5 , Daryl Naef  4 , Elizabeth Carter  2 , David Stockwell  6 , Randall S Burd  7 , Stephan Marsch  8
Affiliations
Randomized Controlled Trial

Effects of designated leadership and team-size on cardiopulmonary resuscitation: The Basel-Washington SIMulation (BaWaSim) trial

Sabina Hunziker et al. J Crit Care. 2018 Dec.

Abstract

Objective: During cardiopulmonary resuscitation (CPR), it remains unclear whether designating an individual person as team leader compared with emergent leadership results in better team performance. Also, the effect of CPR team size on team performance remains understudied.

Methods: This randomized-controlled trial compared designated versus emergent leadership and size of rescue team (3 vs 6 rescuers) on resuscitation performance.

Results: We included 90 teams with a total of 408 students. No difference in mean (±SD) hands-on time (seconds) were observed between emergent leadership (106 ± 30) compared to designated leadership (103 ± 27) groups (adjusted difference - 2.97 (95%CI -15.75 to 9.80, p = 0.645), or between smaller (103 ± 30) and larger teams (106 ± 26, adjusted difference 3.53, 95%CI -8.47 to 15.53, p = 0.56). Emergent leadership groups had a shorter time to circulation check and first defibrillation, but the quality of CPR based on arm and shoulder position was lower. No differences in CPR quality measures were observed between smaller and larger teams.

Conclusions: Within this international US/Swiss trial, leadership designation and larger team size did not improve hands-on time, but emergent leadership teams initiated defibrillation earlier. Improvements in performance may be more likely to be achieved by optimization of emergent leadership than increasing the size of cardiac arrest teams.

Keywords: Cardiopulmonary resuscitation; Leadership; Team behaviour.

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Comment in

  • Letter in reply.
    Hunziker S, O'Connell KJ, Stockwell D, Burd RS, Marsch S. Hunziker S, et al. J Crit Care. 2019 Jun;51:223-224. doi: 10.1016/j.jcrc.2019.01.018. Epub 2019 Jan 22. J Crit Care. 2019. PMID: 30709561 No abstract available.
  • In-hospital resuscitation team composition: Are three heads really better than six?
    Lauridsen KG, Nadkarni VM, Løfgren B. Lauridsen KG, et al. J Crit Care. 2019 Jun;51:221-222. doi: 10.1016/j.jcrc.2019.01.017. Epub 2019 Feb 7. J Crit Care. 2019. PMID: 30797613 No abstract available.

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