Medical Safety Podcast

Show notes Elaine Bromiley Healthy 37 year old woman for elective sinus surgery in the UK in 2005 Can’t Intubate Can’t Oxygenate Experienced anesthesiologist + another who joined when help was called for + a head and neck surgeon in the room + experienced OR nurses Elaine’s oxygenation fell and the team could not get oxygen to her through intubation, face mask ventilation, or by using a laryngeal...

Show notes How to make simulation effective Although equipment is expensive and may seem like a barrier to establishing a simulation program, the emphasis of a simulation focused on CRM principles should be communication and having skilled debriefers who can facilitate skills development Using simulation to have someone experience a crisis and reflecting on why things didn’t go well, with the help...

What is Crisis Resource Management (CRM)? It is a set of skills that helps improve team performance through communication, leadership, and interpersonal skills. It can help build a common language and shortcuts so that even people that have not worked together before can work well together. Used well, it can improve efficiency. While it is more formalized in other industries (aviation, military),...

Aspects of CRM Making a welcoming environment, so that others feel they can speak up CRM is not about being perfect. It’s about identifying and mitigating the times of increased risk of making mistakes and identifying why a particular mistake was made. The perceived tension between performance and “soft skills” (CRM) Some people view these non-technical skills as costing time and money and not con...

In this episode Amir and Adam discuss three aviation accidents that parallel the Elaine Bromiley case. Human factors in medicine: As Captain Bromiley put it, this was not an individual failure. It was a system failure. It was a failure of human performance. In aviation, 75% of airline accidents are due to human factors rather than mechanical failure.  Eastern Airlines Flight 401 (1972) Fixation-in...

Welcome to the Medical Safety Podcast where we aim to improve the safety of our healthcare system through the integration of human factors into medical incident investigation and proactive safety measures. This podcast is hosted by two Canadian anesthetists, Drs. Adam Shehata and Amir Hamid. In the inaugural episode, we take a look at the 2005 death of Elaine Bromiley and the lessons learned from...