Uncertainty in Trauma Patient Resuscitation

Abstract

Case segments during trauma patient resuscitation, as primarily captured by videotaping, were analyzed to understand how various types of uncertainty arise during the initial stages of resuscitative efforts. Over 40 case segments were analyzed, with the objective of answering the question of “What is uncertain to the team specifically related to this case segment?” Findings were summarized as a list of categories of uncertain items. Although some of the items have been traditionally considered in decision making, such as patient's prior medical history, others were related to team and organizational factors, and still others to activities of other team members. Given that satisfactory, robust performance requires a team to resolve these uncertainties, studies of decisionmaking in naturalistic settings should be directed at how various uncertainties arise and how they are resolved and tackled.