It is easy to recognize when someone has a lot of experience on a tactical radio – their transmissions are sharp, concise, and have a crisp, clean nature. Military aviation in particular is an even stronger example – combat pilots and forward air controllers have a consistently calm and professional tone to their calls, regardless of the all-too-frequent chaos occurring around them. Whether a pilot is speaking to a rookie student on their familiarization flight in a Cessna or to fighter ace flying Air Force One, their manner of speaking always made the other person feel important, more iconically known as the “Houston Center” or “Chuck Yeager” voice.
In emergency medicine, we often reference aviation and crew resource management with regard to how we communicate in the trauma bay. What additional lessons can we learn from the phrasing and tonality used by tactical combat pilots and ground control to communicate with our teams during a major resuscitation? Can we train our support staff to utilize checklists to minimize errors to mitigate unwanted risk?
Given that running dialogue and open discussion is crucial between physicians, nurses, and technicians, teaching and using standardized terminology and radio-style callbacks may minimize miscommunication and facilitate team cohesiveness, particularly during stressful and critical patient encounters. Having a “silent” resuscitation bay may thus be counterproductive for a complicated patient. Military pilots utilize radio frequencies to communicate with different groups people during a combat sortie – how can we integrate this concept into a crowded trauma bay using subtle changes in volume, terminology, and tone, in order to establish a reassuring command presence and reach the right personnel?
Residents are taught that knowing nurses’ names is the most effective way to send an order – but what if you’re running into a blind code and are meeting everyone for the first time? Military “callsigns” encouraged open communication between different members in the cockpit, fostered camaraderie under a shared mission, and fueled resiliency through discipline. In an ED with high personnel turnover and unfamiliar team members, preset role names may assist in identifying team members for imperative commands.
The 3 concepts I would like to share during this talk include:
• Eliminate the concept of “one voice” in the ED and introduce the concept of switching frequencies and radio channels
• Utilize standardized names and phrases for teammate identification and emergent tasking
• Develop our own confident, professional “Houston Center” EM resuscitation voice to emulate and pass down culturally