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Thoughts From A Clinician

Thoughts from a Clinician: Crew Resource Management


Crew Resource Management (CRM) is something that many of us have heard about and practiced at one point or another in our careers.  Where did this idea of CRM come from and how can it be applied to the modern air medical industry?  In the 1970’s, there was a big push to reduce contributing elements that resulted in aviation mishaps; with particular emphasis on the human factor/s.  Early on, a concept known as the “Domino Effect” helped to explain why aviation accidents happened.  The Domino Effect, which was eventually improved to the (“Swiss Cheese”) Reason Model and Accident Casual Chain, paved the way to Crew Resource Management.  Several devastating air crashes in the 1970’s motivated leaders in the aviation industry to help make air travel safer for crew and passengers; hence the standardized implementation of Crew Resource Management (CRM).


Historically, CRM was practiced, to some extent, in the military for many years, but was never effectively transitioned into the civilian workforce.  Once CRM introduced and implemented in the civilian aviation industry, a significant decrease in air-related accidents was realized.  In those events where the was an accident, there was a drop in the number of human casualties.  Many of these reduced statistics are a result of effective CRM.  Although CRM has not been around very long, it has spread to other industries and created safer workplaces.  Even the Occupational Safety and Health Organization (OSHA) has their own form of CRM.

CRM is both useful and essential for medical personnel; especially those in critical care transport.  It gives us checks and balances which in turn help us to avoid making consequential mistakes.  As providers continue to care for the sickest of patients, we should utilize our checklists and CRM to maximize safe and effective medical care.  If it is good enough for fighter pilots, it should be good enough for me.  For more on CRM related content listen to our very own Dave Olvera’s talk on checklists in EMS (2).  Don’t forget to visit to sign up for #FAST18 and to check out our list of review courses.  As always be safe out there and remember to always think like a clinician!






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