Mitigating Task Saturation in Critical Care Air Transport Team Red Flag Checklist

Critical Care Air Transport Teams CCATTs are a critical component of the U.S. Air Force aeromedical evacuation paradigm. The complexity of patient care and the nature of the missions require competency in both medical care and technical and non-technical skills NOTECHS. The current study was conducted to evaluate predictors of competence in non-technical skills. Sixteen CCATTs were studied over a 6-month period. All teams were videotaped during a simulated CCATT mission during their 2-week advanced course at the University Hospital Cincinnati. Team and individual performances were scored using a validated assessment tool for NOTECHS. Salivary cortisol levels were measured at baseline and pre- and post-simulation exercises. Sixteen simulated missions were reviewed, with 69 crisis events identified. Evidence of task saturation was present in 2969 42 crisis events 63 of participants engaged in intensive unit ICU care and 67 had flown real-world CCATT. Each team member was assigned a non-technical skill score or red flag score. The team s average red flag score correlated with task saturation during the simulated missions odds ratio 0.5, 95 confidence interval 0.32-0.80, p0.01. In the univariate analysis, daily ICU experience p0.04, previous attendance at the Center for the Sustainment of Trauma and Readiness Skills course p0.04, previous experience in simulated CCATT missions p0.04, and previous deployment experience p0.001 correlated with the red flag score. In the multivariate analysis, daily ICU experience p0.03 and previous deployment experience p0.04 continued to be significant. Salivary cortisol levels increased by 0.124 gdL over baseline as the result of the simulation p0.0002 but did not correlate with red flag scores or biographical data, suggesting that the stress of the simulation was similar for all participants. Task saturation is frequently observed in simulated CCATT missions.