Background: Non-technical errors, such as insufficient communication or leadership, are a major cause of medical failures during trauma resuscitation. Research on staffing variation among trauma teams on teamwork is still in their infancy. In this study, the extent of variation in trauma team staffing was assessed. Our hypothesis was that there would be a high variation in trauma team staffing. Methods: Trauma team composition of consecutive resuscitations of injured patients were evaluated using videos. All trauma team members that where part of a trauma team during a trauma resuscitation were identified and classified during a one-week period. Other outcomes were number of unique team members, number of new team members following the previous resuscitation and new team members following the previous resuscitation in the same shift (Day, Evening, Night). Results: All thirty-two analyzed resuscitations had a unique trauma team composition and 101 unique members were involved. A mean of 5.71 (SD 2.57) new members in teams of consecutive trauma resuscitations was found, which was two-third of the trauma team. Mean team members present during trauma resuscitation was 8.38 (SD 1.43). Most variation in staffing was among nurses (32 unique members), radiology technicians (22 unique members) and anesthetists (19 unique members). The least variation was among trauma surgeons (3 unique members) and ER physicians (3 unique members). Conclusion: We found an extremely high variation in trauma team staffing during thirty-two consecutive resuscitations at our level one trauma center which is incorporated in an academic teaching hospital. Further research is required to explore and prevent potential negative effects of staffing variation in trauma teams on teamwork, processes and patient related outcomes.
This paper explores the intersection of Human-Comput- er Integration (HInt) and Critical Disability Studies (CDS) to explore how a posthumanistic epistemology in design can produce knowledge and know-how for the application do- mains of Health and Well-being. To use disability as a catalyst for innovation, a rethinking in the philosophy of sciences is necessary to establish knowledge production that emerges from new fluid politics that operate in ‘composition’ instead of ‘organization’. By placing an emphasis on nomadic practic- es that move beyond fixed borders, the encounters between Disability Studies or Human-Computer Integration can pro- duce situated, embodied and contingent design knowledge that study deviant and complex embodiment, and the kinds of alterations of human characteristics and abilities through technology. The first section of this paper explores the re- thinking in the philosophy of sciences. The second section ar- gues for a posthumanistic epistemology in design, which can be seen as the perfect way to produce situated, embodied and contingent design knowledge on the intersection of HInt and CDS. The final section of this paper highlights the poten- tial for the disciplines of Somatechnics and Soma Design to engage in each other’s body of knowledge to produce trans- formative knowledge through a shared focus on deviant em- bodiment and disability. The takeaway message of this paper is that the intersection of HInt and CDS potentially leads to new – otherwise overlooked - insights on the human-technol- ogy relationship, and therefore can take part in the historical strive for man-machine symbiosis. The posthumanist episte- mology allows for alternative ways of thinking that move be- yond the current Humanist perspective, and builds on a plu- ral, relational and expansive foundation for the development of design practices that catalyze innovation in the application domains of Health and Well-being.
