How can we enhance situational awareness?

1. Pre-task briefing
2. Sterile cockpit concept: Avoid unnecessary distractions
3. Active information gathering through scanning
4. Self-checking
5. Cross checking: Ask other team members
6. Re-check information after interruption or distraction
7. Use open rather than leading questions
8. Encourage junior staff to speak up if concerned
9. Realize that even experts can make errors…and put a heart valve in upside down

• Have a safe word, such as “watermelon,” which means stop. And then use it. And stop

Self-check and CUSS

I’M SAFE is the mnemonic for a self-check list at the beginning of the day and when starting new or major procedures. Are you having any negative effects from the following?

• Illness
• Medication (e.g., codeine for a toothache, antihistamines for a cold, coping with a runny nose behind a surgical mask)
• Stress (personal relationships and time pressures)
• Abuse (substance and alcohol, and its after-effects)
• Fatigue
• Emotion (rudeness, anger, aggression, and personal grief) and Eating (impact of hypoglycemia)