Non-technical skills in out-of-hospital cardiac arrest management: A scoping review

Introduction

Current United Kingdom resuscitation guidance advocates the use of non-technical skills (NTS) such as teamwork, decision-making and communication for ad-hoc teams managing an out-of-hospital cardiac arrest (OHCA). It is unknown which NTS are advantageous or commonly used, or if there is supporting literature. This scoping review sought to establish a literature base and identify key NTS relevant to ad-hoc teams managing an OHCA.

Methods

Arksey and O’Malley’s five-stage framework was used to perform a scoping review to identify relevant literature from the medical domain. Thematic analyses were used to identify relevant NTS in relation to OHCA management.

Results

A total of 12 articles were identified and selected for detailed analysis. The articles represented a range of study designs, with most commenting on observed simulated practice from in-hospital practice. There was a paucity of literature for NTS associated with ad-hoc OHCA teams. Three common NTS were identified: leadership, teamwork and communication, with improved team performance associated with a hands-off team leader. Barriers were also identified and included low confidence in communicating and hierarchical difficulties in resuscitation teams.

Conclusion

We believe this scoping review provides the first comprehensive review of its kind and identifies important knowledge gaps, NTS themes and recommendations for paramedic-led OHCA teams. Three NTS from in-hospital cardiac arrest management can be related to OHCA management, but further research is needed to identify specific NTS for ad-hoc teams managing an OHCA.