LAUSR

ANNALS CASE We’ve all been there. A patient dies. A case goes badly. Bad news is delivered. And then we check the list, and guess what? New patients are waiting. At that moment, we, and likely the rest of the team, might be internally processing what just occurred and contemplating what could have gone better. Do we have another option besides burying our whirring thoughts and emotions in order to function in the emergency department (ED)? One option might be postresuscitation debriefing (PRD). Turns out, facilitated discussion after an event is beneficial in assimilating improved behaviors into practice. PRD has been associated with improved performance measures such as improved cardiopulmonary resuscitation (CPR) quality and better neurologic outcome, as well as decreased provider stress. Although the article by Mullan et al in this month’s Annals of Emergency Medicine evaluates the accuracy of PRD, we wanted to provide practical advice on how to institute PRD in your busy ED. Our expert panel (Appendix), with experience instituting ED PRD programs, is here to help. What are your triggers for debriefing? Our experts agreed that major resuscitation events such as CPR, intubations, and trauma activations should trigger PRDs. Their value, though, may not be limited to major resuscitations. Dr. Kessler recommends debriefing after difficult situations such as dealing with an angry parent. Dr. Zinns debriefs after “psychosocial events