LAUSR

Learning from aviation. Brennan (a maxillo-facial surgeon) and co-authors (who include a commercial airline pilot and Red Arrows pilot) discuss how improved situational awareness (SA) may reduce the risk of human error. They begin with the premise that everyone makes mistakes. SA is being aware of what has happened, what is happening now and what might happen in the future. SA is developed in teams through empowering all involved to be free to speak without fear of retribution at all times. Possible complications within a clinical setting should be discussed at a team briefing, highlighting particularly ‘what if ...?’ and the importance of every team member being clearly aware of their role if something does go wrong. Both distraction and intense concentration may affect SA. The authors recommend taking a break if operators are hungry, angry, late or lonely, tired (HALT) and at any time, be prepared to stop (down tools, think, engage brain), look (what is out of the ordinary here?), assess (is the unexpected being expected?), manage (regroup, talk, change approach if appropriate) – SLAM.