EMS Essentials - Effective Teamwork Skills

In the prehospital setting, effective teamwork is critical for the success of emergency medical services (EMS) operations. 

EMS Providers must be able to work seamlessly together under high-pressure, time-sensitive conditions. 

Here are some key elements of effective teamwork:

1. Clear Communication

Closed-Loop Communication: When one team member gives a direction or request, the recipient should repeat it back to confirm understanding, and the sender should confirm that the message was understood correctly.

Concise & Timely: Communication should be clear, concise, and delivered in a timely manner, especially when sharing critical patient information (e.g., vital signs, treatment decisions).

Non-Verbal Cues: Body language and other nonverbal signals are essential, especially in noisy or chaotic environments where verbal communication might be difficult.

2. Role Clarity and Task Delegation

Defined Roles: Each team member should know their role and responsibilities. This reduces confusion and redundancy during an emergency situation.

Task Delegation: Leaders should effectively delegate tasks based on team members’ skills and experience to maximize efficiency and reduce errors.

Leadership In Critical Moments: During high-stress situations, a clear leader should emerge or be designated to direct operations and make final decisions.

3. Interdisciplinary Collaboration

Coordination With Other Responders: EMS providers often work alongside law enforcement, firefighters, or other healthcare professionals, and it’s important to understand their roles to ensure smooth collaboration.

Unified Command Structure: Especially in large incidents, integrating into a unified command or Incident Command System (ICS) ensures all responders are working toward a common goal with shared information.

4. Trust and Mutual Respect

Trust: Team members must trust each other’s skills, decisions, and judgment. This fosters a supportive environment and allows quicker execution of tasks.

Respect: Mutual respect is key to maintaining a positive team dynamic, even during disagreements or high-pressure moments. Every member should value the contribution of others.

5. Situational Awareness

Shared Mental Model: Every team member should maintain an awareness of the overall situation, patient condition, and potential risks. This allows for quick decision-making and adaptability.

Continuous Reassessment: Teams must continually reassess the situation, making adjustments to treatment plans as needed based on new information.

6. Conflict Management

Quick Resolution: Conflicts should be addressed quickly and professionally to maintain the focus on patient care.

De-Escalation: Leaders and team members should know how to manage and de-escalate interpersonal tensions, as conflict can reduce team effectiveness.

7. Debriefing and Feedback

Post-Call Debriefs: After every major incident, teams should debrief to discuss what went well and what could be improved, allowing for continuous learning and improvement.

Constructive Feedback: Providing and receiving constructive feedback helps team members grow and better prepare for future emergencies.

8. Adaptability and Flexibility

Adapt To Changing Conditions: EMS teams must remain flexible to changing circumstances, such as evolving patient conditions or unexpected challenges at the scene.

Resourcefulness: Team members should be prepared to adapt their approaches, including improvising when resources are limited or when things don’t go as planned.

9. Physical and Emotional Support

Physical Support: Team members should assist each other with physically demanding tasks, such as patient lifting or moving equipment, to prevent injuries.

Emotional Support: High-stress situations can take an emotional toll, so it’s important for team members to support one another mentally, recognizing signs of stress or burnout and offering encouragement or a break when needed.

10. Preparedness and Training

Ongoing Training: Regular team training, including scenario-based exercises, helps build trust, coordination, and familiarity with each other’s strengths and weaknesses.

Cross-Training: Team members should be cross-trained in multiple roles so they can step into different positions as needed in the field.

By understanding and applying these elements of teamwork, EMS providers can improve patient care, operational efficiency, and overall team morale in the prehospital environment.

Further Reading:

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education

Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, Massachusetts: Pearson

Fernandez, W. G., Benzer, J. K., Charns, M. P., & Burgess, J. F. (2020). Applying a Model of Teamwork Processes to Emergency Medical Services. Western Journal of Emergency Medicine 21(6): 264-271 Accessed September 12, 2024

Foster, D. T., Goertzen, B. J., Nollette, C., & Nollette, F, P. (2013) Emergency Services Leadership - A Contemporary Approach. Burlington, Massachusetts: Jones & Bartlett Learning

Knox, A. G. S. (2018) Conflict Resolution & The Importance of Teamwork in EMS. EMS1. Accessed September 12, 2024

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education