Mr Jason Belcher1
1St John WA, Australia
Biography:
An Ambulance Paramedic since 2010, Jason’s undertaken a variety of roles across SJWA. A compassionate and caring leader, Jason current role is Resuscitation Improvement Specialist for SJWA.
Abstract:
Technical metrics for cardiac arrest management such as compression quality, defibrillation timings, and Advanced Life Support (ALS) interventions are routinely captured from cardiac monitor/defibrillators and patient care records. However, non-technical aspects like leadership, communication, and teamwork, which are critical to resuscitation success, are harder to measure.
In 2019, St John WA introduced cardiac monitors capable of audio recording during defibrillation mode. These recordings, uploaded with other case data, are stored for two weeks to allow for review. While access to audio is restricted under policy, findings are aggregated to inform education and practice improvement.
Review of audio recordings has yielded valuable insights, including:
The role of closed-loop communication in minimising compression pause times.
How strong leadership fosters calm coordinated scenes.
The effect of language early in resuscitation attempts such as “we’re just going to run to 20 minutes,” in priming teams to expect poor outcomes, potentially affecting performance.
The importance of communication to produce a mindset that anticipates and prepares for Return of Spontaneous Circulation (ROSC), improving readiness for ongoing care.
These lessons have been integrated into graduate, intern, and ongoing paramedic education. Positive trends, such as improved communication and leadership, have emerged with continued audio reviews post education. Clinical Leads have also observed changes in language at cardiac arrests.
Although more subjective than technical metrics, audio recordings offer unique insights into resuscitation dynamics and support continuous improvement in cardiac arrest care.