Verbal pressure made by a team leader can decrease the quality of chest compressions during cardiopulmonary resuscitation: a pilot study

Introduction
Currently, there is a lack of scientific data outlining the impact of a team leader’s negative influence on other team members. The objective of this simulation study is to evaluate the influence of verbal pressure made by a team leader on the efficiency of team members.

Material and methods
Twenty seven Polish paramedic students were randomized into two groups. Members of both groups were asked to find a phone number on the list and to call a serology laboratory and order 0 Rh (–) red blood cell concentrates for life-saving transfusion. During this activity 14 students (control group) were working without any additional comments from anyone while the leader was urging 13 students (study group). Immediately after this part participants were asked to perform 2-minute chest compressions. Results of chest compression quality were combined with results of our similar previous study (14 participants). The heart rate (HR) of participants was measured before and after the simulation scenario.

Results
The number of errors in when noting down the phone number was higher in the study group (5 vs. 1, p-value = 0.050). Verbal pressure made by a team leader leads to a higher incidence of incorrect chest recoil during compressions (combined groups: 9 vs. 4, p-value = 0.045) and higher percentage increase in the HR during the scenario. Moreover, self-reported stress is correlated negatively with the chest compression rate.

Conclusions
Verbal pressure made by a team leader can potentially reduce the quality of cardiopulmonary resuscitation. It also influences negatively accuracy of a minor (but also crucial) task such as looking for and noting down the phone number.