ABSTRACT

This chapter argues that decision-making in emergency medical services (EMS) can be improved through interventions targeting the immediate precursors of good decision-making. Situation awareness (SA), the degree to which one has actionable, goal-directed knowledge of elements in the prehospital environment, provides a metric of precursors of effective decision-making in EMS. Across domains, SA has been most effectively described as a predictor of quality decision-making in sociotechnical systems. Sociotechnical systems are a way of understanding and improving systems at the large scale, macroergonomic level. The chapter summarizes the state of the art in SA theory and practice as they apply to EMS, and illustrates how SA fills a gap in our understanding of how individual human performance affects patient care. It concludes with recommendations for the measurement of SA, the use of SA as a performance metric, and methods to predict the impact of interventions on SA.