Paramedic Teamwork Breakdown: Driscoll

What?

We attended a time-critical incident alongside a second crew. No one clearly took or was allocated the lead role. In the first minutes, both crews began overlapping tasks - two people prepared equipment for the same intervention while another key preparation was missed entirely, causing a short but real delay when it was needed. Communication was fragmented: instructions were spoken into the general noise rather than directed to a named person, and at one point two conflicting plans were being enacted simultaneously. The patient was ultimately treated and conveyed appropriately, but the scene felt chaotic, and both crews knew it.

So what?

My initial reading - that the other crew had 'taken over' - softened on reflection. The truth is that I was the senior clinician on scene and I did not claim the leadership role, partly because the other crew arrived first and partly because asserting myself felt awkward. That hesitation created a vacuum, and every subsequent problem flowed from it: nobody was allocating tasks, so tasks allocated themselves badly. The communication failures were textbook - undirected instructions are dropped instructions, which is exactly why closed-loop communication exists. What struck me most is that everyone on that scene was individually competent; the failure was entirely in the structure we didn't build in the first sixty seconds.

Now what?

I have made three commitments. On arrival at any multi-crew scene, I will establish who is leading within the first minute - claiming the role explicitly if it falls to me, or naming and supporting whoever holds it. I will direct all critical instructions to a named person and request read-back. And I initiated an informal debrief with the other crew, which we held a few days later; it was constructive, both crews recognised the same failures, and we have agreed to raise scene-leadership allocation as a topic for station training. I am also reading our service's guidance on scene management to sharpen the framework I carry into the next chaotic job.