Situational Awareness

Situational awareness refers to the degree to which one's perception of a situation matches reality. In the context of crisis management, where the phrase is most often used, situational awareness includes awareness of fatigue and stress among team members (including oneself), environmental threats to safety, appropriate immediate goals, and the deteriorating status of the crisis (or patient). Failure to maintain situational awareness can result in various problems that compound the crisis. For instance, during a resuscitation, an individual or entire team may focus on a particular task (a difficult central line insertion or a particular medication to administer, for example). Fixation on this problem can result in loss of situational awareness to the point that steps are not taken to address immediately life-threatening problems such as respiratory failure or a pulseless rhythm. In this context, maintaining situational awareness might be seen as equivalent to keeping the big picture in mind. Alternatively, in assigning tasks in a crisis, the leader may ignore signals from a team member, which may result in escalating anxiety for the team member, failure to perform the assigned task, or further patient deterioration.