The team leader role is arguably the most important role of the trauma team, and a role that shouldn’t be undertaken lightly. Prior to the reception of a trauma patient, the team leader role needs to be clearly allocated, so that all team members are aware of who is defined as the team leader. The position does not need to be allocated to the person with the most experience, but it should be someone with knowledge of the treatment of critically ill trauma patients.

The individual should possess a strong set of communication skills and an ability to create and lead a cohesive team ⁽¹⁰⁾.Team leadership is defined as the ability to direct and coordinate the activities for all team members, assess team performance, work with the team to develop collective knowledge, skills, and abilities, motivate team members, plan, and organize as well as establish a positive working atmosphere. ^{(8, 9)}.

A good team leader will support and encourage the team, seek advice from other expert members of the team and allow their instructions to be questioned. Members of the team must respect their authority and be prepared to carry out the instructions of the leader. The team leader may not always be correct, but following a robust and respectful team discussion the leader must make the final decision.

Strong leadership will provide the members of the team with a sense that the best possible outcome was achieved, even if the patient does not recover. In contrast, poor leadership may induce frustration and anxiety, having a negative impact on the team and its future performance ⁽¹¹⁾.

Monitoring simultaneous activities is hard, and as team leader it is necessary to have a dynamic mental model of what is occurring with each element of the resuscitation, what rate the assessment and management of each component (A/B/C/D) is proceeding at, and how the dynamic changes in each component are affecting the other elements of the resuscitation.

What is situational awareness?

Situational awareness can be defined as itself the perception of environmental elements within time and space, the understanding and processing of their meaning and the projection of their status in the near future. Although, in a practical sense situational awareness (SA) can be viewed as ‘being aware of what is going on around you, being able to see the bigger picture and reacting appropriately to it without getting caught up in the minutiae’.

When managing complex situations with multiple competing tasks (e.g., the multi-trauma patient) it is possible to become fixated on one problem. This often means that by focusing on a single part of the situation, other critical elements may deteriorate around you without recognition.

It is important that the team leader and all members of the team maintain situational awareness to avoid increasing the risk of negative patient outcomes and improving patient safety ⁽¹²⁾. There are a few mechanisms to improve SA, with the current evidence suggesting real time simulation, reflective feedback from simulations and actual situations, as well as continued professional development in non-technical skills ^{(12, 13)}.