Trust Centric Teamwork

Trust Centric Teamwork

The Coastal Redwood is the tallest tree on the planet. Standing as high as 380 feet, this tree is more than twice as tall as the Statue of Liberty. The wood from one of these giants (nearly 250,000 board feet of lumber) could build 40 homes. Astounding!

But what is more impressive about these behemoths is how they get so big and strong. It’s all about teamwork. Though the Redwoods have some of the shallowest root systems, their inter-connectedness provides tremendous strength as they hold onto each other.

We, like the Redwood, should avoid the toxicity of isolation and learn to grow more connected. Optimum strength will never be found in one person but in a team of people working together.

Unfortunately, COVID increased our propensity for self-sufficiency. More than 60% of Americans say they feel lonely. Not only are we achieving below our potential, we are hurting ourselves. The health detriments of loneliness are worse than smoking 15 cigarettes per day. The US Surgeon General[1] is calling this an epidemic. Our culture is dying of isolation and loneliness. We need each other!

As a former collegiate football player, NFL physician, and ER doctor, I’ve seen highly effective teams and highly ineffective teams. I believe that trust is the secret to maximizing group effectiveness. When we trust each other, we are interconnected like the roots of the mighty Redwood tree. We are linked together in a way that unlocks our collective potential. Alone and isolated, we could never achieve such magnificent heights as when we share the power of trust.


The Brain:
Working against Teamwork

When our amygdala is stimulated, it hijacks the rest of the brain, preventing rational thought. These animal instincts are almost always counterproductive to teamwork. It requires intentional thought by the prefrontal cortex to make sense of these neural inputs to the amygdala.

Take a Brain Break with Axene CE

Management Pearls: The Nursing Home Patient

Our elderly population is growing. Today more than 50 million Americans are over 65 years of age. This number is projected to double over the next 25 years[2]. As more and more of these individuals have no extended family to take care of them, their dependence upon the EMS community grows.

What should we be looking for when we treat the elderly? At Axene CE we have focused our efforts and resources on four potential killers.

Stroke, Trauma, Sepsis and the common chief complaint of Altered Mental Status (which could be all three of the aforementioned killers)


01 Stroke

The key is early identification. Every minute we delay treatment our patients can potentially lose 7.5 miles of myelinated nerves! If you suspect this killer, do your stroke assessment and transfer promptly to the appropriate facility. Get the LKN the last time the patient was at their baseline normal. This is crucial to ER management!

02 Trauma

Falls are extremely common in the elderly for a myriad of reasons. These falls can cause head injuries, spine injuries, and musculoskeletal injuries among many others. We must have a high degree of suspicion for any elderly patient who has fallen.

03 Advanced Sepsis

Advanced sepsis, or MODS (multi-organ dysfunction syndrome) can carry a 30% mortality rate.

HR >90
T >38°C or <36°C
RR >/=22

EtCO2 < 25 = Lactate > 4

04 Altered Mental Status

An acronym to help with the evaluation of Altered Mental Status [AMS]: BUS STOP CAFE

  • B – Blood sugar
  • U – Uremia
  • S – Stroke
  • S – Sepsis
  • T – Trauma
  • O – Oxygen/Overdose
  • P – Poisonings
  • C – Carbon Dioxide
  • A – Alcohol
  • F – Fever
  • E – Electrolytes