Book Reviews Operations

Saving Lives with Checklists

This is a guest post by Timothy Clemans. If you want to guest post on this blog, check out the guidelines here.

Soon after take off two pilots who had never flown together were faced with a nightmare situation. Their airplane with 155 people on board was falling out of the sky. And it wasn’t falling out of the sky over the ocean or farm country but over densely populated New York City. US Airways Flight 1549 should have ended in disaster. Instead Flight 1549 is one of the most remarkable success stories in the history of aviation.

The successful landing of Flight 1549 in the Hudson River is due to a number of factors including two expert pilots, luck, and checklists. Checklists brought order to a chaotic nightmare. In my opinion without checklists the 20,000 combined fly hours of captain Chesley Sullenberger and first officer Jeffrey Skiles wouldn’t have been enough. When three minutes mean the difference between life and death there’s no time for panic. There’s no time to decide what to do with the engines. There’s no time for debate. There’s only time to think about where to land. Checklists made that important decision-making possible. By having a checklist for all the critical things that had to be completed Sullenberger was able to concentrate on deciding where to land.

Checklists and Health Care

Checklists don’t just save lives at 50,000 feet. Checklists are used to reduce deadly hospital errors. World renowned surgeon and author Atul Gawande is so fascinated by checklists he wrote The Checklist Manifesto: How to Get Things Done Right. His thesis is every profession could be more effective if they used checklists. For example, EMS professionals could use checklists as they prepare and administer medications for medical emergencies like asthma and anaphylaxis. Wake County EMS has a checklist for cardiac arrest patients.

According to Dr. Gawande a good checklist has these traits:*

  • Precise
  • To the point
  • Easy-to-use
  • Only a reminder of critical steps
  • Practical

Do you use checklists for certain types of incidents or patients? Is a protocol different from a checklist? Share your thoughts in the comments area.

* From page 120 of the Checklist Manifesto

By Greg Friese

Greg Friese, Stevens Point, Wisconsin, is an author, educator, paramedic, and marathon runner.

Greg was the co-host of the award winning EMSEduCast podcast, the only podcast by and for EMS educators. Greg has written for,, Wilderness Medical Associates, JEMS Magazine, and EMS World Magazine, and the NAEMSE Educator Newsletter.