Agile Resuscitation

One of the things I’ve always enjoyed while working with clients is finding parallels that relate Agile to everyday life.  When you stop to think about it, life is largely an Agile process in a lot of different ways.  Think of one proven thought model – the OODA loop.  OODA stands for Observe, Orient, Decide, Act.  Humans have a tendency to follow those steps in a lot of interactions.  We watch what’s going on, decide what to do about it, then act upon it.  Then, that process repeats.  It’s iterative.  It’s natural.

One parallel that I particularly enjoy exploring is the Agile nature of medical science.  Think about that for a minute.  What do doctors and other medical professionals do?  They observe symptoms.  They decide on a course of treatment.  They act on that course of treatment.  And then, after a period of time, the doctor will re-evaluate the patient’s response to treatment. 

So – there’s the parallel.  Plan, act, retrospect, iterate.

Let’s take a look at an even more rigid, iterative medical process: Resuscitation.  This one is near and dear to me – along with being an Agile coach, I’m also a paramedic – so I get to see this particular process in action often.

When a patient’s heart stops, there is limited time to get it started again, and there’s a rigorous, tested process to do so.  Not surprisingly, the rescucitative process is arranged into iterations.  First, we start CPR, followed by analyzing the heart rhythm, giving appropriate drugs, and providing defibrillation.  This is all done in two minute cycles – our miniature medical iteration.

Every two minutes, we stop CPR, check for a pulse, and analyze the heart rhythm.  In that moment, we’re reviewing the previous “Sprint” – did what we did work?  And just like that, we’re into planning.  What do we need to do this time around?

This process repeats until one of two things happens: The heart is restarted, or the patient dies.

Also built into the process is a continual retrospective process.  A provider is always thinking about what we call the “H’s and T’s” – a mnemonic that tells us what things we may have missed that may have either caused the cardiac arrest or is causing it to continue.  There are 6 H and 5 T words – Hypothermia, Hyper/Hypokalemia (High or low potassium), Hypoxia, Hydrogen Ion (Acid/Base Imbalance), Hypovolemia, and Hypoglycemia.  For the T’s, we have Toxins, Thrombus, Tension Pneumothorax, Tamponade, and Trauma.  By evaluating each of these things continually, or at least at the end of each two minute iteration, we avoid missing any reversible causes.

What parallels can you find in your daily life or hobbies?  I bet there’s more than you’d ever imagine!