Uneasy working and uncertainties facing: the power of intuition in emergency decision making. Neuro-psychobiological correlates

摘要

The influence of complex cognitive processes on the decision-making is an extremely important factor in the field of emergency medicine, as it is closely related to the environmental, cultural and functional characteristics of the system. The article analyses the group, organisational and emotive aspects that interfere with the effectiveness of emergency staff, the role of intuition in analytical operating models, and the interrelations with the areas (cortical and subcortical) of the brain involved in decisional conflict situations. There are members of the emergency teams who are the organisers of the process, and who monitor it; they share the difficulty to act, as well as procedures, and guarantee the “local knowledge”, which often deals with limited information, emergencies and unexpected events in the clinic. The various professional roles involved in the decision-making process itself use diagnostic instruments and personal experience, which often makes use of a psychic function, namely, intuition. Intuition is an unconscious process that allows access to a large number of models, information, and data learnt and stored in the long-term memory, without the need for any clear conscious cognitive effort. In this context, the characteristics of intuition and its function and reliability are investigated, as are the value of heuristics in making decisions and its role in different cognitive styles. Improving the outcomes of the decision-making process and the levels of safety in an emergency requires shared rules and operating procedures, knowledge of the situation, awareness of the human tendency to make cognitive and emotional distortions, and an ability to blend, safely, intuitive cognitive and analytical styles, depending on the task at hand.