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Open Access Dissertation

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First Advisor

Allen Batteau


In this dissertation, I apply the methodology of Conversational Analysis to highlight the informal communication of an emergency room work group with the objective of discovering recurrent patterns of interaction and the inherent relational work necessary to accomplish the safe medical care of patients in a Trauma Code on a level of safety comparative to that of ultra-safe systems as described in the literature of High Reliability Organizations.

The significance of relational elements of interaction on emerging social order is highlighted in processes of attunement, or the diminishing of difference of status in the use of mitigated speech and the co-construction of narrative. The use of mitigated speech and narrative serve as conversational moves of consequence, by which participants seek cooperation, coordination, and collaborate in face-to-face interaction, in a mutually constructed course of action; that is, in providing safe medical care in a highly complex and high risk environment.

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