Dr Amutha Samuel's

Letter of Recommendation





Hi John and Pete.



I just wanted to applaud your initiative with the "Below Ten Thousand" communication tool.


I am a consultant anaesthetist and Medical Director of Simulation at the Geelong Clinical School, Deakin University.


Both positions have given me first hand insight into crisis resource management and team skills training.


In my experience, the "Below Ten Thousand" tool can be used as a verbal trigger to help the team to re-focus on the tasks at hand.


I have personally used it in elective situations to maintain a quiet environment for induction of anaesthesia.


I have also used it in a crisis situation when I have needed a multi-disciplinary team to pay attention to an instruction requiring everyone to be on high alert.


I look forward to watching this initiative develop and I am hopeful that it will be validated as an important communication tool for health care teams of any discipline.



Best wishes,



Dr Amutha Samuel

Co-Medical Director of Simulation & Clinical Skills

Geelong Clinical School, School of Medicine - Deakin University




Postal: Geelong Clinical School – C/O The Geelong Hospital - PO Box 281 - Geelong VIC 3220

Location: 285 Ryrie Street, Geelong 3220.

Geelong Clinical School entry via Kitchener House.

PH: 4215 5100

FAX: 4215 5149

Below Ten Thousand

An international collaboration

Empowering clinicians in safety culture