‘Do you want me to take over?’ ; displaying epistemic primacy in medical emergencies

This paper reports on the ways in which healthcare professionals display and negotiate epistemic primacy through the use of questions and positioning in the material space in the context of medical emergencies. We bring together two high-risk, high-pressure emergency contexts, obstetrics and major trauma, and explore the nuances of ad hoc multidisciplinary teams. Taking an Interactional Sociolinguistics approach, we zoom in on the role of the institutionally defined team leader while special attention is also paid to the ways in which institutional power asymmetries are negotiated across the team in leadership enactment. Drawing on eight different teams from a larger sample of twenty, we present the emerged typology of questions in our data and position those in a spectrum from a not knowing (K-) to a knowing (K+) status. Our analysis illustrates consistent patterns in displays of epistemic primacy, with team leaders raising most of the questions indicating a K+ status across contexts. We argue that verbal claims of epistemic primacy are conditioned upon team leaders’ positioning at certain material zones of the emergency room as integral part of doing their role. For the last part of our paper, we turn to the ways epistemic primacy is locally challenged and/or negotiated and alternative epistemic rights are claimed by more junior professional roles