The article discusses leadership enactment in medical emergencies. We draw on video recordings of simulated obstetric emergencies and investigate how senior clinicians ‘do being’ the leader discursively in the spatiomaterial context of the emergency room. We take an interactional analysis approach, combining conversation analysis and interactional sociolinguistics and look specifically into the ways in which professional roles do interactional control using directives and questions in the material space of the obstetric room. We discuss this interactional performance in relation to the clinical performance of the teams. Our analysis shows that leadership in medical emergencies is multimodally achieved; professionals draw on discursive strategies, the affordances of material space, body and gaze orientation, which build on each other and converge in indexing leadership. Our findings highlight the situated nature of negotiating responsibility, illustrating that leadership in our context is claimed, projected and resisted discursively. We provide a typology of the functions of questions in the emergency encounter, and close the article by foregrounding the implications of our study and providing directions for further research.

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This article is concerned with the in situ negotiation of epistemic primacy in the context of medical emergencies. It investigates the mobilisation of questions and positioning in the material space as mechanisms for claiming control and for co-constructing epistemic authority. We bring together two high-risk, high-pressure emergency contexts – obstetrics and major trauma – and show the patterns that emerged from a bottom-up interactional sociolinguistic analysis of the data. We draw on a corpus of approximately 400 questions from a sample of ten teams; 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. We discuss the typology of questions that emerged from our data on a spectrum from a not knowing (K-) to a knowing (K+) status. Our analysis demonstrates consistent patterns in displays of epistemic primacy, with team leaders raising most of the questions indicating a K+ status across contexts. Further, we show that verbal claims of epistemic primacy are conditioned upon team leaders’ positioning at specific material zones of the emergency room as an integral part of doing their role.

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