Now let’s cover high performance team dynamics as it relates to ACLS.
The complexity of advanced resuscitation attempts requires a systematic and highly organized
set of assessments and treatments to take place simultaneously in order to efficiently
and effectively work as a team.
In order for this to happen, it often requires an effective team of highly trained healthcare
professionals to act in an organized communicative and effective manner.
When this happens, the resuscitation rate increases while improving the chances of a
successful patient outcome.
Successful high-performance teams do not happen by chance, they are created.
Not only do these teams have medical expertise and a high level of mastery of resuscitation
skills, they are able to demonstrate effective treatments while utilizing effective communication.
In a high performance resuscitation team, there are no members that are better than
another.
Whether one team member is filling the role of a team leader or a supportive team member,
all of you are extremely important and all play a special role in successful resuscitation
efforts.
So whether you’re a team leader or a team member during a resuscitation attempt, all
of you should understand not just your particular role but the roles of the other resuscitation
team members as well.
This will help each team member anticipate what may be expected next and will help them
perform their role with efficiency and communicate well as a vital member of a high-performance
resuscitation team.
Now let’s take a look at what each of these roles are and what requirements are for that
role.
The team leader is a role that requires a “Big Picture” mindset and it has many
different moving parts.
The team leader: keeps the resuscitation team organized and on track.
They Monitor the team’s performance and accuracy while backing up team members when
needed.
They train and coach while facilitating understanding and they focus on comprehensive patient care.
You see, every symphony needs a conductor and every high performance resuscitation team
needs a person to fill the role of team leader if the group is going to operate efficiently
and effectively.
It’s the responsibility of the team leader to ensure that all team members are doing
everything that should be done in the right way and at the right time.
A team leader should be able to explain why the following is important, like, pushing
hard and fast in the center of the chest, ensuring complete chest recoil, minimizing
interruptions in chest compressions, and avoiding excessive ventilation.
The roles of team members must be carried out in a proficient manner based on the skills
that those team members are authorized to do because of their scope of practice.
It’s vitally important that the resuscitation team understand and are: clear about role
assignments, they’re prepared to fulfill their role and responsibilities, that they
have working knowledge regarding algorithms, and that they have had sufficient practice
in resuscitation skills, and that they are committed to the success of the ACLS resuscitation.
There are a total of 6 team member roles and each of these is roles is critical to the
successful delivery of high performance resuscitation techniques.
You have the team leader, the person who is the compressor, the person who manages the
airway.
You have the individual overseeing AED/monitoring and defibrillation while we have an IV and
an IO individual who also administers medications and delivers those medications appropriately
all the time while we have the last team member which is the timer or recorder.
Now let’s break each of these roles out and speak briefly about what each role is
expected to do.
We talked a bit about the team leader in a vague overview kind of a way, but now we’re
going to speak more specifically about what they’re supposed to do as part of the team.
The team leader is the one who when necessary, assigns the remaining needed roles to appropriate
team members.
They must make appropriate treatment decisions based on proper diagnosis and interpretation
of the patient’s signs and symptoms including advanced assessment like 12 lead EKGs, Laboratory
reports and overall appearance of the patient.
It’s the team leader who has the responsibility to give feedback to the team and they assume
the roles of those who are not available or assignable.
A compressor assess the patient and performs CPR according to the latest and most effective
recommendations and resuscitation guidelines.
This person may alternate with the AED/Monitor/Defibrillator every 5 cycles or every two minutes.
This can occur sooner if the compressor suffers from fatigue.
Now the person in charge of airway, they have to open the airway, but also maintain the
airway.
They work diligently to give proper bag-mask ventilation and they are also responsible
for inserting both basic and advanced airway adjuncts as deemed appropriate.
The next person is called the AED/Monitor Defibrillator.
This team member may be the person who brings and operates the AED/monitor or defibrillator.
And in certain cases they may already find that that monitor/defibrillator is already
there, but they may have to moved it or slant it in such a way that the Team Leader along
with most of the other team members are able to see it clearly.
This person can change positions with the Compressor every 5 cycles or approximately
every 2 minutes or at which time where the Compressor is showing signs of fatigue and
needs to change out.
It’s important that we realize that the CPR being delivered needs to be effective.
That means compressions need to be deep enough, and fast enough, because if the BLS is not
effective, it’s going to then make the whole ACLS resuscitation ineffective as well.
The next person is the IV/IO Medication person.
The vascular access and medication role is an Advanced Cardiac Life Support role.
It not only initiates vascular access using whatever technique required for successful
and patient access, it also administers medications with accuracy and when appropriate.
The next person is called the Time/Recorder.
The Timer/Recorder team member records the time of interventions and medications and
then announces when the next treatment is due.
They record the frequency and duration of interruptions in compressions and communicates
these to the team leader and the entire team.