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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.
The complexity of advanced resuscitation requires a systematic and highly organized set of assessments and treatments that:
In this lesson, you'll learn about how these high-functioning teams operate, including a breakdown of the individual roles and responsibilities for each.
As successful resuscitation rates increase, so do the chances that the patient receives the best chance for a positive, long-term outcome. And for a resuscitation attempt to be successful, all parts must be performed correctly by a high-performing team of highly trained, organized, and communicative healthcare professionals.
Successful high-performance teams take a lot of work and don't just happen by chance. Each individual in a team must have the expertise to perform his or her job and a high-level mastery of their resuscitation skills. And they have to function as one cohesive unit, which requires a focus on communication within the team dynamic.
It doesn't matter if you're a team leader or a supportive team member. All members of a resuscitation team are equal, and each plays a vital role in any team resuscitation scenario.
Pro Tip #1: What does matter is your ability to not only understand your role, but also the roles of others on your team. When you know the roles and responsibilities of each team member, you can anticipate what's coming next, which will increase the ability of the team to communicate, improve the efficiency and performance of the resuscitation, and the chances for the patient to have a positive outcome.
Now that you understand the importance of understanding the roles and responsibilities of each team member, let's look at some common duties and requirements for each.
The roles of each team member must be carried out in a proficient manner based on the skills of each team member and their scope of expertise and practice.
It's vitally important that each member of a resuscitation team:
There are a total of six team member roles and each are critical to the success of the entire team.
Now let's look at the roles and responsibilities of each.
The team leader is required to have a big picture mindset. This includes the following duties:
Every symphony needs a conductor, just as every successful resuscitation team needs a team leader for the group to operate effectively and efficiently.
The team leader has a responsibility to ensure that all team members are playing their individual role to the best of their abilities, and this includes doing things the right way at the right times. But perhaps the biggest responsibility of the team leader centers on his or her ability to communicate clearly and effectively and explain to team members the specifics of resuscitation care, such as:
The team leader assigns the remaining roles to the other team members and makes appropriate treatment decisions based on proper diagnosis and interpretation of the patient's signs and symptoms.
The team leader also provides feedback to the team and assumes any team roles that other team members cannot perform or if some team members are not available.
The team member in charge of compressions should know and follow all the latest recommendations and resuscitation guidelines to maximize their role in basic life support.
Chest compressions are vital when performing CPR. So vital, in fact, that this team member often rotates with another team member (usually the AED/monitor/defibrillator) to combat fatigue.
The best time to switch positions is after five cycles of CPR, or roughly two minutes. However, if you're feeling fatigued, it's better to not wait if the quality of chest compressions has diminished.
The airway manager is in charge of all aspects concerning the patient's airway. This includes opening the airway and maintaining it. And using equipment like a bag valve mask or more advanced airway adjuncts as needed.
As you might have guessed, this team member is in charge of bringing an AED to the scene (unless one is already present) and operating the AED. This team member is also the most likely candidate to share chest compression duties with the compressor.
Pro Tip #2: It's important to understand how important high-quality CPR is to the overall resuscitation effort. The compressions must be performed at the right depth and rate. ACLS begins with basic life support, and that begins with high-quality CPR. If BLS isn't effective, the whole resuscitation process will be ineffective as well.
This team member is in charge of all vascular duties, including:
The time recorder is responsible for keeping a rolling record of time for:
The time recorder also announces to the team when/if a next treatment or more medication is due. If no one person is available to fill the role of time recorder, the team leader will assign these duties to another team member or handle them herself/himself.