3.2 Team-Based Resuscitation in a Clinical Setting

When additional rescuers arrive, CPR transitions from a two-rescuer approach to a fully coordinated team-based resuscitation. This allows for greater efficiency, reduced rescuer fatigue, and improved patient outcomes.

Why Team-Based CPR Improves Outcomes

• Clear role assignments: Each rescuer focuses on a specific task, minimizing confusion.
• More efficient compressions and ventilations: Dedicated roles ensure better coordination and timing.
• Reduces rescuer fatigue: With more responders, rescuers can rotate tasks while maintaining high-quality CPR.

Key Roles in Team-Based Resuscitation

A well-functioning team operates like a pit crew, with each member assigned a critical role:

• Compressor: Performs high-quality chest compressions and switches every 2 minutes to prevent fatigue.
• Airway Manager: Maintains an open airway and delivers breaths via bag-mask or advanced airway device.
• AED/Monitor Operator: Attaches defibrillator pads, analyzes rhythm, and delivers shocks as indicated.
• IV/Medication Provider: Establishes vascular access and administers emergency drugs (if within scope of practice).
• Team Leader: Oversees the resuscitation, assigns roles, and ensures effective communication and coordination.

Transitioning from Two-Rescuer to Team-Based CPR

1. New team members quickly identify and assume their assigned roles.
2. The initial responder provides a brief status update to the team leader.
3. Fresh rescuers take over compressions and airway management to relieve fatigue.
4. Rhythm checks and defibrillation occur without delaying compressions.

Effective Team Coordination: The Pit Crew Model

High-performance teams follow the Pit Crew Model, where each person has a defined responsibility and all actions are executed simultaneously, not sequentially.

Example of a Well-Coordinated Resuscitation Team

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Example of a Well-Coordinated Resuscitation Team

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• Compressor: Delivers continuous compressions, rotating every 2 minutes.
• Airway Manager: Provides ventilations with a bag-mask or assists with advanced airway placement.
• AED/Monitor Operator: Attaches pads, interprets rhythm, and performs defibrillation when indicated.
• IV/Medication Provider: Secures IV/IO access and administers medications such as epinephrine per protocol.
• Team Leader: Directs the code, ensures accurate execution of interventions, and communicates with external teams as needed.

Common Pitfalls in Team-Based CPR (And How to Avoid Them)

• Unclear role assignments → Assign roles immediately upon team arrival.
• Poor communication → Use closed-loop communication (covered in the next lesson).
• Fatigue affecting performance → Rotate roles regularly to maintain performance.

When executed correctly, team-based resuscitation is highly effective and leads to better patient outcomes. Next, we’ll cover how to use closed-loop communication to enhance teamwork and reduce errors.