Team dynamics are an important aspect when there a multiple rescuers trying to save a life. If it improves your chances of saving a life, accept all the help you can get.
Resuscitation times are tense, which might lead to emotions getting out of hand. So, it’s important to be calm and composed.
During a code, there are many people around watching all the rescuers perform. If you yell/shout at someone, their ego can be hurt and situations can deteriorate. Be tactful in dealing with team members. Effective communication is the glue that can make the team stick together. Let’s consider the following things to keep in mind when you are part of a team or leading a team.
Roles and responsibilities
When there are many people in a team, it’s important to let them know what to do when the need arises.
Without a clear assigned role, multiple team members may rush to do one thing and forget to do another task, which might go unnoticed. Before you start a resuscitation, always assign a “clear role” to each team member.
As a team member, if you are given a role you are not competent enough at, you should let the team lead know and ask for another role. Do not take a new role by yourself.
For example, if you have a shoulder dislocation problem, and your team lead asks you to perform compressions, tell him about it and ask for another role. This is known as “knowing your limitations“. Knowing what you are capable of doing and what you are not good at.
Assigning roles – suggestions
Based on the number of rescuers, following roles may be taken up. (Compressor – C; Ventilations – V; AED – A; Team lead – T; Recorder – R; Medications – M [if feasible]) (= means alternate, + means 2 roles)
– Single rescuer – C/V
– Two rescuers – C=V+A. V role rescuer can operate AED.
– Three rescuers – C=V/A+T
During ACLS scenarios, it’s important to have roles of medication and recording.
– Four rescuers – C=V(alternate)/A+M/T+R
– Five rescuers – V/C=A/T/R+M
– Six rescuers – V/C=A/R/T/M
These are just suggestions. You may modify as per your needs.
Clear language and polite manners are the key.
A team lead should be in control of his voice, so that the team member doesn’t feel like he’s being bossed upon.
As a team member, you must follow a closed loop communication to prevent errors in following orders. When a team lead orders you to “load 1mg of adrenaline”, you should respond by saying “am loading 1mg of adrenaline”.
What if you think the team lead gave a wrong dosage and you know the right dose? You may correct a colleague politely.
When you hear your lead say “Give 0.5mg of epinephrine” during a cardiac arrest, you may correct the lead saying “I have heard an order of 0.5mg of epinephrine but i think the correct dose is 1mg.” And the lead may respond by saying “Thank you, you are correct”. This is sharing knowledge/ constructive criticism.
If you are a team member and you notice another member not doing his role effectively, you may suggest him to correct.
Say if someone’s compressions are slow, you may tell them “Let’s maintain a rate of 100-120/min”.
Things to avoid:
– Do not push a colleague and do his role as your colleague is not doing it well.
– Do not yell at another team member. Do not be mean or insulting to another member.
– Do not get offended when you are corrected.
– Do not respond with incomplete loop of communication to orders received. Repeat the entire order.
I’ll do it,
Am on it,
etc are poor ways of communication.