Teamwork is just as important as knowing what to do during a cardiac arrest.

Successful team dynamics are critical during a resuscitation attempt. The interaction among the team has a profound impact on the effectiveness of each member’s individual performance as well as the patient’s survival. The better and more efficiently a team works the better the potential outcome for the patient.

For a resuscitation to be successful it is important that each member understands not just what to do during a resuscitation attempt but how to communicate and perform as an effective team regardless of their role.

Successful resuscitation teams not only have medical expertise and mastery of resuscitation skills they also practice good communication skills and adhere to the key elements of effective team dynamics in the most efficient way possible.

The essential elements of team dynamics can be grouped into three main categories, roles, what to communicate and how to communicate.

Clear roles and responsibilities should be established immediately. All members should know their function and responsibilities during a resuscitation attempt for the team to function smoothly and efficiently. The delegated team leader should clearly define and delegate tasks according to each team member’s area of competence. Every team member should be aware of their own limitations and the team leader should be aware of them as well.

Team members should ask for assistance and advice early, not when the situation deteriorates. Should a team member or leader need to correct actions that are either incorrect or inappropriate it should be conducted in a tactful manner especially if it needs to be made prior to the colleague makes the mistake whether it be a drug, dosage or intervention.

Knowledge sharing is a critical component of effective team performance. Team leaders should ask for good ideas for patient management and frequently ask for observations from team members about any possible oversights.

Summarising information out loud assists in the maintenance of an ongoing record of treatment and acts to evaluate the patient’s status, interventions performed and the team’s progress within the algorithm of care. This technique can also help the team members respond to the patient’s changing condition.

Closed loop communication is important for both the team leader and team members. Team leader’s orders should be confirmed that they heard and understood the order. The team leader should call people by their names and if possible, make eye contact to ensure that the team member has understood the order before assigning additional tasks. The team member should tell the team leader when the order has been completed the intervention. Everyone on the team should use clear messages using clear and concise language to prevent misunderstandings. The tone of voice should be loud enough to be understood but also calm and confident in order to keep all team members focused on the task at hand.

All team members should display mutual respect and a professional attitude to other team members, regardless of their personal expertise or training. Emotions can run high during a resuscitation attempt therefore it is especially important that the team leader speaks in a friendly, controlled voice and avoids shouting or aggression.

Not only is it important to know what to do during a cardiac arrest but it is just as important to know how to work as a team.

Debriefing as a team is an important component of every resuscitation attempt. Performing this during and after an attempt helps individual team members perform better and more efficiently. It may also bring system strengths and deficiencies to light.

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