Resuscitation Triangle Team Roles in ACLS

In a successful team, each member knows and understands their roles and responsibilities and how they interact to accomplish the goal. Whether it is a work group, a sports team, or something as vital as an ACLS clinical team, outcomes depend on roles working well together. This dynamic does not come by accident, but with careful planning.

The ACLS resuscitation triangle is one of the most crucial models for teams, and the structure features six roles, with three key roles positioned around the patient’s body in a triangle. Each role has a unique job in ACLS and similar life-support scenarios. Read the blog to explore resuscitation triangle roles in a high performance team.

Effective high-performance team dynamics

A team is effective when its performance produces something that is greater than the sum of its parts. It is a group that

• Anticipates each other’s needs
• Performs constructive criticism, seeking to continually improve.
• Recognizes each other’s strengths and weaknesses to complement each other for better performance.

Communicate continually

Whether an ACLS team consists of two people or ten, the basic roles and structure are adaptable. In an ACLS resuscitation triangle, it is crucial to maintain ACLS team roles with a robust structure, and clear communication is the powerful key to success that carries all ACLS scenarios and creates the best outcomes.

Resuscitation triangle: roles and responsibilities

An essential aspect of the ACLS team is that its structure revolves around a triangle. Nevertheless, it may incorporate several roles and tasks according to the resources and people that are at their disposal.

There are six defined roles within the high-performing ACLS team, divided into two categories: the roles of members in resuscitation triangle leadership, including primary practitioners.

The roles are:

• Resuscitation triangle roles
• Compressor
• AED Monitor or Defibrillator
• Airway Role
• Leadership Roles
• Team leader
• IV/IO medications
• Timer/recorder

Team leader

Every resuscitation team must have a defined leader. It helps designate the leader ahead of time, whether the role is pre-defined or defined by a shift plan.

Role and responsibilities:

• Assigning roles to team members
• Provide feedback to the team 
• Making treatment decisions

Compressor

This critical role is non-negotiable. If the team has two or three people, then this person may alternate with the AED/defibrillator role and may take over the responsibilities of a team leader.

Role responsibilities:

• Assesses the patient.
• Carries out five compression cycles.
• Alternates with the AED/defibrillator every five cycles or after about 2 minutes.

 

1. AED, Monitor, or Defibrillator
   This critical triangular role is also undoubtedly crucial as well. If the resuscitation scene does not have an AED or defibrillator, the scene is considered a BLS rather than any other category of ACLS.

Role responsibilities:

• To provide the AED, or defibrillator/monitor, and operate it.
• Alternates with the compressor every fifth cycle or two minutes (or when becoming fatigued).

 

1. Airway Role

The airway function is critically essential and must always be given priority. You can dislodge a replacement airway during CPR, and even after putting in place an artificial one, bringing it down is easier. Constant vigilance and care of the airway are key.

Role responsibilities:

• Provides opening to the airway, thus positioning a patient could result in an easy opening of a patient’s path towards breathing. 
• Offers bag-mask ventilation.
• When appropriate, insert an adjunct airway.
• Monitors the correct placement of the airway and airway effectiveness.
   

1. IV/IO Medications

This crucial role may be delegated to others on teams of five or fewer people.

Role responsibilities:

• Initiates IV/IO access.
• Administers medications as per the team leader and ACLS algorithm.
• Make certain IV/IO access remains patent.

 

1. Timer/Recorder

Documentation and accounts are useful for the decision process. It also plays a crucial role in the analysis of the episode for improvement opportunities during debriefing.

Role responsibilities: 

• Delivers interventions and medication timing (states when next will be due).
• Documents how long and frequent interruptions in compressions occur (see section on Measures below).
• Passes this information on to the rest of the team, including the leader.

When role clarity is poor, performance suffers significantly. It is possible to have chaos where everyone wants to assist others but is in a state of disorder. This is why it becomes very easy for tasks to be repeated.

Team dynamics

With team dynamics being the ‘rules of the game’, it makes the team work effectively.

Know your limitations

Everyone must know their limitations, and the team leader must be familiar with effective assignments and decision-making. A high-pressure situation is not the time to practice new skills. Hence, if a team member needs help, they must speak up. This is not a weakness, but rather effective teamwork.

Knowledge Sharing

Sharing information is a crucial component of the team, and any error can help avoid fixation errors. This traps a person into selective thinking. It is crucial to talk as a team, and questioning everything has been ineffective.

Conclusion

Thus in this blog, resuscitation triangle roles in a high performance team, we can conclude that every ACLS resuscitation team must have highly trained clinicians, but not everyone has the right communication and skills to ensure optimal performance. This is why it is crucial to learn the roles and team dynamics that have been proven to be most effective. After each practice, the team leader should walk back through the scenario and assess not just clinical performance but also communication and leadership.