1. EFFECTIVE RESUSCITATION
AND TEAM DYNAMICS
PRESENTOR: DR PRAKASH MAN SHAH
MODERATORS: DR BASANT RAI
DR SUBASH BASNET
DR RAMESH DAS
2. Objectives
• Understand the role of each resuscitation team member and
team leader.
• Recognize the importance of teamwork during resuscitation
effort.
• Assign essential task to team members while working as the
team leader of a resuscitation effort.
• Reviewing your performance as a team leader or team
member during a post event debriefing.
3. ROLE OF TEAM LEADER AND TEAM MEMBER
TEAM LEADER
• Organizes the group
• Monitors individual performance
• Provides support
• Models excellent team behavior
• Trains and coaches
• Facilitates understanding
• Focuses on comprehensive patient care
4. • TEAM MEMBER
• Clear about role assignments
• Prepared to fulfill role responsibilities
• Well practiced in resuscitation skills
• Knowledgeable about the algorithms
• Committed to success
5. ELEMENTS OF EFFECTIVE RESUSCITATION
TEAM DYNAMICS
• Close-Loop communication
1. The team leader gives a message, order or assignment to a
team member
2. Team leader confirms the message was heard and understood
by receiving a clear response and good eye contact from team
member
3. Team leader listens for confirmation from the team member
that the task was performed before assigning another task.
6.
7. CLEAR MESSAGES
• TEAM LEADER
• Provide clear messages and orders
• Encourage team members to speak clearly and distinctly
• Request clarification of any ambiguous message
• Speak in a calm and normal tone of voice
8. • Team members
• Repeat the prescription medication order
• Question an order if it is ambiguous or not understood
9. CLEAR ROLES AND RESPONSIBILITIES
• TEAM LEADER
• Define all roles of team member in the clinical setting.
• Assign roles and responsibilities according to competence
of each member.
• Distribute assignments evenly.
10. • TEAM MEMBERS
• Perform tasks that are clearly defined and appropriately
to the level of competence.
• Inform team leader if the role or task given is too difficult
based on experience.
• Be prepared to assist with tasks as needed.
12. KNOWING LIMITATIONS
• TEAM LEADERS AND MEMBERS
• Call for assistance early.
• Ask other team member to help if one team member is
having difficulty.
• Seek advice from more experienced personnel if patient’s
condition worsens.
13. KNOWLEDGE SHARING
• TEAM LEADER
• Encourage an environment of sharing and ask for
suggestions
• Ask opinions of team members regarding reversible cause
of arrest and factors that may be limiting effectiveness.
• Ask if anything has been overlooked.
• Consider all clinical signs that are relevant to treatment.
14. • TEAM MEMBER
• Share information with other team member.
• Try to identify factors that may limiting the effectiveness
of resuscitation effort.
15. CONSTRUCTIVE INTERVENTIONS
• TEAM LEADER
• Intervene if a team member is performing an incorrect
step.
• Take corrective actions to ensure team members are
performing tasks in appropriate sequence.
• Reassign a team member if that team member is not able
to perform the task.
16. • TEAM MEMBER
• Ask the team member or leader if u think that a team
member is about to make a mistake.
• Suggest an alternative drug, drug dose or therapy if u
observe an error.
17. REEVALUATION AND SUMMARISING
• TEAM LEADER
• Ask for suggestions from team member regarding
differential diagnosis and factors contributing to
ineffective resuscitation.
• Frequently review drugs and treatment given.
• Change the treatment strategy when new patient
information or patient response present.
• Inform arriving personnel of patient’s plan and further
actions.
18. • TEAM MEMBER
• Draw attention to significant change in patient’s
condition and increase monitoring.
19. MUTUAL RESPECT
• TEAM LEADER
• Speak in a friendly, controlled tone of voice.
• Provide positive feedback to team members.
• Intervene if team members begin to raise voice or speak
disrespectfully.
• Remember that all team members are performing well
20. • TEAM MEMBER
• Speak in a friendly, controlled tone of voice.
• Remember that the team leader and all team member
are trying to perform well.
Teamwork divides the tasks while multiplying the chances of a successful resuscitation
Successful resuscitation teams not only have medical expertise and mastery of resuscitation skills, but they also demonstrate effective communication and team dynamics.
This Part discusses the importance of team roles, behaviors of effective team leaders and team members, and elements of effective resuscitation team dynamics
The role of the team leader is multifaceted
The role of the team leader is similar to that of an orchestra conductor directing individual musicians. Like a conductor, the team leader does not play the instruments but instead knows how each member of the orchestra fits into the overall music.
Team members must be proficient in pertorming the skills authorized by their scope of practice
Await confirmation that the previ ous task has been completed (eg, "Vascular access in place") before assigning another task.
Confirm receipt of a completed assignment (eg, "Good, now that the IV is in, give 1 mg of epinephrine").
"Did the patient get IV propofol so I can proceed with lhe cardioversion?" "No, I thought you said to give him propranolol.“
Yelling or shouting can impair effective team interaction. Only 1 person should be talking at any time.
When roles are unclear, team performance suffers. To avoid inefficiencies. the team leader should clearly del egate tasks. Team members should question ambiguous or Incorrect requests. In addition. team members should communicate when and if they can handle additional responsibilities. The team leader should encourage team
members to provide input and feedback to the team leader as needed.
During the stress of an attempted resuscitation, do not practice or explore a new skill. If you need extra help, request it early. II is not a sign of weakness or incom petence to call for help; It Is better to have more help than needed than to have Inadequate help. Inadequate resources can compromise the quality and success of the resuscitation.
Sharing Information is a critical component of effective team performance. Team leaders may become focused on a specific treatment or diagnostic approach and neglect to consider others
When resuscitative efforts are ineffective, the team leader must review the basics and talk with the team. "Let's con sider the reversible causes of arrest,
During a resuscitation attempt the team leader or a team member may need to intervene If an action that is about to occur may be Inappropriate. Although constructive Interven tion is necessary, it should be tactful. Team leaders should avoid confrontation with team members. Instead, conduct a debriefing after the resuscitation if constructive criticism is needed.
