ACLS team members must work seamlessly, maintaining awareness of their own specific roles as well as others, and communicating effectively. While the number of team members may vary depending on the situation, a six-member team is outlined in the algorithm below to demonstrate a typical ACLS team.

Six Person High-Performance Team Positions

ACLS team location and flow

Priority-Based Multiple-Rescuer Response

Clear Roles

If team roles are not clear, ACLS effectiveness decreases. Signs of poor role delineation include inappropriate repetition of tasks, skipping crucial tasks, and overworked team members despite adequate numbers. To avoid these pitfalls, team roles should be well defined, and team members must state if they can perform their tasks. Team members should be free to contribute to the overall resuscitation effort when indicated.

Limitations

Each team member should be aware of their clinical limitations, as should the team leader. In this way, no one takes on an inappropriate role. The team leader does not assign inappropriate roles and is aware when more assistance is needed. A resuscitation event is not the time to try out a new skill. Instead, it is best for team members to ask for help as soon as it is needed.

Appropriate Care

Both team leaders and members have a responsibility to intervene to provide appropriate care. This should not be done aggressively. If feedback is required, this can be done at a debriefing following the resuscitation.

Share information 

By sharing information, ACLS members prevent stagnant thinking. Occasionally, the team leader may suffer from fixation errors and become overly fixated on a rigid way of thinking. It is vital that if a plan of action is not effecting change, the team is open to reviewing the resuscitation approach and redirecting efforts. Vital to this is continued feedback about the patient’s status to guide care.

Continuous evaluation

The team leader should continuously evaluate the resuscitation effort, including:

• the patient’s response to treatment
• interventions provided
• the results of assessments.

It is useful to state the overview of the resuscitation aloud to all team members. This can keep everyone on the same page as well as alert the team to the next important steps. Of course, as a resuscitation should be flexible based on the patient’s response, the team leader should be aware that the plan may need to change accordingly.

Effective Communication

ACLS members should incorporate close-looped communication. This type of communication ensures that every message is heard, acknowledged, and acted upon. Here are the steps for using close-looped communication:

• The team leader requests an action from a specific team member using eye contact.
• The team member verbally acknowledges and confirms receipt of the request.
• When the task is completed, the team member confirms its completion.

Closed-Loop Communication

Whenever team members communicate, they should do so clearly and calmly with an even tone. They should never yell but make sure their voice is loud enough to be heard by the whole team. Team members must take turns talking and keep extraneous noise to a minimum.

Professionalism

All members of the ACLS team must be professional and respectful. Respect is key with a focus on the best care for the patient rather than ego or a need to be right.