Team Approach To Resuscitation (Primary Care)

Optimising the chances of survival

A systematic approach to resuscitation will optimise the chances of the patient surviving. This system requires technical and non-technical skills (teamwork, situational awareness, leadership, decision making). An effective team leader is paramount. Ideally, the clinician with the highest level of resuscitation training should assume the role of team leader, allocating team members specific roles they understand and are able to undertake.

Whether the emergency is in the surgery itself, or in another part of the building, it is important to ensure there is 360 degree access to the patient (Circle of Life – Deakin C, Brown S, Jewkes F et al. Pre-hospital resuscitation. 2015.).

Position 1

Airway & ventilation – if a bag/valve/mask (BVM) device is used, then ideally two persons are needed; one to open the airway and ensure a good seal with the mask while a second person squeezes the bag.

Position 2

High quality chest compressions – at patient’s left side. Be prepared to alternate with the operator at position 3 to avoid fatigue.

Position 3

AED use and alternative chest compressions provider (avoiding fatigue) – ideally the opposite side of position 2.

Position 4

Team leader standing at the foot end of the patient – by standing back and overseeing the resuscitation attempt, the team leader will be in a better position to help ensure that the resuscitation attempt runs smoothly, effective resuscitation is provided, appropriate decisions are made and the patient and rescuer’s safety is maintained.

If extra staff are available, ask someone to take responsibilty for recording times that treatment started/ended, any shocks given etc.(consider SBAR or RSVP).

In the event of a cardiac arrest in the setting, clinicians should ensure a prompt, effective and safe resuscitation response to help optimise the chances of survival. The Resuscitation Council (UK)’s Guidelines emphasise the importance of calling 999, performing effective chest compressions and switching on the AED and following its instructions as soon as possible.

Example of Circle of Life Team Approach

Watch this video to see an example of the Circle of Life resuscitation system. Ensure that in the case of cardiac arrest in your setting, each member of your team knows exactly what to do, when to do it and how to do it.