the integration of other members of the interdisciplinary health care team into client care.
Competency 7
Rapid sequence intubation, airway management, cardiac arrest, and post-cardiac arrest care involve a team of healthcare providers to optimize outcomes. This team is often called upon and directed by the registered nurse. After exploration of your clinical hour activities this week, reflect upon all of the team members that are needed in order to give the patient the best opportunity for survival.
Identify these team members, describe their role, and indicate when you, as the lead RN, would call upon each member. Speak to roles outside of other RNs and MDs.
Competency #7
Facilitates the integration of other members of the interdisciplinary health care team into client care. Including, but not limited to:
Physical Therapy/Occupational Therapy> Nutritionist
Respiratory Therapy >Case Manager >Social Worker
Acknowledges the advantage of quality team communication and collaboration
Code team positions
Code team member roles are identified using the acronym ABCDEFG.
- Airway management: This team member ensures that the patient’s air-
way is maintained, delivers ventilation using a bag-valve-mask device,
and provides advanced airway placement when needed.
- Back-up chest compressor: The AHA recommends that chest com-
pressors rotate every five cycles.
- Chest compressor: This team member performs effective cardiac
chest compressions, allowing the chest to recoil.
- Defibrillator/medication nurse: The critical care nurse delivers defibril-
lation and administers medications.
- Event recorder/timer: The nurse is responsible for recording code
events, providing updates of medications administered, indicating the time to switch chest compressors and when a rhythm check is needed, and summarizing code events when requested.
- First provider: The first provider on the scene is the team leader. He or she directs the resuscitation effort and organizes the group. The first provider also assigns specific tasks and communicates with the team.
- Go to: This team member runs errands for needed supplies, maintains crowd control, and provides support for the family and other patients in the area if necessary.
- Identification of Team Roles and Positions
- Our first task was to identify the necessary members of a code team, then assign their permanent roles and responsibilities (table 1) and their positions during a code (figure 2). For example, an ideal team leader keeps the group organized, monitors the team’s performance, emulates proper team behavior, works as a trainer and coach, and also focuses on the patient’s care. A team member must be clear about his/her role and proficient in the skills required of that role, willing to keep in practice to maintain those skills, and prepared to perform those skills at a moment’s notice.
- Table 1
- List of necessary code team members, their assigned roles and responsibilities
| Position / # Needed | Role | Primary Responsibility | Secondary Responsibility |
| Leader / 1 | Resident or emergency physician | To lead team resuscitation; identify reversible causes. | To correct errors and assist team with duties if needed (i.e. procedures). |
| Hospitalist / 1 | Back-up to resident | Observe and assist leader. | |
| CPR / 2 | Two staff nurses from 3N and/or 6N and/or intern; located on the right and left of the patient; intern could take on the role of the left side staff nurse | RIGHT SIDE: Evaluate need for CPR and provide uninterrupted high quality CPR, audible counting with metronome. Assure back board in place. LEFT SIDE: Need for CPR and provide uninterrupted high quality CPR, alternate compressions every 2 minutes with right CPR. Evaluate airway and breathing. |
RIGHT SIDE: If CPR not needed, assist with IV/meds as needed. |
| Airway/Respiratory / 2 | Respiratory therapist and anesthesia | Provide appropriate bag valve mask or advanced airway ventilations as needed. | Assist with patient comfort, supplemental oxygen, suctioning, and positioning. |
| IV/Meds / 1 | ICU nurse | Assess and/or place IVs, IOs immediately, accept med orders and administer medications. | Assist with patient comfort and positioning. |
| Monitor/Defib / 1 | ICU nurse | Hook up patient to defib and monitor, provide defibrillation, cardioversion as needed and at the direction of the leader. | Assist in placement of IV/IO if needed. |
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