BLS Certification Manual: Team Roles

In Basic Life Support (BLS), especially in a setting where multiple trained responders are present, clear roles are defined to ensure an efficient and coordinated response. This team-based approach is essential in emergency situations, such as cardiac arrest, where multiple tasks must be performed simultaneously. Effective cardiopulmonary resuscitation requires well-coordinated team dynamics to maximize patient outcomes. Here are the common team roles in BLS:

Team Leader:  This person coordinates the efforts of the team, makes critical decisions, and ensures that communication among team members is clear. The team leader also monitors the performance of all procedures, makes adjustments as necessary, and interfaces with advanced life support providers as they arrive. Closed-loop communication is crucial in this role to ensure instructions are understood and carried out.

Compressor:  This team member is responsible for performing chest compressions. Given the physical exertion required to maintain effective compressions, it is common to have multiple people assigned to this task who rotate every 2 minutes to prevent fatigue and ensure the compressions remain effective. Effective CPR team dynamics are essential in managing the resuscitation attempt.

Airway Manager:  This role involves ensuring the airway is open using techniques such as the head-tilt, chin-lift or jaw-thrust maneuver. In more advanced settings, this could involve airway adjuncts like oropharyngeal or nasopharyngeal airways. This team member also provides rescue breaths via a bag-mask device or mouth-to-mouth if a barrier device is available. Timing and effectiveness of breaths are crucial, and this role requires coordination with the compressor to ensure breaths are given during brief pauses in chest compressions. Effective teamwork is vital in these high-pressure situations.

AED Operator:  This person is tasked with retrieving, setting up, and operating the Automated External Defibrillator (AED). They must prepare the patient for shock by ensuring the chest is bare and dry, apply the electrode pads, and deliver shocks as directed by the AED, all while communicating with the team leader. Being part of a high-performance team with clear goals and understanding individual strengths is essential for this role.

Medication Administrator:  This person is tasked with administering medications. This person is required to be qualified in advanced cardiac life support (ACLS). In the context of in-hospital cardiac arrest, the performance of the team is critical to patient outcomes.

Recorder/Timekeeper:  This role involves documenting everything that occurs during the resuscitation attempt, including the time of each intervention (like shocks delivered and medication administration). This is vital for ensuring continuity of care once advanced life support takes over and for review and improvement of emergency response protocols. Addressing resuscitation system errors is crucial for improving patient outcomes.

These roles can be adjusted depending on the number of responders available and their level of training. Effective communication and role clarity are key to a successful BLS effort, and regular training and drills can help ensure each team member understands and can perform their roles under pressure. Having a defined leader for the resuscitation team is essential for clarifying team goals and guiding the assignment of responsibilities.

The three essential roles are compressor, airway manager and AED operator.  If there are not six rescuers, the rescuers in these three roles may take on the additional leadership roles of: team leader, medication administrator and recorder/timekeeper. Ensuring clear team dynamics is crucial for successful resuscitation efforts.