A graphic describing the Resuscitation Triangle Roles in a High Performance Team
Resuscitation Triangle Roles Cheat-Sheet (Credit to the AHA)

To successfully rescue someone who is experiencing a medical emergency, efficiency, appropriate knowledge, and teamwork are needed.

Healthcare providers often have to work together simultaneously on one patient to effectively deliver the necessary treatment and stop the situation from worsening e.g. through stemming the flow of blood, repositioning someone, etc.
Effective teamwork can make the difference between life and death in a medical emergency.

The “Resuscitation Triangle” and “High-Performance Team Dynamics” frameworks provide useful guidelines for how to carry out resuscitation cooperatively, improving the survival chances of a patient through clear, structured roles. Members of the team are expected to stick to their roles and not leave the triangle or the team unless necessary for their own safety.

What are the roles in a resuscitation triangle?

There are 3 hands-on roles within the triangle that do the actual CPR/resuscitation process, and then 3 leadership roles, meaning 6 in total.

Ideally, there should be 6 people to take one role each, but when there are fewer, one person may hold more than one role/perform tasks from different roles as long as they are prioritized appropriately.

The Resuscitation Triangle roles are:
Compressor
AED/Monitor/Defibrillator
Airway/Ventilator

While the Leadership roles are:
Team Leader
IV/IO/Medication Administrator
Timekeeper/Recorder

Explaining the Roles in a High Performance Team

Compressor

The Compressor is the person who assesses the status of the patient. They also do 5 cycles of chest compressions and alternate with the person in the AED/Monitor/Defibrillator role every 5 cycles or 2 minutes (whichever comes sooner). This is to stop fatigue from setting in and allow the compressor to have a break. They should switch out earlier if they start feeling too tired as consistency with the compressions is key during CPR.

AED/Monitor/Defibrillator

This person operates the AED/Monitor/Defibrillator, whichever is being used. They alternate with the compressor to avoid fatigue, and this role-swap is best done during the rhythm analysis phase of CPR. If the team is using a monitor, the person in this role should put it somewhere where the Team Leader can easily see it.

Airway

The Airway takes charge of ventilations and keeping the patient breathing. They must open the airway and use Ambu bag ventilations to keep them oxygenated. If necessary, they can also insert airway adjuncts.

Team Leader

This is a very important, multifaceted role that involves leading the resuscitation team. They assign the team members’ roles and make final decisions regarding the treatment of the patient. They shoúld provide constructive feedback and keep morale up, leading their team to work effectively. They also have the responsibility of handling roles which have not been assigned to anyone.

IV/IO/Medication Administrator

The IV/IO/Medications person takes an ACLS provider role, handling the administration of medications during the rescue process and initiating IV/IO access, if possible and necessary.

Timekeeper/Recorder

Also known as a Timer, this person records the timings of treatments and medications given by the high-performance team that they’re a part of. This helps track when the next are due and avoids accidental overdosing. They also record the compressions being done by the Compressor, as well as interruptions and their length. The Timer keeps up good communication with the Team Leader, reporting the data they track to them.

Tips for Members of a High-Performance Team

  • Don’t stay quiet if you don’t understand what you’re supposed to be doing. In CPR and medical emergencies, you need to know your task so that you can work with your team members effectively.
  • Voice your concern if you are not sure you can do the work you’ve been assigned because you’re not experienced with it.
  • Ask more experienced colleagues for advice if the patient begins to deteriorate regardless of treatment

Tips for Team Leaders in a High-Performance Team

  • Make sure that your team members have clearly-defined roles and know what they’re supposed to be doing
  • Don’t let anyone sit by the sidelines – make sure every member has a fairly equal share of the work
  • Don’t try to use unfamiliar treatments or therapies without consulting with more experienced or authoratively superior personnel