In Advanced Cardiovascular Life Support (ACLS), the success of a resuscitation effort depends on more than just individual skill, it requires coordinated teamwork. One of the most effective team models used during cardiac arrest management is the Resuscitation Triangle. This approach divides the team into three core roles that work together to deliver high-quality, efficient care.
What is the Resuscitation Triangle?
The Resuscitation Triangle is a concept used to position three key team members around the patient in a triangular formation. Each person has a clear, specific responsibility. This structure helps reduce confusion, supports effective communication, and keeps the team focused on delivering life-saving interventions without delay.
The Three Key Roles in the Triangle
1. Compressor
The person in this role performs chest compressions. Their priority is to deliver consistent, high-quality compressions with minimal interruptions. Switching compressors every two minutes helps prevent fatigue and ensures the quality of compressions remains strong throughout the code.
2. AED/Monitor Operator
This team member manages the defibrillator or monitor. Their tasks include placing and operating the pads, analyzing rhythms, and delivering shocks when necessary. They also assist with rhythm checks and help the team stay aligned with the timing of interventions.
3. Airway Manager
The airway role is responsible for managing the patient’s ventilation and securing the airway. Depending on the situation and available personnel, this can involve using a bag-mask device, placing a supraglottic airway, or performing endotracheal intubation. Oxygen delivery and monitoring are also part of this role.
Supporting Roles That Boost Performance
While the triangle includes three primary positions, additional roles are essential for a fully functioning high-performance team. These include:
Team Leader: Oversees the entire code, makes decisions, and keeps the team organized and focused. Often stands slightly away from the triangle to maintain a clear overview.
IV/IO Access Provider: Establishes and maintains vascular access, prepares medications, and helps administer drugs as needed.
Recorder: Documents interventions, times, and events. Keeps track of rhythm checks, medication administration, and team member rotations.
Why the Triangle Structure Matters
This model promotes clear communication and reduces chaos during high-stress situations. Each person knows their job, which helps minimize delays and errors. The triangle also creates physical spacing around the patient that allows everyone to work efficiently without getting in each other’s way.
Tips for Effective Triangle Role Execution
- Practice regularly to improve role clarity and timing
- Rotate compressors to maintain high-quality compressions
- Use closed-loop communication to confirm that tasks are heard and understood
- Stay focused on your role but be aware of the overall progress of the code
- Work under the guidance of the team leader for synchronized interventions
Final Thoughts
High-performance teams in ACLS rely on structure, communication, and practice. The Resuscitation Triangle helps create an organized environment where critical tasks happen quickly and efficiently. When each team member understands their role and executes it with precision, the chances of a successful resuscitation improve significantly.
