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Often when a patient goes into a cardiac arrest in a hospital setting, the information leading up to that arrest is available in the form of the chart at the end of the bed. This often can almost predict that an arrest is going to happen if it is interpreted correctly. But when a patient does go into a collapsed state, it is important that whoever recognises that, alerts the rest of the cardiac arrest team. Most organisations have a crash call number or a pager system which will alert a team to respond to the ward or department where the emergency has arisen.

It is important that basic life support measures commence immediately, rather than waiting for the rest of the team to get there. And it may well be, but in the first instance, this is just carrying out chest compressions and simple ventilation. When the crash team arrive at the scene, it is important that a team leader is identified. This will often be a senior medic who can determine the actions of each member of that team. Often somebody will be put in charge of the airway, perhaps an anaesthetist or an ODP. Somebody will be in charge of the chest compressions, and it is important that this is a team inside a team so that the efficiency of the chest compressions can continue to the maximum.

And every two minutes, the team leader should be instructing those people to change place. Often somebody will be put in charge of the defibrillator and the ECG, this person will be responsible for delivering the shock. It is important that the sequence of events is recorded minute by minute. And it is important also that we have a timekeeper to call out the two-minute intervals. When you have a multi-disciplinary team around the patient, it is important that the leader is identified, but also that people take ownership of their role and also listen to the prompts from the team leader. A good team leader needs good followers, and the patient needs an effective team around him or her to improve their chances of survival.