Team Dynamics
Most in-hospital resuscitations are run by a team, and disorganized teams deliver low-quality CPR even when every member is individually competent. The BLS course teaches specific communication behaviors that keep compressions fast, deep, and uninterrupted.
Closed-loop communication and clear roles
In closed-loop communication, the team leader gives an order, the receiver confirms and repeats it back, and then reports when it is done. This prevents missed or duplicated actions. Each rescuer should have a clear role — compressor, ventilator/airway, AED operator, timer/recorder, and team leader — and should perform within their scope. Knowing your limitations and asking for help early, rather than attempting a task you are not trained for, is an expected professional behavior.
Constructive intervention and rotation
Any team member should speak up if they see an error about to happen — for example, if compressions are too shallow or if the rate has slipped. This 'constructive intervention' is directed at the action, not the person. The team leader monitors the quality of CPR, keeps interruptions short, and calls for a compressor switch about every 2 minutes to combat rescuer fatigue. Summarizing and re-evaluating out loud keeps the whole team's mental model synchronized.