Notes

Working in a Team
-As previously mentioned, teamwork involves a group of people working together to achieve a common goal. Elements of effective teamwork include:
-Understanding Roles and Responsibilities – Clear roles and responsibilities should be defined as soon as possible. The team leader should clearly define the roles and assign tasks according to each team member’s skill. When every member knows their job, the team functions smoothly.
-Good Communication – Information and knowledge about the situation should be shared. Instructions should be clear. Closed-loop communication should be used to eliminate misunderstandings. All communication should be made with mutual respect and a professional attitude.
-Performing a Debriefing – After the emergency, a good team always debriefs by reviewing what went well and what needs improvement.

Two-Person Rescue
-A two-person adult rescue is very similar to a one-person rescue. However, since there are two people, the rescuers can share roles, especially during CPR. For example, one rescuer can provide chest compressions while the other rescuer gives breaths.
-Additionally, chest compressions provided during CPR can rapidly cause rescuer fatigue. As a result, the compressions become shallow and ineffective. To avoid this, a two-person rescue team can switch roles allowing rescuers to rest from chest compressions.

Two-Person Adult BLS Steps
The main steps for two-person adult BLS procedure are the same as the one-person procedure. These steps are:

1. Verify the scene is safe.
Survey the scene around the victim and verify that it's safe to approach. If the scene doesn't seem safe, back
off and alert the emergency response system.
Observe the victim. Treat immediate life-threatening injuries. Look for clues as to what may have caused the emergency. Ask bystanders what happened.

2. Check for responsiveness.
Tap the victim's shoulder and ask loudly, "Are you OK?"
If the victim does not respond, one rescuer should activate the emergency response system appropriate to the setting and retrieve an AED and any other emergency equipment. The other rescuer should check the victim’s pulse and breathing.
Note: Lack of oxygen to the brain can cause movements that make a victim appear to be conscious. These movements appear as temporary motions, such as the quick raising of arms. Do not mistake these movements for a response

3. simultaneously check pulse and breathing and determine next action.
Make sure the victim is in the supine position. Give the victim a chance to breathe by opening their airway using the head-tilt/chin-lift technique. If spinal trauma is suspected, use the jaw-thrust technique.
Check for a carotid artery pulse.
At the same time, check for normal breathing.
Feel for a pulse and check for normal breathing for at least 5 seconds but no longer than 10 seconds.

4. Perform high-quality CPR
The pulse and breathing checks are used to determine the next course of action.
-If the victim is breathing normally and has a definite pulse, do not begin CPR. Place the victim in the recovery position and monitor. Re-evaluate their pulse and breathing every 2 minutes
If the victim has a definite pulse but no normal breathing:
-Give one rescue breath every 5 to 6 seconds, or about 10 to 12 breaths per minute. Each breath should last about one second. (Lesson 4 provides more information on rescue breathing.)
-If an opioid overdose is suspected, administer naloxone according to local protocol. Naloxone is a drug that can reverse the effects of the opioid. (Lesson 6 provides more information about opioid overdoses.)
-Re-evaluate their pulse and breathing every 2 minutes.
-If the victim lacks a pulse and normal breathing, the victim is in cardiac arrest – begin CPR (go to Step 4)

Two-Person Adult Rescue (Step 4)
Perform High-Quality CPR
At this point, the emergency response system should be activated, and an AED is being retrieved.
Perform high-quality, two-person adult CPR:
-If needed, move the victim if their current position or location does not allow for effective CPR, move them as needed.
-Expose the victim’s chest. Any type of clothing or under garments will hinder CPR and the use of an AED
-One rescuer should perform chest compressions. The second rescuer should provide 2 rescue breaths after 30 chest compressions. Do not stop chest compressions for longer than 10 seconds to give rescue breaths.
-Rescuers should switch positions about every two minutes, or five cycles, to prevent fatigue from doing chest compressions. Typically, this switch can be done when the AED is analyzing the heart rhythm.
-Repeat the CPR cycle, 30 compressions to 2 breaths, until a valid reason to stop occurs.

5. Attempt defibrillation
-When an AED is available, it should be used immediately. Follow all the prompts provided by the AED. The general procedure is the same as the one-person adult rescue.
-While one rescuer sets up the AED, the other rescuer should continue with chest compressions.
-When the AED is checking the heart’s rhythm or delivering a shock, the rescuers should stop working on the victim and stand clear. All rescuers present should use the closed-loop communication method to indicate that everyone is clear of the victim.
-When the AED is checking the heart’s rhythm or delivering a shock, the rescuers should stop working on the victim and stand clear. All rescuers present should use the closed-loop communication method to indicate that everyone is clear of the victim.

6. Assist to recovery position
-If the victim begins to show signs of ROSC, such as coughing, normal breathing or movement, assist the victim to the recovery position

However, because there are two rescuers, the details for several steps are different.
As always, rescuers should use personal protective equipment when responding to an emergency.