Team Dynamics and Opioid-Associated Emergencies
Resuscitation is a team performance. High-functioning teams close communication loops (the leader gives a clear instruction to a named person, who confirms it back), use clear roles (compressor, airway/ventilation, AED/monitor, team leader, recorder), and practice mutual respect and debriefing. The team leader should assign roles explicitly, monitor the quality of CPR, and avoid doing tasks that pull them away from oversight. A frequent trap is a stem in which a team member silently performs a task without confirmation-the correct answer emphasizes closed-loop communication and explicit role assignment.
Opioid-associated emergencies
Opioid overdose can cause respiratory arrest and, secondarily, cardiac arrest. The priority sequence matters:
- If the person is unresponsive with no normal breathing but has a pulse: open the airway, provide rescue breaths, and administer naloxone per protocol while awaiting advanced care.
- If there is no pulse: start CPR immediately; naloxone is not a substitute for CPR and is not given to restore circulation in cardiac arrest.
- Naloxone reverses opioid-induced respiratory depression; it may be given intranasally or intramuscularly per local protocol. Its effect may wear off before the opioid does, so continued monitoring is essential.
A classic trap is choosing naloxone instead of CPR for a pulseless victim, or withholding rescue breaths because naloxone was given. Another trap is forgetting that after naloxone, the person still needs monitoring and possible repeat dosing.
Worked example: A team responds to an unresponsive adult with pinpoint pupils, slow gasping respirations, and a palpable pulse. Correct action: open the airway, give rescue breaths, and give naloxone per protocol-CPR is not yet indicated because a pulse is present.
Rule of thumb: Pulse present and breathing inadequate: ventilate and give naloxone. No pulse: CPR first.