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Cardiac arrest resuscitation requires timely and accurate execution of interventions. Because of the multitude of simultaneous tasks, cardiac arrest resuscitation requires a carefully coordinated team effort, potentially between rescuers from different agencies. EMS personnel should regularly train for cardiac arrest situations to determine the most efficient ways to carry out protocols. When possible, such training should involve the first‐responders who may also attend these incidents. Recent studies of medical emergency team training in simulation settings demonstrate the importance of teamwork and assigned roles [103, 104].

One systematic review described a lack of well‐designed studies examining the retention of adult ALS knowledge and skills in health care personnel, but commented that the available evidence suggests that ALS knowledge and skills decay by 6 months to 1 year after training, with skills decaying faster than knowledge [105]. Simulation has been shown to be superior in the development and maintenance of skills in cardiac arrest management. Learner satisfaction and competency outcomes favor simulation over non‐simulation teaching. Simulation‐based training for resuscitation is highly effective, particularly if employing strategies such as team/group dynamics, distraction, and integrated feedback [106].

Team training, particularly using simulation, may be helpful in improving safety and reducing anxiety among team members. For example, although defibrillator charging during chest compressions poses little risk, rescuers often do not follow the practice because of safety concerns [107].

EMS personnel must possess the equipment necessary to carry out cardiac arrest resuscitation. Key resuscitation equipment includes monitor‐defibrillators, airway management tools, vascular access equipment, and appropriate medications. Cardiac monitors that record and provide real‐time chest compression feedback are preferable, as are monitors that are able to use dynamic filtering to remove compression artifact and reveal underlying rhythms. However, one must remember that accelerometer‐based compression feedback devices overestimate chest compression depth when performed on soft surfaces [108].

In addition to intubation equipment, airway management tools should include capnography and alternate airway devices such as the Combitube®, King LT® airway, or iGel®. In addition to standard intravenous catheters, EMS crews should also carry rapid‐access vascular tools such as intraosseous devices. Medical directors should provide regular training on the use of all equipment. Even in busy systems, many personnel may not perform important skills or use specific equipment for months at a time.