The American Heart Association guidelines focus heavily on prioritizing high-quality chest compressions, but what does that actually mean?
There are several measurements of CPR quality that all medical providers should be aware of.
Compression rate
Compression rate is the measurement of how fast CPR is being performed. The idea used to be that faster was better.
Now, deliver 100-120 compressions per minute. If compressions are too slow, blood is not being circulated effectively around the body, especially to the brain and heart. If compressions are too fast, the heart does not have enough time to adequately fill between compressions so cardiac output drops off.
Compression depth
Compression depth is the measurement of how deep the sternum is pushed down during CPR. The preferred compression depth is two inches for most adults.
It is equally important to allow the chest to fully recoil following each compression. By allowing full recoil, rescuers allow the heart to fill with blood completely which improves cardiac output.
Caregivers should never rest their weight on the patient’s chest during CPR.
Compression fraction
Compression fraction is the percent of time during the cardiac arrest that CPR is actually being performed. Each time CPR is stopped the output of the heart falls off dramatically. After CPR is restarted, it takes time to build up cardiac output again.
Minimizing interruptions during CPR is one of the most important ways to ensure high-quality resuscitation. This finding has led some EMS systems to avoid the use of advanced airways with a preference placed on an OPA or NPA if the providers can maintain a patent airway.
Continue compressions as another rescuer places an AED or obtains IV or IO access.
Ventilatory rate
Ventilatory rate is the rate at which rescuers are delivering ventilations often via a bag-valve mask. While patients need ventilation, over-ventilating or hyperventilating the patient can be detrimental to their outcome; too much ventilation can increase pressure in the chest cavity and may reduce the output of the heart.
How well do you know high-quality CPR?
- AED defibrillator designed for ease of use and prompt response
- Step-by-step voice prompts and CPR guidance provide real-time guidance
- Easily converts to an AED trainer when you attach training pads
- AED trainer, pre-programmed with 5 scenarios
- Included pads compatible for both adults and children
This article, originally published on May 27, 2014, has been updated.
