Cardiopulmonary resuscitation (CPR) is vital to the survival of a cardiac arrest victim. When someone goes into sudden cardiac arrest, their heart is no longer pumping oxygenated blood to the brain and vital organs. CPR circulates oxygenated blood remaining in the body to minimize neurological damage until defibrillation can be administered. It may also convert someone in a state of asystole (flatline) into a rhythm that is “shockable” by an automated external defibrillator (AED), allowing the heart to reset itself. Statistics for best survival rates usually mention “High-Quality CPR”, but what makes CPR high-quality?
When it comes to out-of-hospital bystander CPR, there is one factor which is always variable in each situation – bystander CPR is performed by humans, and humans come in different sizes, capabilities, knowledge, and responses. Even trained EMS professionals may perform tasks differently depending on their fatigue, training, and the particulars of a situation (environment, trauma level, on-lookers, etc.).
To define “High-Quality CPR” for teens and adults, there are certain courses of action identified by the American Heart Association’s 2015 CPR & ECC Guidelines to maximize the benefits of CPR, and they are simple:
Compressions at a rate of 100-120 per minute
Compressions at a depth of 2” – 2.4”
Full recovery of chest after each compression
Minimal interruptions to compressions
In a nutshell: “Press the chest – fast and deep” until an AED is utilized (and again after, if necessary), EMS arrives, or the person shows signs of life.
Note rescue breaths are not included in this list. The AHA (American Heart Association) does recommend rescue breaths at a rate of 30 compressions to 2 breaths when the rescuer has been trained and is confident in the technique, so interruptions to the compressions are no more than 10 seconds (and still stresses the importance of breaths when performing CPR on children and infants), but has recognized “hands-only” CPR is an effective alternative when the rescuer is not confident in their ability to provide ventilations or is untrained. Hands-only CPR also removes the potentially uncomfortable step of placing one’s mouth onto the mouth of a stranger if no CPR mask or shield is available.
Never hesitate to attempt CPR, regardless of experience or skill level. Someone in cardiac arrest is already clinically dead, and you cannot make them any more dead! Any CPR is better than no CPR, and if there is an AED handy, it should be retrieved and deployed as quickly as possible for the victim’s best chance for survival.
Remember: “Press the chest – fast and deep!”