6 Factors That Influence CPR Performance According to CPR Expert, Chris Siska


Every month, an alarming 50,000 people experience a cardiac arrest event, and the success rate of CPR stands at a low of 12%. Imagine if just 1% more people initiated CPR – lives could be saved. 


In this article, we delve into 6 factors that can significantly influence CPR performance with expert insights from Chris Siska, a seasoned CPR instructor with 15+ years of experience in the first response industry.  



There are many contributing factors to CPR. If you don’t know how to do CPR, read “How to Perform CPR” step-by-step in When and When Not to Use an AED. Chris hears commonly asked questions from students that address topics you may not have thought about. 


1. Disabled victims that are stuck in a wheelchair

A common concern is how to perform CPR on a victim stuck in a wheelchair. This may be a concept that you may not have thought of as a CPR instructor, a student learning CPR, or a bystander who has never had CPR training before.


In an emergency situation, the first instinct for many is to panic, but in this particular scenario, simple adjustments can be made to properly perform chest compressions on a victim who is in a wheelchair. 



Chris instructs, “You would simply move them to the ground and lay them flat on their back.” You may need to call for help from another person in this situation if you are unable to safely remove the victim from their chair.” 


Having the victim lay flat on their back will allow the rescuer to have proper hand placement and the ability to push with enough force to the recommended 2 to 2.4 inches when giving chest compressions. 


Some patients may be tougher to remove from their wheelchairs due to injury, weight limits, or fear of hurting the victim. If you are caring for a person who is limited to a wheelchair, be sure to ask their medical provider or research the best way to lower the chair backward to the ground in case of emergencies. 


2. Choking victims that need CPR 

Another common factor that can affect CPR performance is if the victim is choking on an item. The Heimlich Maneuver is the typical rescue protocol for a choking victim, however, if that does not work and the person choking becomes unconscious, then CPR can be used. 



Throughout Chris’s many years of CPR instructor experience, he mentioned many students would ask if someone is choking and they go unconscious how do you get the item out of their airway? 


By starting CPR you can help force the obstructing item out of the airway. With every chest compression, you are pushing air up to force the item out of the airway. This method shows that CPR can not only be used to restart the heart but also to address life-threatening and unexpected complications like choking. 


Other choking protocols that can be used are devices like the LifeVac, but these tools should be used as a last resort – after the Heimlich Maneuver and CPR have been tested. 


Related Article: CPR & Choking: Why You Need a LifeVac 


3. Obstacles during Mouth-to-Mouth Techniques 

If you are performing mouth-to-mouth techniques on an unconscious choking victim, you may be wondering if breathing in their mouth would push the obstructed item deeper into their airway. 


Performing breath blows helps to move the item to a different position so the force from the chest compressions can move it again. Chris explains, “Think of it like a car stuck in the dirt, if you step on the gas the tires just spin. But if you try to rock the car back and forth it will eventually grip and move out.” 


The same goes with items stuck in the airway – moving them around with breath blows will help push the obstructed item out when you resume giving chest compressions.  





4. Weight Limitations 

Factors like weight may also limit rescuers’ ability to properly perform CPR. In scenarios involving unconscious, individuals who are overweight or clinically obese, rescuers may not be able to move them to a safe location.


For example, as a lifeguard who is trying to save a drowning victim, what happens if the victim is too heavy for the rescuer to safely bring them out of the water? Or if an obese victim is unable to be carried out of their wheelchair? 



Specialized techniques like learning about how to administer mouth-to-mouth to an unconscious obese victim while in the water or how to use tools that can help safely pull obese victims out of the water can provide insights to overcome weight-related limitations. Check out our bariatric manikin options. 


5. Climate conditions 

Other factors that may affect CPR performance are climate or environmental conditions. In some cases, an individual in the utility industry may work in extreme temperature conditions. 


Conditions that could be an obstacle during CPR performance are:

  • Hypothermia
  • Too much humidity
  • Precipitation


Hypothermia is when an individual’s body drops to extremely cold and dangerous temperatures (below 30 C). In severe cases, hypothermia can lead to sudden cardiac arrest or hypothermic cardiac arrest making typical resuscitation techniques more difficult to perform. In this case, CPR may need the addition of other treatment modalities to resuscitate the patient. 




On the opposite spectrum, humidity and high precipitation can be a dangerous factor that affects the performance of CPR as well. Not only will the rain/sweat make hand placement more difficult due to a slippery grip, but performing chest compressions in extremely humid outdoor environments can be draining. 


If you work outdoors in a year-round humid area, you know that heat exhaustion can be fatiguing. Imagine performing CPR chest compressions at 120 beats per minute for 15-20 minutes before emergency medical services arrive on the scene to take over. 


Having an automated external defibrillator (AED) on-site or in a work truck can be helpful in breaking up the continuous chest compressions as AEDs automatically analyze the heart’s rhythm and deliver a shock in between CPR use. See How to Use an AED to learn more.




If using an AED, be sure to move the victim to a safe, dry area before attaching the electrode pads. If there is sweat on the victim’s chest, be sure to wipe it down with a cloth, shirt, or towel to help prevent any interference with the electrode pads. 


6. Uneducated Rescuers 

Uneducated rescuers are one of the most impactful factors that can influence CPR performance. If a rescuer is educated on the wrong thing to do – they can injure themselves or the individual that they’re trying to resuscitate. 


The best way to combat this obstacle is to be sure that whether you’re a medical professional, CPR instructor, or individual, you are educated on best practices and common myths around CPR.




One common question that Chris sheds light on is sternal rubs – what are they and are they used in CPR? Chris states students of his would say they have heard of this technique in other CPR classes, “What’s a sternal rub? – Sternal rubs are no longer used but it was a way to see if the patient was responsive by pressing on their sternum in the center of a victim’s chest. It is painful and not socially accepted anymore.” 


Another common misconception that Chris mentioned hearing in the classroom is that breathing techniques are no longer needed. “This is not true. You only do not give breaths if you are unable or unwilling to,” Chris says, “If you are able to give breaths you absolutely should as that will increase the chances of success when giving CPR.”  


The biggest uneducated guess bystanders may have is that they have to be trained in CPR to give CPR to a person in need. Anyone can perform CPR, no training is needed. Even though training helps, you do not need to be certified to be able to follow the steps to giving CPR. 


The more people trained in CPR the more confident communities will be to perform CPR when an emergency arises. 


Most emergencies happen either at work or at home, so learning could mean saving the life of a friend or family member. Don’t wait – visit our AEDSuperstore resource center today or sign up for CPR certification courses


DISCLAIMER: Information and resources found on the AEDSuperstore website/blog are intended to educate, inform, and motivate readers to make their health and wellness decisions after consulting with their healthcare provider. The authors are not healthcare providers. No information on this site should be used to diagnose, treat, prevent, or cure any disease or condition.


Reviewed by Chris Siska, EMT, Owner/Instructor at CPR and More

​​Chris Siska has been in the first response industry for 15+ years. His journey started as an EMT-B in 2006. Chris’s dedication to his community in the emergency response industry continued when he started as a CPR instructor in 2008. Chris became a Firefighter in 2012 and started teaching to help give back to his community. When he left the fire service, Chris made teaching CPR courses his full-time career. 


2 Responses to “6 Factors That Influence CPR Performance According to CPR Expert, Chris Siska”

January 26, 2021 at 4:46 pm, HealthForce Training Center said:

Very informative. Thank you for sharing .


January 26, 2021 at 4:47 pm, HealthForce Training Center said:

Thank you for sharing this article it is very informative.


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