HIGH-QUALITY CPR

High-quality cardiopulmonary resuscitation (CPR) is the cornerstone of successful resuscitation efforts. It involves effective chest compressions and adequate ventilations to circulate oxygenated blood to the vital organs until spontaneous circulation returns or advanced interventions can be implemented.

COMPONENTS OF HIGH-QUALITY CPR

High-quality CPR focuses on several key elements:

• Chest Compression Rate: Compressions should be delivered at a rate of 100-120 compressions per minute. A helpful mnemonic is to compress to the beat of the song “Stayin’ Alive.”

• Chest Compression Depth: Compressions should be at least 2 inches (5 cm) deep for adults. In children, compress about one-third the anterior-posterior (front-to-back) diameter of the chest.

• Full Chest Recoil: After each compression, allow the chest to recoil completely. This allows the heart to refill with blood, maximizing the effectiveness of subsequent compressions. Avoid leaning on the chest between compressions.

• Minimizing Interruptions: Interruptions in chest compressions should be minimized to the absolute shortest time possible. Even brief interruptions can significantly reduce the chances of successful resuscitation.

• Avoiding Excessive Ventilation: Provide adequate ventilations (breaths), but avoid excessive ventilation, which can lead to complications. Give 1 breath every 6 seconds (10 breaths per minute) when an advanced airway is in place. If no advanced airway is present, use a compression-to-ventilation ratio of 30:2. Each breath should be delivered over 1 second and result in visible chest rise.

HAND PLACEMENT FOR CHEST COMPRESSIONS (ADULTS)

• Place the heel of one hand in the center of the victim’s chest, on the lower half of the breastbone (sternum).
• Place the heel of your other hand on top of the first hand.
• Interlock the fingers of your top hand or hold them up, ensuring that pressure is not applied to the victim’s ribs.
• Position your shoulders directly over your hands, keeping your arms straight.

CPR SEQUENCE

The recommended CPR sequence is C-A-B (Compressions-Airway-Breathing):

1. Compressions: Start with chest compressions.
2. Airway: Open the airway using the head-tilt/chin-lift maneuver (unless cervical spine injury is suspected, in which case use the jaw-thrust maneuver).
3. Breathing: Deliver rescue breaths.

High-quality CPR is crucial for improving patient outcomes in cardiac arrest. Healthcare professionals should be proficient in performing CPR and should continually practice these skills to maintain competency.