TWO-RESCUER ADULT CPR

When two trained rescuers are available, they should work together to maximize CPR effectiveness. One rescuer performs chest compressions while the second manages airway and ventilations.

Step 1: Assigning Rescuer Roles

Rescuer 1: Chest Compressions

• Positions at the victim’s side and delivers high-quality compressions.
• Compression rate: 100-120 per minute.
• Compression depth: At least 2 inches (5 cm).
• Minimizes interruptions and switches roles every 2 minutes to prevent fatigue.

Rescuer 2: Airway & Ventilations

• Positions at the victim’s head.
• Uses head tilt-chin lift (or jaw thrust if spinal injury suspected).
• Provides rescue breaths using a bag-mask device (BVM) or mouth-to-mouth.
• Delivers 2 breaths after every 15 compressions.

Step 2: Compression-to-Ventilation Ratios

• Adults: 30:2 (same as single rescuer).
• Children & Infants: 15:2 (increased ventilation support).
• With an advanced airway (e.g., endotracheal tube):
  • Continuous compressions (no pauses).
  • 1 breath every 6 seconds (10 breaths per minute).

Step 3: Switching Roles to Prevent Fatigue

To maintain high-quality compressions, rescuers should switch roles every 2 minutes (or 5 cycles of 30:2).

Step-by-Step Role Switch

1. Rescuer 2 (airway) signals: “Switch after this cycle.”
2. After the 30th compression, Rescuer 1 moves to the head to take over ventilations.
3. Rescuer 2 immediately begins compressions.
4. The switch should take less than 5 seconds to minimize interruptions.

Key Benefits of Two-Rescuer CPR

• Reduces rescuer fatigue, ensuring consistent high-quality compressions.
• Allows better airway management, especially with a bag-mask device.
• Minimizes hands-off time, maximizing survival outcomes.