4.2 Minimizing Interruptions for Maximum Survival

One of the most critical factors in cardiac arrest survival is maintaining continuous, high-quality chest compressions. Any interruption in compressions reduces coronary and cerebral perfusion, decreasing the chance of successful resuscitation. Healthcare providers must use strategic techniques to minimize hands-off time and keep blood flowing effectively.

Why Interruptions in CPR Are Dangerous

• Interruptions cause a drop in blood pressure, reducing perfusion to the brain and heart.
• After an interruption, it takes several compressions to rebuild circulation.
• Longer pauses lead to lower survival rates—every second counts.

1. Preload AED Pads Before Stopping Compressions

• Apply AED pads while compressions are ongoing
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  Apply AED pads while compressions are ongoing

  

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  to avoid unnecessary pauses.
• Ensure the AED is ready to analyze the rhythm immediately once compressions pause.
• Minimize the time between shock delivery and resuming compressions (aim for less than 5 seconds).

2. Perform Chest Compressions While AED Charges

• Modern AEDs take a few seconds to charge before delivering a shock.
• Do not stand clear during charging—continue compressions until just before the shock is delivered.
• Immediately resume compressions as soon as the shock is delivered.

3. Anticipate Role Switching to Prevent Delays

• Plan for a smooth switch every 2 minutes or 5 cycles of CPR.
• Use the hover technique—the incoming compressor places their hands above the chest, ready to take over immediately.
• Ensure the transition happens within 5 seconds to maintain circulation.

4. Use a Two-Person Bag-Mask Ventilation Technique

• One rescuer seals the mask and maintains an open airway.
• The second rescuer delivers breaths, ensuring minimal time is wasted between ventilations.
• This technique improves ventilation efficiency and reduces interruptions.

5. Establish Clear Team Communication

• Use closed-loop communication
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  closed-loop communication

  

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  to confirm tasks are completed (e.g., “Resume compressions now”).
• The team leader should call out "Prepare to switch" before role transitions.
• Verbalize "Resume compressions" immediately after defibrillation or airway interventions.

Key Takeaways: Every Second Counts

• Apply AED pads early and continue compressions during charging.
• Minimize interruptions to less than 10 seconds whenever possible.
• Use the hover technique to switch compressors quickly.
• Coordinate ventilations with compressions to avoid wasted time.
• Communicate clearly to ensure a seamless, high-performance CPR effort.

By following these strategies, healthcare providers can maintain continuous, high-quality CPR, improving survival rates and maximizing patient outcomes.

With this, we wrap up the key clinical skills of team-based resuscitation. Now, let’s move into professional considerations, including ethics and legal responsibilities in BLS.