What is High-Quality CPR?
High-quality CPR is cardiopulmonary resuscitation that meets performance metrics set by international resuscitation guidelines. When a patient in cardiac arrest receives high-quality CPR, their chances of survival and neurological outcomes improve. In fact, high-quality CPR makes it up tofour timesmore likely that a victim neurologically recovers.
Always remember to ensure the scene is safe and call 911 before starting CPR. If you can deliver chest compressions while you or a fellow rescuer is on the phone with 911, that is great. Otherwise, if you are alone and need to leave to access a phone, prioritize calling 911 over starting CPR.
Components of High-Quality CPR
In 2020, based on updates to the international CPR guidelines, the AHA releasedupdated guidelineson how to deliver high-quality CPR to adults. These guidelines offer four main metrics to meet to ensure the CPR you give to adult victims is as safe and effective as possible. Let’s take a closer look!
1. Safe, Supportive Positioning and Location
During CPR, your hands must be placed appropriately to ensure accurate and safe chest compressions. You should place the heel of one of your hands in the middle of the victim’s chest toward the bottom third of their sternum. Fold your other hand over the top, interlacing your fingers to create a good grip.
If you can perform CPR safely where the victim is found, do not move the victim. Ideally, you will perform CPR on a firm surface and the victim will be on their back.
2. Compression Rate and Depth
The recommended compression rate for high-quality CPR is between 100 and 120 compressions per minute. Rates above or below this range reduce the chances of survival of the victim.
The American Heart Association has developed aplaylistto help people remember the correct rate for chest compressions, by using the beat of a familiar song! All of the songs in this playlistare between 100–120 beats per minute.
When delivering compressions, the amount of time you spend compressing the chest and allowing it to recoil should, ideally, be equal. Leaning on the chest should be avoided between each compression.
A person performing CPR should compress the adult victim’s chest to at least two inches, but no more than 2.4 inches. For prepubescent children and babies, the compression depth should be 1.5 inches (4 cm) in infants to 2 inches (5 cm) in children. When doing CPR, focus on getting the compressions down to the correct depth.
3. Chest Compression Fraction, Rescue Breathing, and Pauses
Chest compression fraction (CCF) is the proportion of CPR time spent providing compressions during a cardiac arrest event.When performing CPR, you need to minimize any pauses in chest compressions to have adequate CCF. The AHA recommends a CCF of at least 60%. That means you are spending 60% or more of the time delivering compressions. If you give rescue breaths, anypause you make for delivering them should be as short as possible, bearing in mind that according to the AHA each rescue breath should last 1 second.
When someone is in cardiac arrest, usually the blood oxygen levels are sufficient for at least 3-5 minutes, and perhaps longer. However, their blood needs help circulating what oxygen they do have and need to their organs and tissues. When compressions are interrupted for too long, there is not enough blood flow to deliver oxygen to important organs and tissues.
According to theAmerican Heart Association,the recommended compression-ventilation ratio for one or two rescuers for an adult is 30:2. This ratio is the number of compressions (30) and breaths (2) during one cycle of CPR.
4. AED shocks
If you gain access to an AED before medical personnel arrive on the scene, make sure to turn it on and follow its prompts to deliver safe, effective shocks to the victim as soon as possible.
Learnhow to use an AED
High-Quality CPR Steps
There are some differences in how to administer CPR, depending on the person’s age or size.Infants, Children, and Adultseach have different CPR requirements.
Here are the Key Steps for Providing High-Quality CPR:
- Make sure the scene is safe for you and the victim.
- Check breathing andresponsiveness. If there is no breathing, or only unusualgasping, and the person is not responsive, the person requiresCPR.
- Call911! If you are alone, find a phone and call. If someone is with you, tell them to call 911 while you begin CPR. You can also call from your cell phone on speakerphone as you begin compressions.
- Push! Start compressions.Hands-only CPR(that is, continuous chest compressions without rescue breaths), even if it’s not performed perfectly, greatly increases a person’s chances of survival.If you are willing, able, or trained in CPR,provide rescue breathsat a rate of two breaths for every 30 compressions during one cycle of CPR. Remember to keep pauses to compressions as short as possible and do not over ventilate the patient.If you aren’t willing or able to do rescue breaths, you can still jump in and help by providing hands-only CPR, which will still greatly improve the victim’s chance of survival.
- After initiating high-quality CPR, the next thing you would need to do isadminister ashock.When an AED arrives, deliver a shock if needed.
- Continue CPR until prehospital providers arrive.
5 common CPR mistakes to avoid
1. Rescuer Exhaustion
Providing the proper compression depth at the proper rate can be exhausting. When rescuers become exhausted, they can deliver compressions that are too shallow or too slow. They can also lean too heavily on the victim, blocking complete chest recoil. When two or more rescuers are available, the AHA recommends switching off who does compressions every two minutes, which is about 5 cycles of 30 compressions and 2 rescue breaths.
2. Leaning on the Victim Too Much
You need to take your full weight off of the victim between compressions. The chest needs to recoil fully between compressions.Complete chest recoilis essential because it allows the chest to fully expand, which creates negative pressure that pulls blood back into the chest and cardiac tissues. Drawing blood back into the chest allows for the heart to get the oxygen it needs to survive the ordeal. Leaning or keeping pressure on the chest between each compression is the main cause of incomplete chest recoil and will actually decrease blood flow, reducing the quality of CPR.
3. Mistiming Chest Compressions Around AED Shocks
Make sure your hands are clear from the victim when delivering an AED shock so you can avoid being shocked yourself. However, the gap between when your compressions end and when the shock is delivered should be as short as possible. Similarly, you should resume compressions as soon as is safe after delivering an AED shock.
4. Checking for A Pulse
The AHA only recommends that healthcare workers check for a pulse. If you are a lay rescuer, whether you are trained or not, you should not waste time checking for a pulse if someone is unresponsive. This is because it is difficult to tell if someone has a pulse or not during a medical emergency, and it is easy to get it wrong and waste precious time.
5. Overemphasis on Rescue Breaths
Bystanders should docompression-only CPRif they are unable, untrained, or unwilling to provide rescue breaths.According to the AHA, if you see an adult suddenly collapse you should—at a minimum—call 911 and provide high-quality chest compressions by pushing hard and fast in the center of the chest, minimizing interruptions.The AHA emphasizes chest compressions over rescue breaths, since the circulation of oxygen to vital organs is more important than delivering more oxygen to the victim.
Conclusion
High-quality CPR saves lives! In fact, according to theAmerican Heart Association,high-quality CPR is one of the most important factors to improve the chance of survival from cardiac arrest.
FAQ
Take a look at some common questions we see about high-quality CPR.
Which Victims Require High-Quality CPR?
All people suffering from Sudden Cardiac Arrest (SCA) require high-quality CPR! SCA can occur in people of all ages and can occur at any time. High-quality CPR increases the chances of a person surviving, and leaving the hospital without lasting damage to their heart or brain.
Why is Allowing Complete Chest Recoil Important when Performing High-Quality CPR?
Allowingcomplete chest recoil allowsthe chest to fully expand, which creates negative pressure, pulling blood back into the chest and cardiac tissues. Drawing blood back into the chest allows the heart to get the oxygen it needs to survive the ordeal.
How do You Perform Chest Compressions when Providing High-Quality CPR to a Child?
Children requirechest compressions at the same rate as adults. The main difference is the force needed on the chest. If the child is young or small, you may only need to use one hand to press down one and a half inches into the chest. Older and larger children may need two inches of depth compression.
*All information on the Avive website is provided in good faith. However, Avive makes no representation or warranty of any kind, express or implied, regarding the accuracy, validity, or completeness of any information on the Site. Any medical/health information on the Site is for general informational and educational purposes only and is not a substitute for professional medical/health advice.
UNDER NO CIRCUMSTANCE SHALL WE HAVE ANY LIABILITY TO YOU FOR ANY LOSS OR DAMAGE OF ANY KIND INCURRED AS A RESULT OF THE USE OF THE SITE OR INFORMATION PROVIDED ON THE SITE. YOUR USE OF THE SITE AND YOUR RELIANCE ON ANY INFORMATION ON THE SITE IS SOLELY AT YOUR OWN RISK.
FAQs
What are the 4 components of high quality CPR? ›
- Chest compression fraction >80%
- Compression rate of 100-120/min.
- Compression depth of at least 50 mm (2 inches) in adults and at least 1/3 the AP dimension of the chest in infants and children.
- No excessive ventilation.
There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation.
Which of the following are components of high quality CPR select 3 answers quizlet? ›High-quality CPR means: - Rate of at least 100 chest compressions/minute. - Compression depth of at least 2" in the adult victim. - Complete chest recoil after each chest compression.
What are the components of high quality CPR according to the Red Cross? ›- Hand position: Two hands centered on the chest.
- Body position: Shoulders directly over hands; elbows locked.
- Depth: At least 2 inches.
- Rate: 100 to 120 per minute.
- Allow chest to return to normal position after each compression.
Compression rate is the measurement of how fast CPR is being performed. The idea used to be that faster was better. Now, however, it is becoming clear that a rate of 100-120 compressions per minute is ideal. If compressions are too slow, blood is not being circulated effectively around the body.
What are the 7 steps of CPR in order? ›The seven steps of CPR are as follows: check for Danger, call for help, check the Victim's Airway, give Two Rescue Breaths, perform Chest Compressions, switch Roles with the Compressor (if available), and continue Compressions until Advanced Medical help arrives.
What are the 3 most critical components of CPR? ›What Are the Three Parts of CPR? The three basic parts of CPR are easily remembered as "CAB": C for compressions, A for airway, and B for breathing.
What is CPR vs high quality CPR? ›Most bystanders can perform hands-only CPR where compressions are administered. However, with high-quality CPR, a trained individual delivers the CPR that fits the specific guidelines which involve two (2) rescue breaths for every thirty (30) compressions.
What is the most important component of CPR? ›Compressions means you'll use your hands to push down hard and fast in a specific way on the person's chest. Compressions are the most important step in CPR .
What are the six steps is performing high quality CPR? ›- Start Chest Compressions Within 10 Seconds of Recognition of a Cardiac Arrest.
- Chest Compressions Should Be Hard and Fast.
- Allow Complete Chest Recoil After Each Compression.
- Minimize Interruptions to Chest Compressions.
- Give Effective Rescue Breaths.
- Avoid Excessive Ventilation.
Should you continue with high quality CPR until an AED prompts to clear? ›
Rescuers Should Continue High-Quality CPR: Rescuers should continue with high-quality CPR until the AED delivers a prompt to clear the victim for analysis. If No Shock is Advised: If no shock is advised and after any shock delivery, immediately resume high-quality CPR, starting with chest compressions.
What are the special considerations when using an AED? ›Do not use an AED near flammable or combustible materials (e.g. gasoline). It is safe to use an AED when the person is lying on a metal surface, but don't allow the AED pads to contact the metal surface. Do not use an AED if the person is in or near water. Avoid getting the AED wet.
What are the components of CPR summary? ›1 rescuer: Perform cycles of 30 compressions and 2 breaths. When second rescuer arrives, perform cycles of 15 compressions and 2 breaths. Use AED as soon as it is available. Monitor until emergency responders arrive.
Which is high-quality CPR in order? ›Five Components of High-Quality CPR
Achieving a rate of 100–120 compressions per minute. Compressing the chest to a depth of 2–2.4 inches (5–6 centimeters) Avoiding leaning on the chest to allow for full chest wall recoil after each compression. Minimizing pauses in compressions (chest compression fraction > 60%)
High-quality cardiopulmonary resuscitation (CPR) has been shown to improve survival outcomes after cardiac arrest. The current standard in studies evaluating CPR quality is to measure CPR process measures—for example, chest compression rate, depth, and fraction.
When using an AED What is very important to do while the AED is analyzing? ›STEP 3: Stand back for analysis.
It is critical that no one be touching the victim as the AED analyzes. If someone is touching the victim, the AED can pick up on that person's heart rhythm and falsely indicate whether or not a shock is needed.
The PedFACTs course also covers the “4Cs of Pediatric First Aid” help focus providers on the steps they need to take to safely manage emergencies: Check, Call, Care, and Complete.
What do the 3 C's stand for in CPR in the correct order? ›Training your brain before you find yourself in a high-pressure situation may help you save a life or potentially help someone in pain. There are three basic C's to remember—check, call, and care. When it comes to first aid, there are three P's to remember—preserve life, prevent deterioration, and promote recovery.
What are the 4 rules of first aid? ›- Use a systematic approach in all medical emergencies.
- Identify and avoid risks to yourself, the person affected and third parties.
- Request support early (first aiders, AED, emergency number 144).
- Be “suspicious” and primarily assume it is something serious.
After every 30 chest compressions at a rate of 100 to 120 a minute, give 2 breaths. Continue with cycles of 30 chest compressions and 2 rescue breaths until the child begins to recover or emergency help arrives.
How many breaths per second in CPR? ›
For respiratory and cardiac arrest, provide 1 breath every 6 seconds (10 breaths per minute).
What is the compression rate for CPR? ›In adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compressions at a rate of 100 to 120/min and to a depth of at least 2 inches (5 cm) for an average adult, while avoiding excessive chest compression depths (greater than 2.4 inches [6 cm]).
Why do we perform high-quality CPR? ›High-quality CPR will help deliver more oxygenated blood to the brain and other vital organs while you wait for emergency services to arrive.
How is CPR AED different from BLS? ›The main distinction is that BLS is more comprehensive and is geared toward medical professionals and first responders, whereas CPR and AED use are skills anyone can learn. To clarify, anyone can attend and obtain either certification, and doing so would be a great way to safeguard yourself and those around you.
What is high-quality CPR heart and stroke? ›There is continued emphasis on the characteristics of high-quality CPR: compressing the chest at an adequate rate and depth, allowing complete chest recoil after each compression, minimizing interruptions in compressions, and avoiding excessive ventilation.
What are 5 important facts about knowing CPR? ›- More than 350,000 cardiac arrests occur outside of a hospital setting in the U.S. every year. ...
- Most cardiac arrests take place in the home. ...
- CPR saves lives and improves outcomes. ...
- Bystander CPR is underused. ...
- The out of hospital survival rate is low. ...
- It's easy to get CPR certified.
- Airway.
- Breathing.
- Circulation.
The main areas of focus of high-performance CPR include performing chest compressions at the optimal depth and rate, minimizing compression interruptions, and avoiding leaning on the patient's chest.
How do you do high-performance CPR? ›When administering high-performance CPR, compression depth and rate are a major determinant of survival outcomes. The American Heart Association and European Resuscitation Council recommend delivering compressions at a rate of 100–120 per minute at a depth of 2–2.4 inches (5–6 centimeters), in the middle of the chest.
How do you perform high quality rescue breaths as part of your CPR? ›Give mouth-to-mouth:
Pinch the soft part of the nose closed with your index finger and thumb. Open the person's mouth with your thumb and fingers. Take a breath and place your lips over the patient's mouth, ensuring a good seal. Blow steadily into their mouth for about 1 second, watching for the chest to rise.
How many times do you do CPR before AED? ›
If prompted to begin CPR, follow the cycle of 30 compressions and 2 rescue breaths. After five cycles allow the AED to analyze the rhythm again. Continue CPR until help arrives or until the AED announces rhythm restored.
How soon should an AED be used once CPR has been started? ›Make it very clear who should do each task by pointing at the person and yelling their name. Then, start performing CPR immediately and don't stop until the person comes back with the AED. Use the AED as soon as it arrives!
How long do you perform CPR for between each cycle of analysis from the AED? ›Immediately following the shock, begin CPR for 5 cycles (or approximately 2 minutes). Begin CPR for 2 minutes (5 cycles). Perform CPR for 5 cycles of 30 compressions to 2 breaths. Note: Do not remove the AED pads to perform CPR.
What are 4 safety procedures before using an AED? ›- Do Not touch the victim while defibrillating. ...
- Do Not use alcohol to wipe the victim's chest dry. ...
- Do Not use an AED in a moving vehicle. ...
- Do Not use an AED on a victim who is in contact with water. ...
- Do Not use an AED on a victim lying on a conductive surface.
- 1Complete the CHECK and CALL steps.
- 2As soon as an AED is available, turn it on and follow the voice prompts.
- 3Remove clothing and attach pads correctly.
- 4Plug the pad connector cable into the AED, if necessary.
- 5Prepare to let the AED analyze the heart's rhythm.
- Step 1: Check for Breathing. ...
- Step 2: Call 911. ...
- Step 3: Adjust your Body to Perform Chest Compressions. ...
- Step 4: Perform Chest Compressions. ...
- Step 5: Don't Stop.
CPR works on the principle of 30 chest compressions and 2 breaths of rescue breathing (mouth-to-mouth) – known as 30:2). Automated external defibrillators (AEDs) can be used by anyone in an emergency and are easy to use.
What is standard CPR vs high quality CPR? ›Most bystanders can perform hands-only CPR where compressions are administered. However, with high-quality CPR, a trained individual delivers the CPR that fits the specific guidelines which involve two (2) rescue breaths for every thirty (30) compressions.
What are the main components of CPR? ›What Are the Three Parts of CPR? The three basic parts of CPR are easily remembered as "CAB": C for compressions, A for airway, and B for breathing.
What are the steps when using an AED? ›- 1Complete the CHECK and CALL steps.
- 2As soon as an AED is available, turn it on and follow the voice prompts.
- 3Remove clothing and attach pads correctly.
- 4Plug the pad connector cable into the AED, if necessary.
- 5Prepare to let the AED analyze the heart's rhythm.
What are the 4 steps of hands only CPR? ›
Push hard, push fast. Compress the chest at least 2 inches. Compress at least 100 times per minute. Let the chest rise completely before pushing down again.
What are the 3 ABC of CPR? ›cardiopulmonary resuscitation procedures
may be summarized as the ABCs of CPR—A referring to airway, B to breathing, and C to circulation.
Answer and Explanation:
High-quality CPR is provided to people who have suffered cardiac arrest. This means that the person's heart is either not beating, or it is not beating sufficiently enough to pump blood to vital organs. High-quality CPR is also administered if a person is unresponsive or does not have a pulse.
Rescuers Should Continue High-Quality CPR: Rescuers should continue with high-quality CPR until the AED delivers a prompt to clear the victim for analysis. If No Shock is Advised: If no shock is advised and after any shock delivery, immediately resume high-quality CPR, starting with chest compressions.
Why is an AED needed? ›An AED, or automated external defibrillator, is used to help those experiencing sudden cardiac arrest. It's a sophisticated, yet easy-to-use, medical device that can analyze the heart's rhythm and, if necessary, deliver an electrical shock, or defibrillation, to help the heart re-establish an effective rhythm.
When should an AED be used? ›If the person is not breathing and has no pulse or has an irregular heartbeat, prepare to use the AED as soon as possible.