The five critical components of high-quality CPR.

A recently published consensus statement from the American Heart Association is a timely reminder of the five critical components of CPR that have been shown to improve the chances of a victim surviving neurologically intact:

1 Minimise interruptions in chest compressions. At least 80% of the time a victim is receiving CPR should be spent providing high-quality chest compressions.

2. Avoid leaning on the chest between compressions, to allow the chest recoil fully, and blood to return to the heart.

3. Ensure compressions are adequately deep (at least 5cm in adults, at least 1/3 chest diameter in children and infants) AND

4. Ensure compressions are fast enough (100 - 120/minute)

5. Avoid excessive ventilation of the victim - no more than 12 breaths/minute, with a volume sufficient to make the chest just rise.

The statement also addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient’s response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. 

The full version of the paper is essential reading for all healthcare professionals and first responders. It can be accessed for free at the Circulation website . 

Meaney PA, Bobrow BJ, Mancini ME, Christenson J, de Caen AR, Bhanji F, Abella BS, Kleinman ME, Edelson DP, Berg RA, Aufderheide TP, Menon V, Leary M, CPR Quality Summit Investigators, the American Heart Association Emergency Cardiovascular Care Committee, and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation. Cardiopulmonary resuscitation quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the american heart association. Circulation. 2013 Jul 23;128(4):417-35. PubMed PMID: 23801105.


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