During the 2015 AHA cardiopulmonary resuscitation (CPR) guideline update, the CPR compression rate was changed from 100 chest compressions per minute to 120 chest compressions per minute. This change is for both adult CPR and child/pediatric CPR as well. This was a major change in cardiopulmonary resuscitation treatment and emergency cardiovascular care for adult basic life support as well as child/pediatric basic life support treatment protocol.
The return of spontaneous circulation (ROSC) and complete survival from cardiac arrest are both influenced by high-quality cardiopulmonary resuscitation (CPR) in emergency cardiovascular care. Studies have shown that achieving a cardiopulmonary resuscitation chest compressions rate between 100 and 120 per minute is associated with improved survival. Metronome-guided CPR compression rate assistance has shown improvement in chest compressions metrics during out-of-hospital CPR and AEDs with Real CPR Feedback are even more effective in increasing the survival rate of sudden cardiac arrest (SCA).
This article will focus primarily on hands-only CPR with only some mention of rescue breathing also referred to as mouth-to-mouth breathing for victims of SCA.
Cardiopulmonary resuscitation is an emergency cardiovascular care procedure that is performed in an attempt to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is often suffering from SCA. Bystander cardiopulmonary resuscitation or CPR by emergency medical personnel are addressed with the same procedures.
It is recommended that chest compressions be performed at a rate of 100–120 per minute. Two recent Cochrane reviews suggest that there is insufficient evidence to support or refute the CPR compression rate being above or below 100 chest compressions per minute.
The new cardiopulmonary resuscitation guidelines for performing CPR released in 2015 recommend a compression rate of 120/minute for all victims, regardless of age. This is based on the evidence that suggests that higher rates improve blood flow to the brain and heart, and lead to better outcomes.
The CPR compression rate is important, but it is only one part of the equation. Cardiopulmonary resuscitation performance or chest compressions protocol is influenced by a variety of factors, including:
All of these factors are important in achieving high-quality CPR.
Here are some tips to help you when performing CPR chest compressions effectively:
As you perform CPR, you should see the chest rise with each chest compression. If the chest does not rise, check to make sure that the victim’s airway is open by lifting the chin. If it is, reposition the victim’s head and try compressions again. If the chest still does not rise, call for help and continue compressions until help arrives.
The American Heart Association released new recommendations that state that bystanders can avoid mouth-to-mouth resuscitation and instead utilize Hands-Only CPR to assist an adult who collapses suddenly. Bystanders dial 9-1-1 and provide high-quality chest compressions by pushing hard and fast in the center of the victim’s chest in Hands-Only CPR.
In SCA, blood flow stops and the victim becomes unresponsive. Lack of oxygen in the brain will cause Brain Death within minutes.
Immediately after calling for help, the primary focus is on restoring blood flow. This can be done through chest compressions. Chest compressions create artificial circulation. By pushing blood through the body, it allows oxygen to reach the brain and other vital organs.
The goal is to keep the blood flowing until professional help arrives and can take over. With modern technology, there are now devices that give real-time feedback on CPR quality, including depth of compression, rate of compression, and release after each compression. AED machines can help laypeople perform high-quality CPR and provide a life-saving shock to the heart if needed.
120 compressions per minute is a fast pace and often difficult to maintain. Every second, a responder will be performing 1 to 2 compressions.
An adult’s chest compressions should be done with both hands at a depth of 2-2.4 inches. You’ll utilize one hand for a baby and two fingers for a child, compressing to only 1/3 the chest depth.
The majority of CPR mistakes are due to insufficient compressions or not doing them quickly enough. Furthermore, data reveal that delivering high-quality CPR, which includes compressions at a constant rate and depth with little gaps between them, allows for complete chest recoil between compressions, and avoids excessive ventilation.
There are two modern tools that assist first responders with CPR coaching and are used to improve CPR performance we will outline each below.
A metronome is a mechanical or electronic device that produces regular, metrical ticks (beats, clicks) — settable in beats per minute. These ticks represent a fixed, regular aural pulse; some metronomes also include synchronized visual motion (e.g., flashing lights).
Real CPR Feedback devices measure compression depth and rate. A Mesa Arizona Real CPR help study found that the cardiac arrest survival rate with Real CPR Help was 55.6% versus only 26.3% without Real CPR Help. The statistics showed that with Real CPR Help, patients were 2.7 times more likely to survive an SCA event.
Metronomes can help keep the rhythm. A study published in 2015 found that when metronome CPR compressions are used in conjunction with standard CPR compression rates, the compression rate may be better maintained. There are various Automated External Defibrillators (AEDs) with a metronome that beeps to the proper speed to assist with chest compressions and every training unit should have one as well. In addition, we recommend that our instructors include the usage of a metronome in their lessons.
Keeping in time with a metronome might also aid with the ventilation rate since you’ll deliver oxygen at the same beat. You’ll be able to pay attention to the depth of your chest compressions a little better when you’re not focused on your speed.
Music to help with the chest compressions rhythm.
Find a song with a beat that is in the proper range if you want to be sure you’re performing chest compressions at the correct speed.
Certain songs have been found to have the right tempo for performing chest compressions. The Bee Gees’ “Stayin’ Alive” and Queen’s “Another One Bites the Dust” are both excellent examples, each having 100 beats per minute. If you’re ever in doubt, these two classics.
For anyone close to you who has a cardiac arrest, the American Heart Association (AHA) offers two simple recommendations. First, call 9-1-1 immediately and push hard and fast in the center of the chest to the beat of the classic disco song “Stayin’ Alive”. CPR can more than double the chances of survival for those who have had a cardiac arrest, and “Stayin’ Alive” has the perfect rhythm for Hands-Only CPR (www.heart.org). The Bee Gees’ song “Stayin’ Alive” has the ideal beat for CPR, with 103 beats per minute in the music. This is around the chest compressions recommended of 100 per every 60 seconds.
The AHA has released a video series to help educate doctors about the importance of dental visits. An actor, comedian, and licensed physician in California, Ken Joeng appears in one of the advertising films and urges people to pay attention.
The modern automated external defibrillator (AED) often has real-time CPR feedback built into the device. Typically the feedback is given through pads (also called feedback pucks) that sit in between the chest of the victim and the hands of the first responder during bystander CPR.
These feedback devices measure the rate and depth of both compression and recoil of the CPR being administered to the SCA victim in real-time. The AEDs typically give audible real-time coaching and feedback to the responder, improving the quality of the CPR.
A 2013 study in the Annals of Emergency Medicine reported that survival from out-of-hospital cardiac arrest (OHCA), more than doubled when emergency medical providers utilized ZOLL defibrillators with REAL CPR Help to coach and assist the responder with the correct bystander CPR compressions rate. Rescuers were informed if they were pushing hard and fast enough to meet current ERC Standards as part of a focused effort to improve pre-hospital CPR quality and maximize survival from OHCA in Arizona.
In this study, ZOLL’s defibrillators with CPR feedback technology, including Real CPR Help® and CPR Dashboard™, in combination with scenario-based training, more than doubled the odds of survival-to-hospital discharge and of achieving a favorable neurological outcome (adjusted odds ratio of 2.72 and 2.69 respectively).
In the pre-hospital environment, the proportion of patients who survived to discharge after specialized (scenario-based) training and usage of ZOLL defibrillators with Real CPR Help® and CPR DashboardTM was almost doubled. Rescuers are informed if they’re pushing hard and fast enough to meet current ERC Standards.
According to one research, cardiac arrest victims who were both witnessed and induced by ventricular fibrillation and treated by an EMS provider that employed feedback technology had a better chance of surviving discharge: from 26.3% to 55.6%, according to the study’s findings. According to data from 484 cardiac arrest patients, a patient treated by an EMS provider with scenario-based training and the CPR Dashboard is 2.72 times more likely to survive than a similar patient who received conventional CPR training without feedback technology.
The research was led by Dr. Bentley Bobrow, medical director of the Arizona Department of Health Services Bureau of EMS and Trauma Systems. “There is increasing evidence that the quality of CPR given to cardiac arrest patients has a significant impact on their chances of survival,” Dr. Bobrow stated in an interview with Occupational Health & Safety. “There’s a lot of uncertainty about whether or not it’s possible to receive effective, high-quality CPR when you have no access to equipment that can help people do high-quality CPR.”
A study released by the Resuscitation Science Symposium, found that men are more likely to receive bystander CPR compared to women, in public locations.
Not all suspected sudden cardiac arrest events are treated with an AED but almost all are treated with CPR to try and keep life-saving blood and oxygen flowing to the brain and other vital organs.
CPR, or cardiopulmonary resuscitation, is an important life-saving technique that everyone should know how to perform. When someone has a sudden cardiac arrest, their heart stops beating and they stop breathing. If CPR is not administered immediately, they will die within minutes.
CPR can help keep the blood and oxygen flowing to the brain and other vital organs until medical help arrives. It is important to remember that CPR is only effective if it is done properly.
The modern AED is so advanced that it can recognize if the victim is suffering from a shockable event that can possibly be reversed with an AED. Often times an AED will recognize that there is no shockable pattern in the heart such as with asystole.
Asystole is a flat line on the EKG and is not a shockable event. If an AED is used on someone in asystole, it will often give voice prompts such as “no shock advised” or “analyzing rhythm”.
The Chain of Survival is a concept created by the American Heart Association to increase the chances of survival for someone who has a sudden cardiac arrest.
The Chain of Survival consists of four links:
1. Early access to emergency medical services (Call 911)
2. Early CPR (Begin Chest Compressions)
3. Early defibrillation (Find and use an AED Immediately)
4. Early advanced care
The main goal of chest compressions is to circulate oxygen-rich blood to the brain and other vital organs. When someone has a sudden cardiac arrest, their heart stops beating and they stop breathing. This means that the blood is no longer circulating and the person will quickly die if CPR is not administered immediately.
CPR can help keep the blood and oxygen flowing to the brain and other vital organs until medical help arrives. It is important to remember that CPR is only effective if it is done properly.
In 2010, the American Heart Association released new guidelines stating that bystanders should perform chest compressions-only CPR for adults who have a sudden cardiac arrest. The reason for this change away from conventional CPR training in removing the long-practiced mouth-to-mouth breathing technique is that research had shown that chest compressions are just as effective as chest compressions with rescue breaths in terms of circulating oxygen-rich blood to the brain.
Conventional CPR rescue breathing, often referred to as mouth-to-mouth breathing can be an important part of CPR, but it can be an obstacle for a first responder. The main reason for this is that rescue breathing requires the rescuer to have their mouth close to the patient’s mouth, which can expose them to potentially infectious diseases. In many cases the rescue breathing caused first responders to hesitate in performing CPR, which can decrease the chances of survival for the patient.
In 2008 new guidelines from the American Heart Association state that bystanders should perform chest compressions-only CPR for adults who have a sudden cardiac arrest. This change is based on research that shows chest compressions are just as effective as chest compressions with rescue breaths in terms of circulating oxygen-rich blood to the brain.
The new guidelines still recommend that bystanders perform CPR with rescue breaths for children and infants who have a sudden cardiac arrest. This is because children and infants are more likely to die from a lack of oxygen than adults.
Basic Life Support for Healthcare Providers is a course that teaches healthcare providers how to properly perform CPR and use an AED. The course is designed for doctors, nurses, paramedics, and other healthcare providers.
The Basic Life Support for Healthcare Providers course is divided into two parts: Part 1 and Part 2.
Part 1 is the classroom portion of the course and Part 2 is the skills portion.
In Part 1 of the course, healthcare providers will learn about the new CPR guidelines from the American Heart Association. They will also learn about the importance of early CPR and defibrillation, as well as the proper techniques for performing CPR and using an AED.
In Part 2 of the course, healthcare providers will have the opportunity to practice their CPR and AED skills on manikins. They will also be able to take a Written Exam and Skills Test to earn their Basic Life Support for Healthcare Providers certification.
The Basic Life Support for Healthcare Providers course is offered by many different organizations, including the American Red Cross and the American Heart Association. The course is usually offered in a classroom setting, but there are also online courses available.
Note that BLS training still includes rescue breathing training for emergency cardiovascular care.
CPR with AED Training is a course that teaches people how to properly perform CPR and uses an AED. The course is designed for laypeople who want to learn how to save a life.
The CPR with AED Training course is divided into two parts: Part 1 and Part 2.
In Part 1 of the course, participants will learn about the new CPR guidelines from the American Heart Association. They will also learn about the importance of early CPR and defibrillation, as well as the proper techniques for performing CPR and using an AED.
In Part 2 of the course, participants will have the opportunity to practice their CPR and AED skills on manikins.
An emergency response system is a plan of action to be taken by first responders in the event of an emergency. The system is designed to help first responders effectively and efficiently respond to an emergency situation.
The emergency response system includes a number of different components, such as:
The emergency response system is a critical component of any community’s public safety infrastructure. It is important that the system is regularly tested and updated to ensure that it is able to effectively respond to all types of emergencies.
Acute coronary syndrome (ACS) is a term used to describe a range of conditions that can lead to a sudden and potentially life-threatening heart attack. ACS occurs when the blood supply to the heart muscle is suddenly blocked. This can happen if the arteries that supply blood to the heart muscle become blocked or narrowed.
ACS is a medical emergency and requires immediate treatment. The most common treatment for ACS is angioplasty, which is a procedure to open up blocked arteries. Angioplasty is usually followed by stenting, which is a procedure to place a small metal mesh tube in the artery to keep it open.
CPR and AED training is essential for anyone who wants to learn how to properly respond to an emergency situation.
The American Heart Association (AHA) is a nonprofit organization that is dedicated to fighting cardiovascular disease and stroke. The AHA provides educational resources, funds research, advocates for public health, and offers CPR and first aid training.
The American Heart Association Guidelines are a set of evidence-based recommendations for the treatment of cardiovascular diseases. The Guidelines are regularly updated based on the latest scientific evidence. The AHA Guidelines are used by healthcare providers around the world to ensure that their patients receive the best possible care.
The American Heart Association Guidelines are important because they provide healthcare providers with an up-to-date, evidence-based roadmap for the treatment of cardiovascular diseases. By following the Guidelines, healthcare providers can ensure that their patients receive the best possible chance of survival and recovery.
Advanced airway training is a term used to describe a range of devices that can be used to maintain an open airway in a patient who is not breathing. Advanced airways include tracheal tubes, laryngeal mask airways, and endotracheal tubes.
The advanced airway is an important part of CPR because it allows oxygen to be delivered to the lungs of a patient who is not breathing by providing rescue breathing. By maintaining an open airway, an advanced airway can help to prevent brain damage and death.
Advanced airway training is a critical part of CPR because it can be the difference between life and death for a patient who is not breathing. It is important that everyone who is trained in advanced life support typically is not applicable to a nonmedical professional first responder.
An untrained bystander is someone who has not been trained in CPR or first aid. Untrained bystanders are often the first people on the scene of an emergency, and they play a crucial role in the response to an emergency.
The American Heart Association (AHA) recommends that all untrained bystanders be trained in CPR and first aid. Untrained bystanders can make a difference in the outcome of an emergency by providing critical care before professional responders arrive.
CPR and AED training is essential for anyone who wants to learn how to properly respond to an emergency situation. The American Heart Association (AHA) provides educational resources, funds research, advocates for public health, and offers CPR and first aid training.
AEDs are designed to be used by untrained bystanders in an emergency situation. AEDs are easy to use and can be operated by anyone, even if they have no medical training.
AEDs are small, portable devices that deliver an electric shock to the heart. AEDs are used to treat cardiac arrest, which is when the heart stops pumping blood. AEDs can be used on adults, children, and infants.
When a person goes into cardiac arrest, their chances of survival decrease with each passing minute. AEDs can help to improve the chances of survival by providing timely defibrillation.
AEDs for untrained bystanders are an important part of the response to an emergency. AEDs will guide any individual with audible and often visual instructions. You should never be hesitant to start CPR and attempt to save a life with these modern medical miracle devices available.
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