High-Quality CPR: Overview & Components To Measure It

High-Quality CPR: Overview & Components To Measure It

High-Quality CPR Overview

High-quality CPR (cardiopulmonary resuscitation) meets specific performance metrics set by international resuscitation guidelines. Administering high-quality CPR to a patient in cardiac arrest significantly increases their chances of survival and improves neurological outcomes. It makes it up to four times more likely that a victim will recover without neurological damage.

Before starting CPR, always ensure the scene is safe and call 911. If possible, perform chest compressions while on the phone with emergency services. If alone and without immediate access to a phone, prioritize calling 911 before starting CPR.

Components of High-Quality CPR

Positioning and Location

Hands must be placed correctly to ensure safe and effective chest compressions. Position the heel of one hand in the middle of the chest, at the lower third of the sternum, and interlace the fingers of the other hand on top.

Perform CPR on a firm surface with the victim lying on their back. Avoid moving the victim unless necessary for safety.

Compression Rate and Depth

Perform compressions at a rate of 100-120 per minute. Using songs with a beat within this range can help maintain the correct pace.

Compress the chest of an adult victim to a depth of 2 to 2.4 inches. For children and infants, adjust the depth accordingly: 1.5 inches for infants and up to 2 inches for children.

Ensure equal time for compression and chest recoil, avoiding leaning on the chest between compressions.

Chest Compression Fraction, Rescue Breathing, and Pauses

Aim for a chest compression fraction (CCF) of at least 60%, meaning compressions should occupy 60% or more of the CPR time.

Minimize pauses in compressions, especially when giving rescue breaths, which should last about one second each.

Maintain a compression-ventilation ratio of 30:2 for adults.

AED Shocks

Use an AED as soon as it is available, following the device’s prompts to deliver effective shocks.

Steps for Providing High-Quality CPR

Ensure Scene Safety

Confirm the environment is safe for both you and the victim.

Check Breathing and Responsiveness

If the person is unresponsive and not breathing or only gasping, they need CPR.

Call 911

Dial 911 immediately. If you are alone, use a speakerphone to call while starting compressions.

Start Compressions

Begin chest compressions right away. If trained and able, provide rescue breaths at a rate of two breaths for every 30 compressions.

Use of AED

Administer a shock with an AED as soon as it is available.

Continue CPR

Keep performing CPR until emergency medical services arrive.

Common CPR Mistakes to Avoid

Rescuer Exhaustion

Performing compressions correctly is tiring. Switch with another rescuer every two minutes to maintain effectiveness.

Leaning on the Victim

Allow full chest recoil between compressions to ensure adequate blood flow back to the heart.

Mistiming Chest Compressions Around AED Shocks

Minimize the time between stopping compressions and delivering the AED shock, and resume compressions immediately after.

Checking for a Pulse

Lay rescuers should not check for a pulse; this can waste valuable time.

Overemphasis on Rescue Breaths

If you cannot or do not want to give rescue breaths, perform hands-only CPR, focusing on continuous chest compressions.


High-quality CPR saves lives. Following the American Heart Association’s guidelines can significantly improve the chances of survival from cardiac arrest.

Frequently Asked Questions (FAQ)

Who needs high-quality CPR?

Any person suffering from Sudden Cardiac Arrest (SCA) requires high-quality CPR, regardless of age.

Importance of complete chest recoil?

Complete chest recoil allows the heart to refill with blood, ensuring adequate circulation during CPR.

Performing chest compressions on children?

For children, use the same rate as adults but adjust the force and depth based on the child’s size. One hand may be sufficient for smaller children, while older ones may require compressions similar to adults.

By following these guidelines, you can ensure that the CPR you provide is effective and increases the chances of a positive outcome for the victim.