When someone experiences sudden cardiac arrest (SCA), survival depends on bystanders quickly intervening to provide cardiopulmonary resuscitation (CPR) and other lifesaving measures until emergency medical services arrive. A rescuer delivering CPR compresses a victim's chest to perfuse the heart, brain, and other vital organs with oxygenated blood. Some form of manual ventilation may also be provided until the victim shows signs of the return of spontaneous circulation (ROSC), such as breathing, coughing, or a measurable pulse.

What Is High-Quality CPR?

High-quality CPR meets certain performance metrics considered vital by the American Heart Association (AHA) for improving survival from cardiac arrest.^1,2 This includes providing compressions at the proper rate and depth, making sure not to lean on the chest, avoiding excessive ventilation, and keeping interruptions to an absolute minimum.

One study found that when bystanders delivered high-quality CPR to a victim of SCA, it was four times more likely that the victim was discharged from the hospital in a neurologically favorable condition.³ The potential for positive outcomes highlights the need to maximize CPR quality to help save more lives.

Five Components of High-Quality CPR

In their 2020 Guidelines, both the AHA and the European Resuscitation Council (ERC) identified five critical components required for providing high-quality CPR:

1. Achieving a rate of 100-;120 compressions per minute
2. Compressing the chest to a depth of 2-;2.4 inches (5-;6 centimeters)
3. Avoiding leaning on the chest to allow for full chest wall recoil after each compression
4. Minimizing pauses in compressions (chest compression fraction > 60%)
5. Avoiding excessive ventilation by maintaining 2 breaths to every 30 compressions without advanced airway or 10 breaths per minute with advanced airway

The AHA and ERC also provide guidelines for hands-only CPR, which does not include rescue breaths. Hands-only CPR includes the following steps:

1. Call emergency services.
2. Interlock and position your hands on the center of the victim's chest.
3. Press hard and fast on the victim's chest at a rate of 100-;120 beats per minute until help arrives.

Tools to Improve CPR Performance

Rescuers at every experience level need assistance when delivering CPR. ZOLL^® products incorporate CPR technology that uses audio and text prompts to help both professional and lay rescuers deliver high-quality CPR. Hospital systems have doubled the odds of survival both in and out of the hospital by improving their CPR quality and incorporating ZOLL technology. ^4,5

Real CPR Help^® technology featured on ZOLL AEDs (automated external defibrillators) and professional monitor/defibrillators assists both lay rescuers and healthcare professionals alike in delivering high-quality CPR. Visual and audio feedback guides rescuers to deliver CPR compressions fast enough and deep enough to help save a life. ZOLL AEDs also analyze a victim's heartbeat during CPR to determine whether a corrective shock is needed. Before the shock is delivered, audio and visual feedback instructs rescuers to temporarily cease compressions. Once the shock has been delivered, the device automatically instructs rescuers to resume CPR.

On ZOLL's professional defibrillators, the CPR Dashboard™ displays detailed information, including the rate and depth of each compression and whether or not a rescuer is fully releasing the chest following each compression. In addition, See-Thru CPR^® technology filters out compression artifact so that the patient's underlying heart rhythm can be displayed during CPR, minimizing pause times. With Real CPR Help technology, all the key data from the rescue effort is recorded and can be easily accessed for post-event debriefing and training.

The innovative rescue technology built into ZOLL products guides professional rescuers and bystanders alike to deliver high-quality CPR and gives them the peace of mind that they are providing the best care possible.

AutoPulse Resuscitation System and High-Quality CPR

CPR can sometimes be required for an extended period of time. Recent data shows that when CPR quality is high enough, patients can survive long-duration CPR with good neurologic function.⁶ Using mechanical CPR technology, the AutoPulse^® Resuscitation System can deliver continuous high-quality CPR — without the fatigue a rescuer providing manual CPR eventually suffers.

Whether the CPR is manual or mechanical, the goal is a positive patient outcome. ZOLL is committed to helping all rescuers — lay people, EMS professionals, and hospital-based caregivers — perform high-quality CPR to help save lives.