High Quality CPR Overview

High-quality CPR Defined

High-quality CPR means providing compressions at the proper depth and rate, making sure not to lean on the victim's chest, and keeping interruptions to an absolute minimum. The AHA CPR quality consensus statement details the components required to optimise CPR:

  • Chest compression fraction > 80% (Stay on the chest and limit interruptions)
  • Compression rate of 100-;120 compressions/minute
  • Compression depth > 5-6 cm
  • Avoid leaning on the chest, which prevents full recoil
  • Avoid excessive ventilation (Aim for 8-;10 breaths/minute)

CPR Quality Matters for Survival Outcomes

When someone collapses from sudden cardiac arrest, survival depends on the quality of CPR delivered. And it has become increasingly clear that we could do a lot better when it comes to performing cardiopulmonary resuscitation (CPR). The 2013 AHA Consensus Statement on CPR Quality calls for rescuers both inside and outside the hospital to "maximize the quality of CPR and save more lives."1 The 2010 Guidelines from the European Resuscitation Council and the American Heart Association (AHA) emphasised the same message: CPR quality is crucial to patient survival.2

Hands-only CPR

The vast majority of cardiac arrests occur outside the hospital, so organisations like the British Heart Foundation have conducted campaigns to get the word out about the importance of starting CPR immediately—and that almost anyone can do it. The switch to Hands-Only CPR is intended to get more people to start performing CPR while waiting for the ambulance. But regardless of who is performing it, CPR is stressful.

CPR Quality Indicators

There are several indicators of CPR quality that all medical providers should be aware of. This includes compression fraction, compression rate, compression depth, and ventilatory rate.

Compression Fraction

Compression fraction refers to the percent of time during cardiac arrest that CPR is actually being performed. It's important to minimize interruptions during CPR as much as possible to ensure high quality. The ERC recommends a fraction >60%.

Compression Rate

Compression rate is how fast CPR is being performed and it is recommended to shoot for 100-200 compressions per minute. If compressions are too slow, blood won't circulate effectively throughout the body, and if compressions are too fast, the heart does not have enough time to adequately fill and cardiac output drops off.

Compression Depth

Compression depth is a measurement of how deep the sternum is pushed down during CPR. The AHA recommends a depth of >5-6 cm for adults. It is important to remember to allow the chest to fully recoil after each compression so that the heart can fill with blood completely.

Tools to Improve CPR Performance

Rescuers at every experience level need assistance when delivering CPR. ZOLL® is committed to providing technology to do exactly this. Systems, both in and out of the hospital, that have focused on improving their CPR quality and have incorporated ZOLL technology, have doubled the chance of survival.

X Series CPR Dashboard screen

The Real CPR Help® technology on ZOLL's AEDs (automated external defibrillators) and professional defibrillators assists lay rescuers and health care professionals alike in delivering high-quality CPR. Real CPR Help provides visual and audio feedback that guides rescuers to deliver CPR compressions fast enough and deep enough to save a life.

Thanks to CPR Dashboard™, ZOLL's professional defibrillators support health care providers throughout an entire cardiac event. All of the information needed to perform high-quality CPR is clearly displayed on the defibrillator screen. In addition, See-Thru CPR® technology filters out compression artifact so that the patient's underlying heart rhythm can be displayed during CPR, which minimises the duration of pauses. And through Real CPR Help technology, all of the key data from the rescue effort is recorded and can be easily accessed for post-event debriefing and training. Using these technologies, increased survival has been documented both in and out of the hospital.

High-quality CPR for as Long as It Takes

CPR can sometimes be required for an extended period. If the quality of CPR provided is good enough, data now show that patients can survive long-duration CPR with good neurologic function. The AutoPulse® Non-invasive Cardiac Support Pump never gets tired because it provides mechanical CPR. And since every patient is unique, the AutoPulse provides custom compressions. The AutoPulse is the only mechanical CPR system to show significant clinical benefits in human trials.3

Whether the CPR is manual or mechanical, the goal is return of spontaneous circulation (ROSC) and a good outcome for the patient. ZOLL is committed to helping all rescuers—lay people, emergency services professionals, and hospital-based caregivers perform high-quality CPR. It's what patients deserve.

1Meaney PA, et al. Circulation. 2013 Jul 23;128(4):417-;35. Epub 2013 Jun 25.
2Hazinski MF et al. Circulation. 2010 Oct 19;122(16 Suppl 2):S250-;75.
3Ong ME, et al. JAMA. 2006 Jun 14;295(22):2629-;37.