Chest Compression Guidelines: Key Considerations for Effective CPR

Performing chest compressions effectively is crucial during cardiopulmonary resuscitation (CPR). To maximize the chances of a positive outcome, it's important to follow specific guidelines and precautions that ensure both the quality of compressions and the safety of the patient.

Ensure Proper Technique and Continuity

Maintain consistent depth and rate during chest compressions. Aim for a depth of at least 2 inches (5 cm) and a rate of 100 to 120 compressions per minute. Interruptions should be minimized to less than 5 seconds, especially when switching rescuers. If advanced procedures like airway insertion or defibrillation are necessary, interruptions should not exceed 10 seconds to maintain coronary perfusion pressure.

Monitor Signs of Effective CPR

While performing CPR, observe for signs of circulation return, such as palpable pulses (especially in major arteries like the carotid or femoral), improved skin color, and pupil response. A key indicator is when the systolic blood pressure in the brachial artery rises above 60 mmHg. Additionally, look for improvements in skin tone—such as a return of pinkness to the lips, nail beds, and face—as well as any signs of increased consciousness or responsiveness from the patient.

Quick and Accurate Assessment

Before initiating compressions, quickly check for breathing and pulse. This assessment should be completed within 10 seconds to avoid unnecessary delays. If no normal breathing and no definite pulse are detected, begin CPR immediately with chest compressions.

Recognize Contraindications

There are specific situations where chest compressions should be avoided. These include conditions such as tension pneumothorax, rib fractures, active internal bleeding, or hemoptysis (coughing up blood). In such cases, standard chest compressions may cause further harm or complicate the patient's condition. If any of these contraindications are known or suspected, alternative interventions should be considered under medical supervision.