Updated Guidelines on Chest Compressions

When performing Cardiopulmonary Resuscitation (CPR), rescuers locate the center of the chest in between the nipples and depress until two inches have been reached. Once the two inches of chest compressions have been reached, the rescuers relax to allow for recoil of the chest back to its normal position. This technique allows a sustained flow of blood to the heart where oxygen can supply the brain and other organs and keep them functioning until the heartbeats normally after advanced life support has been provided. Without chest compressions, the life expectancy of a person suffering from cardiac arrest (when the heart stops beating) is zero. Over the decades of performing CPR, the guidelines on chest compressions have always been the same where depression to two inches and relaxation to full recoil is repeated thirty times to allow two breaths to be given. Lately, those guidelines have been enhanced by the American Heart Association because of their research on the Return of Spontaneous Circulation (ROSC) and the success it has shown where victims depart the hospital to live a normal life after cardiac arrest. Today, chest compressions are being done more than in the past. The guidelines of chest compressions overtake artificial ventilation because it is important to keep the heart beating rather than allowing ventilation to occur because oxygenated blood flows when performed artificially. Let it be known that artificial ventilation is not entirely removed from the guidelines of cardiopulmonary resuscitation. In certain situations, chest compressions may be insufficient because of the nature of the cardiac arrest. Research have indicated that in drowning situations, victims who are given rescue breaths and just compressions will likely recover if performed early and shortly after the arrest occurred. Chest compressions are always required in cardiac arrest and one of the main reasons hands-only CPR has been established is because a clear majority of people declined to help those in need because they are under the impression that they must do mouth-to-mouth resuscitation. Resuscitation by means of assistant equipment such as a pocket mask or resuscitator continues to be used in the definitive setting, and the prehospital setting with advanced life support providing care. Even with advance life support providing care, the guidelines remain the same. The recommended ratio of chest compressions to ventilations are 30 compressions and two breaths. Compressions are started immediately after the breaths are given. There should be no or very little interruption in chest compressions. For children, the chest compressions for a single person remains thirty compressions to two breaths. However, when there are two rescuers, the compression rates are fifteen compressions to two breaths. This means that the rescuer performing chest compressions are compressing fifteen times while the rescuer at the mouth gives two breaths. When there is one rescuer, the compressions are interrupted to give two breath. However, the compressions must not be interrupted when there are two rescuers. If compressions are interrupted, this is poor CPR which means there is a poor outcome for the victim. CPR is essential and must be performed when the need arises. One of the failures that occur is when people who know CPR and those who don’t decline to act. This delay is deadly and irresponsible as a human being. The guidelines are simple. Push on the chest until two inches is reached. On the other hand, some people may not know how deep two inches are. In this case, just push hard and fast and keep pushing until help from someone else who is trained or not trained in CPR or professional help arrives. If someone arrives and is not trained in CPR, simply show them where to place their hands and demonstrate how hard and fast that you want them to push. Under no circumstance is anyone forced to assist you in CPR. The law provides protection under the good Samaritan law that keeps you from being successfully sued if you are staying within your basic limits of training. The guidelines of chest compressions are just that: they are guidelines, and since there is no other civilian known alternative, it is best to follow those guidelines, especially since it is backed by research. The American Heart Association is a viable and reliable entity that have demonstrated a concern for the wellbeing of all people. The guidelines that they create are not final because with time comes changes. These changes are paramount and important for the survival of humanity. Compress on the front of the thirty times with two breaths when you are alone and helping someone. It is the same with two people, but the guidelines discourage interruptions in chest compressions. Ultimately, you will do your best.

Ennis C. Jackson

Ennis is an Advance Life Support caregiver providing emergency care, training, motivating and educating on a national level for over 35 years with strong concentration and enormous success in business consultation, motivational and safety speaking, minor project management and customer service management. Ennis has been a Supervisor and Associate Supervisor in California, Okinawa Japan, and S. Korea with experience in leading teams and managing large groups of personnel.

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When performing Cardiopulmonary Resuscitation (CPR), rescuers locate the center of the chest in between the nipples and depress until two inches have been reached. Once the two inches of chest compressions have been reached, the rescuers relax to allow for recoil of the chest back to its normal position. This technique allows a sustained flow of blood to the heart where oxygen can supply the brain and other organs and keep them functioning until the heartbeats normally after advanced life support has been provided. Without chest compressions, the life expectancy of a person suffering from cardiac arrest (when the heart stops beating) is zero. Over the decades of performing CPR, the guidelines on chest compressions have always been the same where depression to two inches and relaxation to full recoil is repeated thirty times to allow two breaths to be given. Lately, those guidelines have been enhanced by the American Heart Association because of their research on the Return of Spontaneous Circulation (ROSC) and the success it has shown where victims depart the hospital to live a normal life after cardiac arrest. Today, chest compressions are being done more than in the past. The guidelines of chest compressions overtake artificial ventilation because it is important to keep the heart beating rather than allowing ventilation to occur because oxygenated blood flows when performed artificially. Let it be known that artificial ventilation is not entirely removed from the guidelines of cardiopulmonary resuscitation. In certain situations, chest compressions may be insufficient because of the nature of the cardiac arrest. Research have indicated that in drowning situations, victims who are given rescue breaths and just compressions will likely recover if performed early and shortly after the arrest occurred. Chest compressions are always required in cardiac arrest and one of the main reasons hands-only CPR has been established is because a clear majority of people declined to help those in need because they are under the impression that they must do mouth-to-mouth resuscitation. Resuscitation by means of assistant equipment such as a pocket mask or resuscitator continues to be used in the definitive setting, and the prehospital setting with advanced life support providing care. Even with advance life support providing care, the guidelines remain the same. The recommended ratio of chest compressions to ventilations are 30 compressions and two breaths. Compressions are started immediately after the breaths are given. There should be no or very little interruption in chest compressions. For children, the chest compressions for a single person remains thirty compressions to two breaths. However, when there are two rescuers, the compression rates are fifteen compressions to two breaths. This means that the rescuer performing chest compressions are compressing fifteen times while the rescuer at the mouth gives two breaths. When there is one rescuer, the compressions are interrupted to give two breath. However, the compressions must not be interrupted when there are two rescuers. If compressions are interrupted, this is poor CPR which means there is a poor outcome for the victim. CPR is essential and must be performed when the need arises. One of the failures that occur is when people who know CPR and those who don’t decline to act. This delay is deadly and irresponsible as a human being. The guidelines are simple. Push on the chest until two inches is reached. On the other hand, some people may not know how deep two inches are. In this case, just push hard and fast and keep pushing until help from someone else who is trained or not trained in CPR or professional help arrives. If someone arrives and is not trained in CPR, simply show them where to place their hands and demonstrate how hard and fast that you want them to push. Under no circumstance is anyone forced to assist you in CPR. The law provides protection under the good Samaritan law that keeps you from being successfully sued if you are staying within your basic limits of training. The guidelines of chest compressions are just that: they are guidelines, and since there is no other civilian known alternative, it is best to follow those guidelines, especially since it is backed by research. The American Heart Association is a viable and reliable entity that have demonstrated a concern for the wellbeing of all people. The guidelines that they create are not final because with time comes changes. These changes are paramount and important for the survival of humanity. Compress on the front of the thirty times with two breaths when you are alone and helping someone. It is the same with two people, but the guidelines discourage interruptions in chest compressions. Ultimately, you will do your best.

Vlad Magdalin

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