High-quality CPR is the main component in influencing survival from sudden cardiac arrest, but there is considerable variation in monitoring, implementation, as well as quality improvement. A large gap exists between current knowledge of CPR quality and its optimal implementation, leading to preventable deaths from cardiac arrest.

Through better measurement, training, and systems-improvement processes of CPR quality, we can have a significant impact on survival from cardiac arrest and eliminate the gap between current and optimal outcomes. Here are below some metrics and measurements provided by the American Heart Association® to objectively assess the quality of your CPR.

General Checklist

Was the team leader clearly identified?
Was the scene orderly and quiet?
Was the defibrillator applied quickly?
Was CPR started promptly?
Were pauses in CPR delivery minimized?
Was CPR of subjectively high quality?
Was an airway secured efficiently?

CPR Quality Analysis

Chest Compression fraction (CCF)

Greater than 80%.  CCF is the proportion of time that chest compressions are performed during a cardiac arrest.  Data on out-of-hospital cardiac arrest indicate that lower CCF is associated with decreased ROSC and survival to hospital discharge

Mean compression rate

100 to 120 compressions/min.  As chest compression rates fall, a significant drop-off in ROSC occurs, and higher rates may reduce coronary blood flow.

Mean compression depth

For ADULTS: at least 50 mm (2 inches). For INFANTS and CHILDREN: at least 1/3 AP dimension of chest. Compression generates critical blood flow and oxygen and energy delivery to the heart and brain. The 2010 AHA Guidelines for CPR and ECC recommend a single minimum depth for compressions of ≥2 inches (50 mm) in adults and at least one-third of the anterior-posterior dimension of the chest in infants and children (≈1½ inches, or 4 cm, in infants and ≈2 inches, or 5 cm, in children).

Compressions without leaning 

Full chest recoil. No Residual Leaning. Incomplete chest wall release occurs when the chest compressor does not allow the chest to fully recoil on completion of the compression. This can occur when a rescuer leans over the patient’s chest, impeding full chest expansion. Leaning is known to decrease the blood flow throughout the heart and can decrease venous return and cardiac output.

Mean ventilation rate 

Less than 12 breaths/min; minimal chest rise. The expert panel supports the 2010 AHA Guidelines for CPR and ECC and recommends a ventilation rate of <12 breaths per minute to minimize the impact of positive-pressure ventilation on blood flow.

Train with Bangkok First Aid

Our American Heart Association ® courses encompass adult, pediatric (child and infant) CPR AED and First Aid skills. Moreover, we deliver the specific AHA Basic Life Support (BLS) and Advance Cardiovascular Life Support (ACLS) courses. Furthermore, we offer a comprehensive First Aid at Work course with audit, specifically designed to meet national and international compliance standards for CPR and first aid courses in the workplace. Learn more.

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