Increased chest compression to ventilation ratio improves delivery of CPR

Hostler, David; Rittenberger, Jon C.; Roth, Ronald N.; Callaway, Clifton W.

doi:10.1016/j.resuscitation.2007.01.022

Cited by 36 publications

(21 citation statements)

References 18 publications

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“…3 The feasibility of the AHA and ERC guidelines recommendation that lay rescuers deliver 2 ventilations within 5 seconds was questioned after 2 manikin studies 4,5 showed that lay rescuers and healthcare providers interrupted chest compressions for a much longer duration than recommended (16 and 10 seconds, respectively) to provide 2 ventilations. In a study of automated external defibrillator (AED) use by first responders, the duration of the pause for ventilation after the first and second compression cycles was 6.3 and 6.0 seconds, respectively.…”

Section: Clinical Perspective On P 1590mentioning

confidence: 99%

Duration of Ventilations During Cardiopulmonary Resuscitation by Lay Rescuers and First Responders

et al. 2013

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In the Netherlands, when a cardiac arrest is suspected, 2 ambulances equipped with a manual defibrillator are sent by the dispatcher. Besides the ambulance, the dispatcher sends firefighters or policemen (first Background-The 2010 guidelines for cardiopulmonary resuscitation allow 5 seconds to give 2 breaths to deliver sufficient chest compressions and to keep perfusion pressure high. This study aims to determine whether the recommended short interruption for ventilations by trained lay rescuers and first responders can be achieved and to evaluate its consequence for chest compressions and survival. Methods and Results-From a prospective data collection of out-of-hospital cardiac arrest, we used automatic external defibrillator recordings of cardiopulmonary resuscitation by rescuers who had received a standard European Resuscitation Council basic life support and automatic external defibrillator course. Ventilation periods and total compressions delivered per minute during each 2 minutes of cardiopulmonary resuscitation cycle were measured, and the chest compression fraction was calculated. Neurological intact survival to discharge was studied in relation to these factors and covariates. We included 199 automatic external defibrillator recordings. The median interruption time for 2 ventilations was 7 seconds (25th-75th percentile, 6-9 seconds). Of all rescuers, 21% took <5 seconds and 83% took <10 seconds for a ventilation period; 97%, 88%, and 63% of rescuers were able to deliver >60, >70, and >80 chest compressions per minute, respectively. The median chest compression fraction was 65% (25th-75th percentile, 59%-71%

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Section: Clinical Perspective On P 1590mentioning

confidence: 99%

Duration of Ventilations During Cardiopulmonary Resuscitation by Lay Rescuers and First Responders

et al. 2013

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“…Evidence from 6 human studies (LOE 3 14,21,198,199 ; LOE 4 70 ; LOE 5 6 ) in adults and 23 additional studies (LOE 5: animal, manikin, and computer models) provides conflicting information about the optimal compression-ventilation ratio to maximize ROSC and survival to hospital discharge when CPR is administered by lay rescuers or by professional rescuers to patients with cardiac arrest in any setting.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 5: Adult Basic Life Support

Sayre¹,

Koster²,

Botha³

et al. 2010

Circulation

151

136

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“…12 A before-and-after clinical study among municipal firefighters who originally used 15:2 CPR and then were retrained to perform 30:2 CPR was reported from Pittsburgh. 13 No differences in any outcome measures were found. 13 Our study has several potential limitations.…”

Section: Discussionmentioning

confidence: 90%

“…13 No differences in any outcome measures were found. 13 Our study has several potential limitations. The conclusions of the study may not apply to bystander CPR performed by 2 rescuers when the interruptions for chest compressions to deliver the 2 recommended ventilations after each 30 compressions would not be as long.…”

Section: Discussionmentioning

confidence: 90%