#EMconf: Effective CPR Pearls from Dr. Roberts

Thu, 03/30/2017 - 6:43am
Author: 
Brian Roberts M.D.

 

  • The quality of CPR is probably the single most important treatment-related determinant of outcome from cardiac arrest​

  • 2015 guidelines recommend chest compression rate of 100-120 compressions per minute at a depth of 2 - 2.4 inches (5-6cm).  Err on the side of faster and deeper as opposed to risking too slow or inadequate depth

  • Limit ALL chest compression pauses to less than 10 seconds (e.g. take 5 sec US video clip during pulse check then analyze once compressions resume)

  • Rescue breaths should be administered at a 30:2 ratio (compressions to breaths) or 1 every 6 seconds once definitive airway is placed

  • Over ventilation results in increased intra-thoracic pressure, and decreased cardiac output during chest compressions, decreasing the probability of ROSC and good neurological outcome

  •  EtCO2 can be used to monitor quality of chest compressions with a goal of > 20 mmHg