References
Lateral versus over-the-head chest compression quality in student paramedic
Abstract
Good-quality chest compressions have been the cornerstone of cardiac arrest management since the 1960s and are one of the few interventions proven to improve survival from out-of-hospital cardiac arrest (Feneley et al, 1988; Stiell et al, 2014a). Defining the ‘quality’ of chest compressions, however, can be challenging, although international guidelines and the UK Resuscitation Council emphasise quality in respect particularly to chest compression rate, depth and recoil (Olasveengen et al, 2021; Soar et al, 2021).
Chest compressions should be performed at a rate of 100–120 per minute to maintain coronary perfusion pressure (CPP). Rates that are too slow will allow CPP to fall, reducing perfusion, and rates that are too high will cause reduced cardiac filling and subsequent falls in CPP. This recommended rate is based upon two studies with a combined population of 13 469 patients who achieved higher rates of survival at this compression rate (Idris et al, 2015). Very high chest compression rates were associated with decreased chest compression depth and suboptimal cardiopulmonary resuscitation (CPR) (Stiell et al, 2014a).
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