Emergency Live | ESC 2018 - A change of Italian law to improve the survival rate from cardiac arrest image 5

Cardiopulmonary resuscitation: the compression rate for CPR of adults, children and infants

By Cristiano Antonino On Mar 2, 2023

Cardiopulmonary resuscitation (CPR) consists of chest compressions and mouth-to-mouth breathing to maintain circulatory flow and oxygenation

CARDIOPROTECTION AND CARDIOPULMONARY RESUSCITATION? VISIT THE EMD112 BOOTH IN EMERGENCY EXPO NOW TO LEARN MORE

Different age groups require a different standard for CPR reports

For example, the compression rate for a man with a rounded, larger chest may require a strong push, while for the elderly a strong, fast and deep push may cause ribs to break.

The compression rate for an infant is also different because it requires less effort.

With regard to basic life support for children, the AHA and Emergency Cardiovascular Care guidelines continue to emphasise the importance of high-quality CPR, chest compressions of adequate frequency and depth, complete chest drop with each compression, minimal interruptions, and avoidance of excessive ventilation.

It must be said that the lines of thought, although similar, are varied in different areas of the world, but in general the Anglo-Saxon school is the most widely used in the world.

At the end of this article, you can learn more by evaluating the different lines of thought in different areas of the world.

Remember that looking at rescue through the eyes of another rescuer is always enriching.

WOULD YOU LIKE TO GET TO KNOW RADIOEMS? VISIT THE RESCUE RADIO BOOTH AT EMERGENCY EXPO

Here is the difference between CPR compression ratios for adults and children

Adult CPR ratios

Quality CPR must meet certain parameters set by the American Heart Association to improve cardiac arrest survival.

This includes performing chest compressions at the correct rate and depth.

Here are the CPR ratios to keep in mind when performing adult CPR.

Ratio of compressions to ventilation

The ratio of compressions to ventilation refers to the number of chest compressions performed, followed by the number of ventilation breaths taken while performing CPR.

According to the American Heart Association, the correct ratio of compressions to ventilations for adults is 30:2.

This means that 2 ventilator breaths should be provided during CPR.

This means providing 2 breaths of ventilation after 30 compressions and maintaining a constant rhythm.

If there is another rescuer, the same method must be followed, except that each rescuer can take turns delivering ventilation breaths and compressions without pausing.

The American Heart Association guidelines also indicate that, in patients with an advanced airway, one ventilation breath should be administered every six seconds with continuous chest compressions instead of 30 compressions and two breaths.

In the east of the world, there is much debate around this, and some schools adopt a slightly different method with respect to the number of compressions.

Speed of compressions

This refers to the rate or rhythm of chest compressions per minute during CPR.

For example, a rate of 100 chest compressions per minute means that 100 compressions can be performed in 1 minute if it is not necessary to stop for ventilations.

Typically, a single rescuer performing 100/1 continuous chest compressions will perform approximately 75 chest compressions per minute due to the need to ventilate breathing.

Chest compressions should be performed without stopping until emergency medical personnel take over if the victim has been intubated.

In addition, interruptions should be minimised to achieve a chest compression fraction of 60.

Depth of compressions

The depth of compressions is the depth at which the victim’s chest is compressed with each chest compression.

According to the American Heart Association guidelines, the ideal depth of chest compressions for adults is at least 5 cm, with a frequency of 100-120 compressions per minute.

This point is generally agreed upon.

Rescue breathing

Rescue breathing is the number of ventilator breaths that are delivered every minute.

Each rescue breath must be administered within 1 second with a sufficient tidal volume to produce chest elevation.

This is for victims who still have a pulse but are not breathing. The first responder can provide sufficient oxygen to preserve life by breathing into the victim’s lungs.

It is important to act quickly because brain damage can occur after only 3 minutes without oxygen.

In a previous study of adults with out-of-hospital cardiac arrest, continuous chest compressions without rescue breathing did not result in significantly higher survival rates than 30 compressions and 2 ventilations.

If an Automated External Defibrillator or AED is available, alternate 3-4 shocks with 1 minute of CPR.

CPR should be continued until the patient is seen breathing or regaining consciousness.

CPR reports for children

Adults usually require CPR because of sudden cardiac arrest due to a heart attack, while children tend to require CPR because of a breathing problem leading to cardiac arrest.

It is essential to know the correct CPR procedure, the positioning of the child’s hands and the CPR report for children in order to be prepared when an emergency occurs.

Relationship between compressions and ventilation

According to the American Heart Association guidelines, the ratio of compressions to ventilation for children is 30:2, the same for adults.

This means that it is necessary to perform 30 chest compressions followed by two rescue breaths.

If there are two rescuers, the ratio of compressions to ventilations will be 15:2.

Frequency of compressions

The recommended frequency for performing chest compressions in children is at least 100-120 compressions per minute.

After 30 compressions, tilt the head, lift the chin and take two effective breaths.

Although the frequency of compressions is 100-120 per minute, the actual number of compressions will be lower due to pauses for breathing.

What is the appropriate number of compressions per minute for a child under 1 year of age?

The appropriate number of compressions per minute for a child under 1 year of age is at least 100 compressions per minute.

Depth of compressions

According to the American Heart Association guidelines, the depth of chest compressions for children is at least one-third of the diameter of the chest, i.e. about 2 inches or 5 cm, at a rate of 100-120 compressions per minute.

Rescue breathing

To perform rescue breathing for a child, place one hand on the forehead and push with the palm of the hand to tilt the head back.

Then take a normal breath and blow it towards the child’s mouth for 1 second.

Observe if the baby’s chest rises.

Try to administer 12 to 20 rescue breaths per minute for a child who is not breathing.

This means approximately one rescue breath every 3-5 seconds.

THE IMPORTANCE OF TRAINING IN RESCUE: VISIT THE SQUICCIARINI RESCUE BOOTH AND FIND OUT HOW TO BE PREPARED FOR AN EMERGENCY

CPR reports for infants

CPR is performed when an infant is unconscious, unresponsive or not breathing.

CPR keeps blood and oxygen circulating in the infant’s body with chest compressions and rescue breathing until more experienced personnel take over.

If you are a parent, babysitter or childminder, you can enrol in an infant CPR course to gain a better understanding of CPR.

Compression/ventilation ratio

The ratio of compressions to ventilation for an infant is the same as for adults and children, i.e. 30:2.

This means that 30 chest compressions must be performed.

This means that for neonates it is necessary to perform 30 chest compressions followed by two rescue breaths.

According to the American Heart Association and ILCOR, it is permissible to perform ‘manual’ CPR on adults and older children.

For infants, however, it is recommended to perform the two breaths every 30 compressions.

Speed of compressions

Chest compressions on an infant are different from those performed on adults or children.

Because the infant is more fragile, chest compressions should be performed with only two fingers, in the centre of the chest, just below the nipples.

Rescuers should perform continuous compressions at 100-120 per minute.

Allow the chest to return to its normal position after each compression.

What is the appropriate number of compressions per minute for a child under 1 year of age?

The appropriate number of compressions per minute for a child under 1 year of age is at least 100 compressions per minute.

Depth of compressions

Because infants are more fragile than children and adults, compressions should be performed with only two fingers, in the middle of the chest, just below the nipples.

Do not compress above the xiphoid or ribs.

The depth of chest compressions for infants should be about one and a half centimetres.

Rescue breathing

For newborns, the mouth and nose must be sealed during rescue breathing.

Try to provide 12 to 20 rescue breaths per minute for an infant who is not breathing.

This is one rescue breath every 3-5 seconds.

STRETCHERS, LUNG VENTILATORS, EVACUATION CHAIRS: SPENCER PRODUCTS IN THE DOUBLE BOOTH AT EMERGENCY EXPO

Learn CPR and save a life today

In a cardiac emergency, it is important that first responders perform CPR as soon as possible to increase the chances of survival while waiting for emergency medical services to intervene.

Basic life support workers who successfully perform resuscitation contribute to the survival rate of cardiac arrest in hospital.

If most people knew how and under what conditions to perform CPR and use an AED, we could reduce the number of deaths due to sudden cardiac emergencies.

You can save a life by learning how to practice rescue breathing or CPR quickly and easily through one of our online courses.

CPR is a really important and varied subject.

We invite you to improve your knowledge on specific cases and different schools of thought by reading the in-depth articles below.

Cardiac Arrest: Why Is Airway Management Important During CPR?

Holter Monitor: How Does It Work And When Is It Needed?

What Is Patient Pressure Management? An Overview

Head Up Tilt Test, How The Test That Investigates The Causes Of Vagal Syncope Works

Why Children Should Learn CPR: Cardiopulmonary Resuscitation At School Age

What Is The Difference Between Adult And Infant CPR

CPR And Neonatology: Cardiopulmonary Resuscitation In The Newborn

First Aid: How To Treat A Choking Baby

How Healthcare Providers Define Whether You’re Really Unconscious