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Heart association calls for more uniform CPR quality

Tuesday June 25, 2013
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In a published statement, the American Heart Association called for a renewed focus on improving cardiopulmonary resuscitation techniques and tracking.

Each year in the United States, more than a half-million children and adults suffer cardiac arrest, according to the statement authors, but survival rates vary significantly: 3% to 16% for arrests outside of hospitals, depending on the region, and 12% to 22% in hospitals.

In the statement, published June 25 on the website of the journal Circulation, the association urges professional rescuers to:

• Minimize interruptions to chest compressions. Compressions generate blood flow and should be delivered for 80% of the duration for which the patient does not have a pulse.

• Provide the right rate of compressions; 100 to 120 per minute are optimal for survival.

• Give deep enough compressions — at least two inches for adults and at least a third of the depth of the chest in infants and children.

• Allow the chest to bounce back completely so the heart can refill.

• Give no more than 12 rescue breaths a minute, with the chest just visibly rising, to prevent pressure from the breath from slowing blood flow.

To help ensure CPR providers stay focused on quality of care, the statement also advises:

• Health and emergency care providers should gather data on the quality of CPR delivery and patient response at the scene.

• If possible, an experienced team leader should oversee and evaluate the quality of CPR to ensure guidelines are followed, patient needs addressed and other problems (such as rescuer fatigue) limited.

• To ensure quality improvement, providers, managers, institutions and systems of care should do debriefings, follow CPR delivery checklists, measure patient response measurements, provide frequent refresher courses and participate in CPR data registries.

Organizations that provide CPR need quality improvement programs, and can start by monitoring one measurement, said Peter Meaney, MD, MPH, the statement’s lead author and an assistant professor of anesthesia and critical care at Children’s Hospital of Philadelphia.

“There have been huge advances in CPR, and there’s no question that high-quality CPR saves lives,” Meaney said in a news release. “However, right now there is wide variability in the quality of CPR — and we can do better.”

Download a PDF of the statement: http://circ.ahajournals.org/content/early/2013/06/25/CIR.0b013e31829d8654.abstract.


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