Abstract 125: Faster Chest Compressions are Associated With Reduced Depth and Incomplete Chest Recoil
Background: The 2010 AHA guidelines for healthcare providers recommend performing chest compressions at a rate of at least 100 compressions per minute (cpm) with a depth of at least 51 millimeters (mm). No upper rate limit to compression rate is specified.
Objective: To determine if increased compression rate is associated with reduced chest compression depth and chest recoil during CPR.
Methods: Recordings from a convenience sample of 1413 patients were collected from 2006 to 2012 from 3 EMS agencies and 2 hospitals using the Philips HeartStart MRx defibrillator. Real-time audio and visual feedback was available to the personnel based on the 2005 or 2010 depth guidelines. Compression force and acceleration waveforms were recorded by the Q-CPRTM tool. The compression instantaneous rate, depth and chest recoil were calculated in segments with good signal quality (1,593,540 compressions).
Results: The figure shows the distribution of compression rate and its relationship with depth and chest recoil. A majority (84%) of compressions had a rate of at least 100 cpm. For rates faster than 93, depth decreased. The fastest drop in depth, found by fitting a regression line to the data, was -0.4 mm/cpm for rates between 120 to 125 cpm. More than 75% of compressions slower than 115 had complete chest recoil. Chest recoil decreased at higher rates, with the fastest drop for rates between 120 and 125.
Conclusion: Compression depth decreased with compressions faster than 93 cpm. Compressions faster than 120 are associated with a rapid drop in both depth and chest recoil. Further studies are needed to assess the feasibility of the 2010 guidelines and their impact on clinical outcomes.
- © 2013 by American Heart Association, Inc.