Duration of Ventilations during Cardiopulmonary Resuscitation by Lay-Rescuers and First Responders: Relationship between Delivering Chest Compressions and Outcomes
Background—The Guidelines 2010 for cardiopulmonary resuscitation (CPR) allow 5 seconds to give two breaths to deliver sufficient chest compressions and keep perfusion pressure high. This study aims to determine if the recommended short interruption for ventilations by trained lay-rescuers and first responders can be achieved and its consequence for chest compressions and survival.
Methods and Results—From a prospective data collection of out-of-hospital cardiac arrest we used Automatic External Defibrillator (AED) recordings of CPR by rescuers who had received a standard ERC Basic Life Support and AED course. Ventilation periods, total compressions delivered per minute during each 2 minutes CPR cycle were measured and chest compression fraction (CCF) calculated. Neurologic intact survival to discharge was studied in relation to these factors and covariates. We included 199 AED recordings. The median (25th - 75th percentile) interruption time for two ventilations was 7 seconds (6-9). Of all rescuers, 21% took <5 seconds, 83% took <10 seconds for a ventilation period; 97%, 88% and 63% of rescuers were able to deliver respectively >60, >70 and >80 chest compressions per minute. The median CCF (25th - 75th percentile) was 65% (59-71%). Survival was 49/199 (25%), not associated with long or short ventilation pauses when controlled for covariates.
Conclusions—The great majority of rescuers can give two rescue breaths in less than 10 seconds and deliver at least 70 compressions in a minute. Longer pauses for ventilations are not associated with worse outcome. Guidelines may allow longer pauses for ventilations without detriment to survival.
- Received December 20, 2012.
- Revision received February 25, 2013.
- Accepted March 6, 2013.