Table 2.

Key Challenges to Improve CPR Quality for Adults, Children, and Infants

CPR ComponentKey Challenges to Improving Quality
  • Failure to recognize gasping as sign of cardiac arrest

  • Unreliable pulse detection

Initiation of CPR
  • Low bystander CPR response rates

  • Incorrect dispatch instructions

Compression rate
  • Slow compression rate

Compression depth
  • Shallow compression depth

Chest wall recoil
  • Rescuer leaning on the chest

Compression interruptions
  • Excessive interruptions for

    • – rhythm/pulse checks

    • – ventilations

    • – defibrillation

    • – intubation

    • – intravenous (IV) access

    • – other

  • Ineffective ventilations

  • Prolonged interruptions in compressions to deliver breaths

  • Excessive ventilation (especially with advanced airway)

  • Prolonged time to defibrillator availability

  • Prolonged interruptions in chest compressions pre- and post-shocks

Team Performance
  • Delayed rotation, leading to rescuer fatigue and decay in compression quality

  • Poor communication among rescuers, leading to unnecessary interruptions in compressions