From the Guidelines
Two-person CPR for adults should involve one person performing cycles of 30 compressions and 2 breaths until the second rescuer returns, then switching to cycles of 15 compressions and 2 breaths, while using an automated external defibrillator (AED) as soon as it is available. When performing CPR, it is essential to push hard and fast in the center of the chest at a rate of 100-120 compressions per minute, allowing for complete chest recoil between compressions, as recommended by the 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1. The person doing compressions should compress the chest at least 2 inches (5 cm) deep.
- Key aspects of high-quality CPR include:
- Pushing hard (at least 2 inches [5 cm]) and fast (100-120/min) and allowing complete chest recoil
- Minimizing interruptions in compressions
- Avoiding excessive ventilation
- Changing the compressor every 2 minutes, or sooner if fatigued, as outlined in the guidelines 1 The second rescuer should give 2 breaths after every 30 compressions, with each breath taking about 1 second and making the chest visibly rise. It is crucial to switch roles every 2 minutes or when the compressor becomes fatigued to maintain effective compressions. Continue CPR until emergency medical services arrive, an AED becomes available, or the person shows signs of life. Two-person CPR is more effective than single-person CPR because it reduces rescuer fatigue, allows for higher-quality compressions, and minimizes interruptions in chest compressions, as supported by the guidelines 1. Remember to call for emergency services immediately before starting CPR and use an AED as soon as one is available, following its voice prompts, as recommended in the guidelines for adult basic and advanced life support 1.
From the Research
CPR for Adults with 2 People
When performing CPR on an adult with two people, the following steps can be taken:
- One person can perform chest compressions while the other person provides rescue breaths 2
- The person performing chest compressions should center their hands over the mid-sternum, with their body weight over the middle of the chest
- A compression depth of 5-6 cm is recommended at a rate of 100-120 compressions per minute, while allowing the chest to fully recoil between each compression
- The person providing rescue breaths should give one breath every 6 seconds, or about 10 breaths per minute
Importance of CPR and AEDs
CPR and automated external defibrillators (AEDs) play a crucial role in improving survival rates for cardiac arrest victims:
- Early defibrillation, within 8 minutes of cardiac arrest, can improve survival outcomes 3
- AEDs can be used by first responders, including bystanders, to deliver early defibrillation in out-of-hospital settings
- CPR, including high-quality chest compressions, is essential for maintaining blood circulation and increasing the chances of survival
Barriers to CPR and AED Use
Despite the importance of CPR and AEDs, there are several barriers to their use:
- Fear of litigation and injuring a victim are common barriers to CPR and AED use 4
- Lack of training and education can also hinder the willingness to perform CPR and use an AED
- Emphasizing the importance of CPR and AEDs, and providing legal liability protection, can help empower individuals to take action in emergency situations
Analyzing Resuscitation Quality
Automatic external defibrillator data can be used to analyze resuscitation quality:
- An algorithm can be developed to automatically identify the quality of chest compressions from AED data 5
- This algorithm can calculate CPR quality indicators, such as chest compression number and total flow time, and compare them to manual reviews by experienced physicians.