From the Research
CPR in young people should be continued for as long as possible, with a median duration of 75 minutes, as reported in a study of prolonged CPR, which showed that 83% of patients were alive at 1 year, with full neurological recovery reported in 63 patients 1. The standard CPR protocol involves 30 chest compressions followed by 2 rescue breaths, performed at a rate of 100-120 compressions per minute.
- For infants and children, compressions should be about 1/3 the depth of the chest.
- High-quality CPR is crucial, with minimal interruptions to chest compressions.
- If an automated external defibrillator (AED) is available, it should be used as soon as possible. Young people have more resilient hearts and neurological systems, which means they can potentially survive longer periods of CPR with better outcomes.
- Additionally, the cause of cardiac arrest in young people is often respiratory in nature rather than cardiac, making effective ventilation particularly important during resuscitation efforts. The importance of high-quality compressions is emphasized in a study that highlights the foundation of CPR, optimizing coronary and cerebral perfusion pressure 2. Some studies suggest that medications such as epinephrine may improve return of spontaneous circulation, but do not improve survival to discharge or neurologic outcome 3, 4. However, the most recent and highest quality study on prolonged CPR suggests that young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts 1.