From the Guidelines
The recommended Cardiopulmonary Resuscitation (CPR) ratio for infants and children is 30:2 for single-rescuer CPR and 15:2 for two-rescuer CPR, as stated in the 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1. When performing CPR on infants and children, it is crucial to balance the need for blood circulation through compressions with the delivery of oxygen through rescue breaths. The guidelines recommend that CPR using chest compressions with rescue breaths should be provided to infants and children in cardiac arrest, with a compression rate of approximately 100–120/min 1.
- The compression depth for infants should be at least one third the anterior-posterior diameter of the chest, which equates to approximately 1.5 inches (4 cm), and for children, it should be approximately 2 inches (5 cm) 1.
- For two-rescuer CPR, the recommended ratio of 15:2 allows for more frequent ventilation, which is critical in pediatric cardiac arrest cases 1.
- When performing CPR without an advanced airway, the guidelines suggest a compression-to-ventilation ratio of 30:2 for single rescuers and 15:2 for two rescuers 1.
- It is also reasonable to ventilate with 100% oxygen during CPR and to perform a rhythm check, lasting no more than 10 s, approximately every 2 min 1.
From the Research
Cardiopulmonary Resuscitation (CPR) Ratio
The CPR ratio is a critical aspect of cardiopulmonary resuscitation, and various studies have investigated its optimal composition.
- A study published in 2010 2 recommends a compression-to-ventilation ratio of 30:2 for adult resuscitation.
- Another study from 2011 3 also suggests a 30:2 ratio as acceptable, even for rescuers with a duty to respond if they are alone.
- Research from 2007 4 evaluated a protocol change from a 15:2 to a 30:2 compression-to-ventilation ratio and found that the new ratio resulted in more compressions being delivered during CPR.
- A comparison study from 2010 5 found that a 30:2 ratio was preferred by most participants, but the number of compressions per minute was less than the standard recommended by the American Heart Association (AHA).
- Additionally, a study from 2017 6 compared continuous chest compression CPR with interrupted chest compression CPR and found that bystander-administered chest compression-only CPR increased the proportion of people who survived to hospital discharge.
Key Findings
- The recommended compression-to-ventilation ratio for adult resuscitation is 30:2 3, 2, 4.
- A 30:2 ratio is preferred by most participants and results in more compressions being delivered during CPR 4, 5.
- Continuous chest compression CPR may be beneficial in certain situations, such as bystander-administered CPR 6.