"There are pauses for medications and to place lines," Abella said. "All those pauses contribute to poor outcomes. If caregivers in the field recognize that the central issue is compress, compress, compress, we can improve survival."
The amount of CPR time devoted to chest compressions has increased in recent years, the study noted. Before 2005, less than 50 percent of CPR time was spent on chest compressions. After the American Heart Association updated its guidelines that year to emphasize the importance of chest compressions, that percentage increased, with some emergency centers achieving a rate between 60 percent and 85 percent.
The quality of CPR is "a sum of the rate of chest compressions and the depth of compressions, and the message here is that we need more compressions," Abella said.
While no exact rate has been set, "we do believe that compressions at about 100 per minute and two inches of depth should be maintained while CPR is being delivered," he said.
How long should it be delivered? "Until a pulse is restored or it is deemed futile," Abella said.
Guidelines for cardiopulmonary resuscitation are described by the American Heart Association.
SOURCES: Michael Sayre, M.D,., associate professor, emergency medicine, Ohio State University, and chairman, American Heart Association Emergency Cardiovascular Care Committee; Benjamin S. Abella, M.D., clinical research director, Center for Resuscitation Science, and director, department of emergency medicine, University of Pennsylvania, Philadelphia; Sept. 14, 2009, Circulation, online
All rights reserved