Introduction: Since 2015, both ERC and AHA recommend a chest compression rate (CR) of 100-120 compressions per minute (CPM) and a compression depth (CD) of 50-60 mm. However, it is difficult for the responders to compress both fast and deep. This study investigates the quality of manual CPR compared to the guidelines and the relationship between the achieved CR and CD.
Methods: Resuscitation data from 611 out-of-hospital adult sudden cardiac arrest (SCA) patients and 137 in-hospital adult SCA patients were acquired with Philips MRx defibrillators between 2016 and 2021. Manual CPR was performed, and the CR and CD were recorded with the Philips Q-CPR meter. In total, 16,216 minutes of chest compressions were analyzed. The quality of chest compressions was examined against the recommended CR and CD in ERC and AHA guidelines after 2015.
Results: The average CR was 114 ± 9 CPM (mean ± standard deviation); 77% of the compressions had a CR between 100 and 120 CPM. The average CD was 49 ± 11 mm; 50% of the compressions were more shallow than 50 mm, 37% were between 50 and 60 mm, and 13% were deeper than 60 mm. The relationship between CR and CD is shown in Figure 1. The optimal CD was found at a CR of 100-105 CPM. When the CR increased above 100 CPM, the CD decreased monotonically. The mean CD when the CR was 110-120 CPM was significantly more shallow than the mean CD when the CR was 100-110 CPM (49 mm v.s. 52 mm, p < 0.0001).
Conclusions: In this study, we have observed that a responder’s manual chest compressions are likely to be faster than 110 CPM with correspondingly decreased CD. In order to meet the recommended CD, a CR of 100-110 CPM may be optimal.

Observed Impact of Compression Rate on Compression Depth in Manual CPR

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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