This section links to information on how skills are to be performed. Each skill has specific parameters within which they must be performed. These and are set by the AHA or another authority,
Chest Compressions |
Ventilations |
CPR |
Advanced Airway
SmartMan© gives you an accurate objective way to assess how well you are performing those crucial chest compressions. It is the only system that provides real time feedback that you can immediately understand.
There are two ways that chest compressions provide blood circulation. First, by increasing the pressure inside the chest (intrathoracic) it forces blood out of the chest. Second, the heart is compressed between the sternum and the spine. Opening and closing of the heart valves keeps the blood (with oxygen) flowing forward to the brain and other vital organs.
Under the best of circumstances, CPR can provide up to 20% of the normal blood flow. The standards set in the AHA guidelines are aimed at achieving 20% circulation of blood throughout the body, including circulating through the brain. An error in performing any of the component skills which are part of performing compressions will reduce or even stop blood flow. The AHA guidelines specify how to perform chest compressions properly.
Both the heart and thorax respond to compression rate, compression depth, and chest recoil. In reduced depth and/or reduced rate compressions, the heart and thorax are not pumped sufficiently. Without proper recoil the thorax and heart cannot fill with blood, so the next compression will be less effective and if such ineffective compressions continue in succession it will lead to loss of aortic pressure.
For more information on chest compressions download this document, "Why it is important to get chest compression right".
With SmartMan, you see a couple color bars and immediately know what you have to change to improve. For more information on how SmartMan works, download this 1 page document.
For detail on the latest recommendations on how to perform chest compressions, go here.
Independent clinical studies have already shown that SmartMan improves how you perform compressions. For more information on how EMTs and paramedics went from 20% accuracy to 77% accuracy in only a couple of minutes on SmartMan.
See other reports that are showing that training with SmartMan does make a real difference. Go here.
All compressions unless performed on an infant are performed with the same procedure. Place the hands correctly by using the inter mammary line. Lock the arms into a straight but comfortable position. The use your body to provide smooth regular compressions with full release of the chest.
Quality Matters
Recent studies show that proper CPR performed as soon as possible is important to survival of the victim. In fact, proper CPR can be an important component first step to a successful use of an AED.
Many people believe that they are performing correctly, but accurate objective analysis shows that in fact, the way they perform chest compressions needs to be improved. Real Time feedback is crucial to improving.
Compressions Circulate Blood
If done at the proper rate, to the correct depth and with full release of the chest, chest compressions can lead to perfusion of the heart and of the brain.
Proper Release is Crucial
After each compression you MUST fully release the chest. It is crucial to a victim that you learn to do this.
Often when a person gets tired, he or she will tend to lean on the chest and not fully release the chest.
The Requirements
The guidelines specify how chest compressions are to be performed. With more and more research indicating that chest compressions play an important role in victim survival, there is renewed emphasis on how well they are performed.
The different key components act together and all of the following must be performed correctly as a single skill.
Depth of compressions: The target is to compress the chest between 2 inches adn 2.5 inches. Note that the previous guidelines were 1.5 inches and 2 inches. Compressing the chest less than 2.0 inches will reduce blood flow. While going to deeper will not be beneficial, as long as you are not hitting the bottom it is not causing harm.
Rate of compression: The recommended rate is now 100 to 120 per minute. This is faster than in the previous guidelines. This means that each compression should be performed in about .6 of a second. A rate of less than 100 per minute will decrease forward blood flow, and a rate greater than 120 will increase fatigue, which leads to other performance errors
Full chest recoil: When a compression is released, elastic recoil of the chest will create a negative pressure that pulls blood into the chest. Incomplete decompression will reduce the amount of blood available to be circulated with the
next compression
Emphasis on Quality
There is evidence to suggest that it takes 3 to 7 compressions (or greater) to restore aortic pressure and cerebral perfusion pressure after a pause. In simple terms this means that it takes 3 to 7 compressions to get the blood flowing. Thus the repercussion of performing several poor compressions in a row is much greater than used to be thought. It is now believed to have direct consequences for survival of a victim.
Both the heart and thorax respond to compression rate, compression depth, and chest recoil. In reduced depth and/or reduced rate compressions, the heart and thorax are not pumped sufficiently. Without proper recoil the thorax and heart cannot fill with blood, so the next compression will be less effective and if such ineffective compressions continue in
succession it will lead to loss of aortic pressure.
Emphasis on No Interruptions
The most current research indicates that the sooner you start compressions and the less compressions are interrupted the better they will help the victim.