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.

At the Main Menu select "Compressions" then the the option you want. On SmartMan there are a couple different ways to PRACTICE and take the TEST for compressions.

30 Compressions Test
In the TEST you perform 30 compressions, then wait for the 4 seconds when breaths would be given. Repeat this 5 times.

200 Compressions
Some recent research has suggested that performing chest compressions is more important in the initial stages of onset to a sudden cardiac arrest. Thus some areas are recommending "continuous chest compressions" SmartMan allows you to practice continuous chest compressions.

200 Compressions PRACTICE
In the practice, you perform 200 compressions continuously without stopping. Since it is a practice, you only perform one set.

200 Compressions TEST
In the TEST you perform 200 compressions continuously without stopping, then wait for the 4 seconds when breaths would be given and perform a second set of 200 chest compressions.