High-quality cardiopulmonary resuscitation.
OBJECTIVE
The quality of cardiopulmonary resuscitation (CPR) impacts on outcome after cardiac arrest. This review will explore the factors that contribute to high-quality CPR and the metrics that can be used to monitor performance.


RESULTS
A recent consensus statement from North America defined five key components of high-quality CPR: minimizing interruptions in chest compressions, providing compressions of adequate rate and depth, avoiding leaning on the chest between compressions, and avoiding excessive ventilation. Studies have shown that real-time feedback devices improve the quality of CPR and, in one before-and-after study, outcome from out-of-hospital cardiac arrest.


CONCLUSIONS
There is evidence for increasing survival rates following out-of-hospital cardiac arrest and this is associated with increasing rates of bystander CPR. The quality of CPR provided by healthcare professionals can be improved with real-time feedback devices. The components of high-quality CPR and the metrics that can be measured and fed back to healthcare professionals have been defined by expert consensus. In the future, real-time feedback based on the physiological responses to CPR may prove more effective.
Royal United Hospital, Bath, UK.
Jerry P
JP
Nolan
D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards; D002983:Clinical Competence / Q000592:standards*; D032921:Consensus; D004632:Emergency Medical Services; D057209:Hospital Rapid Response Team / Q000592:standards*; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D018794:Problem-Based Learning; D058996:Quality Improvement; D015996:Survival Rate; D013997:Time Factors; D014481:United States / Q000453:epidemiology