3. “Poor-quality CPR should be considered a
preventable harm. In healthcare
environments, variability in clinician performance
has affected the ability to reduce healthcare
associated complications, and a standardized
approach has been advocated to improve
outcomes and reduce preventable harms. The use
of a systematic continuous quality improvement
(CQI) approach has been shown to optimize
outcomes in a number of urgent healthcare
conditions.”

4. “Despite this evidence, few healthcare organizations
apply these techniques to cardiac arrest by consistently
monitoring CPR quality and outcomes. As a result,
there remains an unacceptable disparity in the quality
of resuscitation care delivered, as well as the presence
of significant opportunities to save more lives.”

7. WE CAN’T EXPECT TO WIN “RACES”
WITHOUT MEANINGFUL PRACTICE
AND AN ONGOING ITERATIVE PROCESS
OF MEASURING AND IMPROVING…

14. DEATH
BY HYPERVENTILATION
A COMMON EXPERIENCE
IN CARDIAC ARREST

17. •Perceived performance does not always match observed performance.
•Aufderheide et al. showed that duty cycle, chest compression depth and
complete recoil were performed significantly less well when directly observed
than EMT perceptions of their performance.
•Wik et al. showed that chest compression rate and depth were both
significantly below AHA guidelines by trained EMS providers, and no flow time
(when there was neither a pulse nor CPR being given) was almost 50% in
directly observed performance evaluations.
•The likelihood of ROSC increases significantly with higher mean chest
compression rate (in a hospital study 75% of patients achieved ROSC with 90
or more chest compressions/minute compared to only 42% with 72 or fewer
chest compressions/minute).
THE PAINFUL TRUTH

24. Quality CPR is a means to improve survival from
cardiac arrest. Scientific studies demonstrate
when CPR is performed according to guidelines,
the chances of successful resuscitation increase
substantially. Minimal breaks in compressions, full
chest recoil, adequate compression depth, and
adequate compression rate are all components of
CPR that can increase survival from cardiac arrest.
Together, these components combine to create
high performance CPR (HP CPR)

27. Compress
> 2 inches
Minimize
interruptions
Full recoil
Rate between
100 and
120/min
Improved
survival
Switch
compressor
s every 2
min.
Hover hands
Prioritize
compressions
C-A-B
Rapid
rhythm
analysis
Minimize
pauses
Administer
drugs
Intubation IV
placement
EMT CPR Foundation
Paramedic
Advanced Life
Support

29. •EMTs own CPR
•Minimize interruptions in CPR at all times
•Ensure proper depth of compressions (>2 inches)
•Ensure full chest recoil/decompression
•Ensure proper chest compression rate (100-120/min)
•Rotate compressors every 2 minutes
•Hover hands over chest during shock administration
-be ready to compress as soon as patient is cleared
•Intubate or place advanced airway with ongoing CPR
•Place IV or IO with ongoing CPR
•Coordination and teamwork

30. •C-A-B
•Minimize interruptions in compressions
•Compress at least 100/min***
•Allow complete chest wall recoil/decompression
between compressions
•Rhythm assessment every 2 minutes
•Rotate compressors every 2 minutes
•Hover over patient with hands ready during
defibrillation so compressions can start immediately
after the shock (or analysis) has occurred

35. 1
2
3
4
5
6

36. 1
3
2
4
56
BOSS
ACCESS
MEDS
MONITOR
CPR 1
CPR 2
AIRWAY
VENTILATION
AIRWAY
ASSISTANT

49. "Eisenberg has done a remarkable job in articulating the steps to be
taken for communities to improve survival from sudden cardiac arrest.
Resuscitate! is a 'best in class' and one of a kind guide that provides
inspiration as well as direction in translating resuscitation science into
practice. It is essential for all those who seek to establish strategies to
improve survival and quality of life for cardiac arrest victims whose
hearts are 'too young to die.'"
- David B. Hiltz, EMT-P Resuscitation Academy Alumni

50. www.heart.org/cprquality
www.resuscitationacademy.org