If you are a health professional, you probably know how important the correct compression depth for adults is. Sadly, many people are unaware of its role in effective Cardiopulmonary Resuscitation (CPR). When an adult’s heart stops beating, immediate and proper chest compressions can maintain blood flow to essential organs, significantly increasing the chances of survival until professional medical help arrives.
In fact, studies have shown that maintaining the proper depth can double or triple the chance of survival in cases of cardiac arrest. Therefore, knowing and applying the recommended compression depth during CPR is crucial for saving lives.
Having said, this article will discuss the science behind these recommendations, the potential risks of incorrect depth, and why regular training is essential for effective CPR.
What is Compression Depth?
Compression depth in CPR refers to how far you press down on the chest when performing chest compressions.
This depth is important because it ensures enough pressure is applied to the heart, helping it pump blood to vital organs like the brain. If the depth of compressions is shallow, it will not be able to perfuse blood, but too deep will cause damage like fractures of the ribs.
The purpose is to strike a balance that will allow the person to perform the best CPR possible while being able to avoid any injuries.
Recommended Compression Depth for Adults
For an adult, chest compression is key because it helps in circulating blood during a cardiac arrest. Current guidelines recommend compressing the chest to a depth of at least 2 inches (5 centimeters) for adults, but not deeper than 2.4 inches (6 cm). This depth has been derived from thorough studies on biomechanics of the chest compressions in relation to the blood circulation.
But, what is the importance of this depth? Well, chest compressions are meant to replicate the pumping action of the heart. To achieve this, the rescuer must apply enough force to compress the chest, pushing the heart to circulate blood throughout the body.
A compression depth of approximately 2 inches has to balance blood supply and the risk of injury like rib fractures or damage to internal organs.
Let’s say you are performing CPR on an adult who has gone unconscious following a heart attack. If you compress the chest less than 2 inches, the heart may not pump blood effectively, drastically reducing the chance of survival.
On the other hand, if you go too deep, for example beyond 2.4 inches, you risk breaking certain ribs. It makes it difficult to resuscitate the patient and can also cause injury inside the patient making it even worse.
Potential Risks of Incorrect Compression Depth
If you use the wrong depth for the chest compressions while performing CPR you will end up with problems such as these:
- Too Shallow: If chest compressions are not deep enough, the heart won’t pump enough blood to vital organs like the brain and heart. This reduces the chances of survival.
- Too Deep: If compressions go too deep, it can cause injuries such as broken ribs or damage to internal organs like the lungs or liver.
To avoid these risks, follow the recommended depth of 2 to 2.4 inches (5 to 6 cm) for adults, and make sure to let the chest rise fully after each compression.
Factors Influencing Compression Depth
To be able to provide a quality adult CPR chest compressions, it’s very important to match the required chest compression depth. A number of effects come into play as this depth may include the following:
1. Rescuer’s Physical Attributes
A rescuer’s physical attributes, such as body weight and strength, significantly influence the effectiveness of chest compressions during CPR.
Typically, heavier rescuers have an easier time getting the correct compression depth due to their size. For instance, research indicates that female rescuers weighing more than 70.5 kg are more likely to attain the optimal chest compression depth of 50 mm, while lighter individuals may struggle to reach this depth.
This underscores the need for specialized instructions to ensure adequate compressions are delivered by all rescuers, regardless of weight class.
2. Patient’s Physical Characteristics
The patient’s body stiffness and weight significantly affect the depth of chest compressions during CPR. Individuals with higher body weight can utilize their mass to generate the necessary force for effective compressions, potentially reducing fatigue and maintaining compression quality over time.
Conversely, those with lower body weight may experience increased fatigue, leading to a decline in compression depth and effectiveness.
On top of that, a stiffer chest wall requires more force to achieve the recommended compression depth, which can be challenging and may increase the risk of causing injuries.
Therefore, understanding these factors is essential for delivering effective CPR and minimizing potential harm.
3. Rescuer’s Experience and Training
Proper training and experience can significantly influence the effectiveness of chest compressions during CPR. Individuals who have undergone CPR training are more likely to perform compressions at the recommended depth, enhancing the chances of survival for the person in need. For example, a study found that participants who received CPR training demonstrated better compression depth and rate accuracy compared to those without training.
Regular practice and refresher courses are essential to maintain these skills over time. Without ongoing training, even well-intentioned individuals may struggle to apply the correct compression depth, potentially compromising the effectiveness of CPR.
Therefore, continuous education and practice are crucial for anyone trained in CPR to ensure they can respond effectively in an emergency.
4. Fatigue During Prolonged CPR
While performing CPR, it’s essential to maintain the recommended chest compression depth to effectively circulate blood to vital organs. However, as CPR continues, rescuers can become fatigued, leading to a decline in the quality of compressions.
Studies have shown that within the first five minutes of CPR, the proportion of chest compressions reaching the recommended depth decreased from 53% to 38%, indicating that fatigue can significantly impact compression depth.
To address this, it’s recommended to rotate rescuers every two minutes. This practice helps prevent fatigue-related declines in compression quality, ensuring that each rescuer can perform at their best.
5. Use of Feedback Devices
Feedback devices are tools that assist rescuers in delivering high-quality CPR by providing real-time information on the rate and depth of chest compressions. These devices help ensure that compressions are performed correctly, which is crucial for effective resuscitation.
Here are some common types of feedback devices:
- Metronomes: These devices emit a consistent beat to guide the rescuer in maintaining the recommended compression rate of 100 to 120 compressions per minute.
- Audiovisual Feedback Devices: These provide both sound and visual cues to inform the rescuer about the depth and rate of compressions, helping to adjust technique as needed.
- Physiological Information Data-Monitoring Devices: These advanced devices monitor physiological parameters, such as chest compression depth and rate, and provide feedback to optimize CPR quality.
- Smartwatches: Some smartwatches are equipped with sensors that can monitor and provide feedback on CPR quality, including compression depth and rate, allowing for hands-free guidance.
Using these feedback devices can significantly improve the quality of CPR, leading to better outcomes for patients experiencing cardiac arrest.
What are the Importance of Full Chest Recoil
Achieving full chest recoil is a critical aspect of the effectiveness of chest compressions during CPR. It refers to allowing the chest to return to its normal position after each compression, without any interruption or resistance. Now, let us look at the reasons why full chest recoil is important:
1. Enhances Blood Circulation
During CPR, allowing the chest to fully return to its normal position after each compression is essential. This full recoil creates a negative pressure within the chest, enabling blood to flow back into the heart. This process, known as venous return, refills the heart’s chambers with blood, preparing it for the next compression.
If the chest doesn’t fully recoil, the heart’s chambers won’t fill completely. This means less blood is available to pump out during the next compression, leading to reduced blood flow to vital organs.
Ensuring full chest recoil between compressions is crucial for maintaining effective blood circulation during CPR.
2. Maximizes Effectiveness of Compressions
Allowing the chest to fully recoil between compressions is essential for effective CPR. This full recoil creates a negative pressure within the chest, facilitating the return of blood to the heart. This process, known as venous return, ensures that the heart’s chambers are adequately filled with blood before the next compression.
Without complete recoil, the heart cannot refill properly, leading to reduced blood flow to vital organs.
Moreover, incomplete chest recoil can impede the heart’s ability to pump blood effectively. When the chest doesn’t fully expand, the heart’s chambers remain partially filled, resulting in less blood being pumped with each compression.
This diminished stroke volume reduces the amount of oxygenated blood delivered to the brain and other critical organs, decreasing the likelihood of a successful resuscitation.
3. Prevents Over-compression
During CPR, it’s essential to allow the chest to fully recoil between compressions. This full recoil ensures that the heart can refill with blood, maintaining effective circulation. If the chest doesn’t fully return to its normal position, it can lead to excessive pressure during the next compression. This increased pressure may cause injuries such as rib fractures or damage to internal organs.
On top of that, incomplete chest recoil can reduce the effectiveness of CPR. Without full recoil, the heart doesn’t refill properly, leading to decreased blood flow to vital organs. This can lower the chances of survival for the person in cardiac arrest.
Therefore, ensuring full chest recoil between compressions is crucial for both preventing injuries and maintaining effective blood circulation.
4. Maintains Proper Compression Depth
Ensuring full chest recoil during CPR is essential for maintaining the heart’s ability to refill with blood between compressions. This process, known as venous return, allows blood to flow back into the heart’s chambers, preparing it for the next compression.
Without complete recoil, the heart doesn’t fill properly, leading to reduced blood flow to vital organs and decreasing the effectiveness of CPR.
Additionally, full chest recoil helps maintain coronary perfusion pressure, which is the pressure needed to supply blood to the heart muscle itself.
Incomplete recoil can disrupt this pressure gradient, making it harder to achieve a return of spontaneous circulation, where the heart starts beating on its own again.
Learn the Right Compression Depth for Life-Saving CPR
If you want to do adult CPR correctly, it is important to keep the recommended compression depth at no less than 2 inches (5 cm). An adequate depth can be helpful in providing blood to important organs which will increase the chance of survival. Compression depth that is inappropriate (insufficient or excessive), reduces the effectiveness and may lead to injury. Regular practice and awareness of CPR guidelines can make a big difference in emergency situations. Remember, high-quality chest compressions with full chest recoil are essential for increasing the chances of a successful outcome during cardiac arrest. Therefore, Be ready and with confidence ready to impact for saving a life.
