Table of Contents

  • Quality Makes the Difference

    “Knowing is not enough; we must apply. Willing is not enough; we must do.”
    —Johann Wolfgang von Goethe

    The impact of out-of-hospital cardiac arrest (OHCA) is enormous, taking the lives of nearly 300,000 people each year in the U.S.(1) Although survival rates vary widely, they are still generally low (less than 10%) in most areas of the country.(2) Yet many communities have significantly improved their survival rates.(3-5)

  • Perception vs. Reality

    Most hospitals and EMS systems in the U.S. require providers to maintain current certification in basic or advanced life support, with recertification occurring every two years. Most EMS providers and many health care workers perform CPR routinely, but in many institutions, biennial recertification is the only time devoted to a formal evaluation of skill proficiency and quality of CPR performed. Recently, quantitative measures of CPR quality have been developed using real-time feedback; however, the health care market has been slow to adopt this technology.

  • The Science of CPR

    Cardiopulmonary resuscitation (CPR) is celebrating its 50th anniversary this year. Although used for many years in conjunction with other resuscitation interventions, recent studies demonstrating the reality of its use in clinical settings and linking its quality to patient outcomes have revolutionized attitudes surrounding the importance of properly performed chest compressions. The key factors important to quality chest compressions include chest compression rate, depth and fraction, which will be described separately below.

    Compression Depth

  • Retraining Pays Off

    The steps for CPR are well known to caregivers and many bystanders. Some are so familiar with the orchestrated movements, they can perform them spontaneously when needed. But are those efforts effective?

  • The Experts Weigh In

    The editors invited the contributors to this monograph and a few guests to answer some questions about the delivery of CPR. We’ve compiled their responses in the following pages.

    Q: Has the fact that the quality of CPR improves survival from cardiac arrest fully filtered down to all emergency medical providers? If no, how could this be accomplished?

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