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Chest Compressions 101: How Deep and at What Rate?

Performing chest compressions is one of the most important components of life-saving

resuscitation. In fact, in many cases – particularly those in which the person

resuscitating is untrained – compression-only CPR (that is, resuscitation without

rescue breathing) is actually recommended. This demonstrates just how important and

effective chest compressions are in helping someone survive cardiac arrest. That

being said, there’s a right way and a wrong way to perform chest compressions.

If you are currently or considering a career in the medical field, a deep,

fundamental understanding of how to properly administer chest compressions is

essential. Even for laypeople, knowing the basics of how hard to push down and at

what rate could mean the difference between life and death for someone experiencing

a medical emergency. That said, let’s dive into these two areas of consideration and

go over some need-to-know information.

How Deep Should You Do Compressions with CPR?

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When someone stops breathing, it’s imperative that CPR is performed as quickly and

effectively as possible. In order for chest compressions to be impactful, you must

ensure that you are applying enough pressure. Keep in mind that the recommended

depth for chest compressions in adults is different from that of children and

infants. These key differences are as follows:

2 to 2.4 inches for adults.

The most recent American Heart Association guidelines set the target depth for chest

compressions performed on adults as at least 2 inches but no more than 2.4 inches.

This is the recommended depth, regardless of whether the patient is male or female.

Prior to 2015, the recommended depth was greater, however, research by the AHA

revealed that compressions delivered beyond the maximum depth of 2.4 inches resulted

in an increased risk of injury related to the resuscitation efforts, such as

fractured ribs.

1.5 inches for infants and 2 inches for children.

Because children and infants have smaller bodies, the depth at which chest

compressions should be performed on them is lower, as is the manner with which the

compressions are carried out. The AHA recommends that rescuers depress the chest of

an infant by approximately 1.5 inches using only two fingers.

For a child up to the onset of puberty, that depth increases to 2 inches and the

compressions should be performed using one hand. Once a child has reached

adolescence, depending on his or her size, the recommended adult compression depth

can then be applied using both hands.

At what rate do you perform CPR compressions?

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The second component of proper chest compressions is the rate or speed at which the

compressions are delivered. Prior to the AHA’s most recent update in 2015, the

recommendation was to push at a rate of “at least 100 compressions per minute.” What

they discovered with this, however, was that rescuers were pushing so fast that they

weren’t achieving an adequate depth, thereby rendering the resuscitation efforts

less effective. The current AHA guidelines are now more specific:

100 to 120 compressions per minute.

This equates to about one to two compressions every second. Keep in mind also that

unlike depth, the recommended rate of compressions during CPR is the same for

adults, children and infants. Using Metronomes to Keep the Pace A metronome is a

device that produces a steady beat (usually an audible click or some other sound) at

a regular interval that is set by the user. Musicians often use metronomes to help

them play rhythms more accurately. In a medical setting, a metronome can be

incredibly useful in helping rescuers administering CPR stay on pace with the

recommended rate of compressions. Metronomes can also indirectly help to improve

compression depth because the rescuer no longer has to manually focus on speed.

One recent study indicated that the use of a metronome alongside chest compressions

resulted in much better maintenance of an accurate compression rate than

compressions performed without the use of a metronome. In fact, most automated

external defibrillators (AEDs) have built-in metronomes that beep to the proper

speed to aid in chest compressions.

Music Can Help with Compression Rate

What happens if you’re not in a hospital setting, you don’t have ready access to a

metronome or you’re simply a bystander trying to help someone out? Another great

tool for making sure chest compressions are being delivered at the appropriate rate

is to sing a song that has a beat within the same range.

The song Stayin’ Alive by the Bee Gees is one classic example that is often used in

CPR classes to help students achieve the proper speed. Stayin’ Alive has a tempo of

103 beats per minute (BPM), which is just over the recommended range. If you’re not

into disco, there are plenty of other songs that clock in with BPMs that match the

recommended rate of chest compressions.

Chest Compression Rate Play List

• “Dancing Queen” – ABBA – 100 BPM
• “Rock Your Body” – Justin Timberlake – 100 BPM
• “Hips Don’t Lie” – Shakira – 100 BPM
• “Fly” – Sugar Ray – 100 BPM
• “Suddenly I See” – KT Tunstall – 100 BPM
• “Cecilia” – Simon & Garfunkel – 102 BPM
• “Work It” – Missy Elliott – 102 BPM
• “Stayin’ Alive” – Bee Gees – 103 BPM
• “Something Just Like This” – The Chainsmokers, Coldplay – 103 BPM
• “MMMBop” – Hanson – 104 BPM
• “Hard To Handle” – The Black Crowes – 104 BPM
• “Crazy” – Gnarls Barkley – 112 BPM
• “One Week” – Barenaked Ladies – 113 BPM
• “Can’t Stop the Feeling” – Justin Timberlake – 113 BPM
• “I Will Survive” – Gloria Gaynor – 117 BPM
• “Just Dance” – Lady Gaga, Colby O’Donis – 119 BPM
• “Girls Just Want to Have Fun” – Cyndi Lauper – 120 BPM
• “Rumour Has It” – Adele – 120 BPM

Add a few of these songs to your play list or find a few of your own using a BPM

calculator and then commit them to memory. That way, in the event that you are in a

position to assist someone who needs CPR, you can be confident that you are

delivering the necessary compressions at a rate that will give them the best chance

of survival.

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