To increase compression fraction, focus on minimizing interruptions during chest compressions, using effective communication, practicing high-quality compressions, incorporating an AED early, monitoring compression depth and rate, optimizing rescuer fatigue management, and using a CPR board or firm surface.
Compression fraction refers to the percentage of time during a cardiac arrest resuscitation attempt that chest compressions are actually being performed. A higher compression fraction means less time is spent not doing compressions, which is critical for maintaining blood flow to the brain and vital organs. Improving compression fraction is a key aspect of delivering high-quality CPR.
Based on best practices, including insights from reputable sources like the one provided, several strategies can significantly boost your compression fraction:
Key Strategies to Enhance Compression Fraction
Implementing specific techniques and protocols can help ensure continuous, effective chest compressions.
1. Minimize Interruptions
Minimizing pauses in chest compressions is paramount. Interruptions occur for various reasons, such as rhythm analysis, defibrillation, rescue breaths, or switching rescuers. Reducing the duration and frequency of these pauses directly increases the time spent compressing the chest.
- Synchronized Actions: Plan tasks like rhythm analysis and defibrillation to overlap as much as possible with ongoing compressions.
- Efficient Hand-offs: Coordinate rescuer changes quickly and smoothly with minimal disruption.
2. Use Effective Communication
Clear and concise communication among the resuscitation team members is vital for coordinated actions and reducing unnecessary pauses.
- Defined Roles: Assign specific roles (compressor, AED operator, airway manager) to avoid confusion.
- Call Out Actions: Announce upcoming actions, such as "stopping for rhythm check" or "preparing to switch."
3. Practice High-Quality Compressions
Delivering compressions that meet recommended depth and rate guidelines is essential for effective blood circulation. While not directly increasing the fraction of time compressing, consistent quality reduces the need for re-attempts or corrections that cause pauses.
- Proper Depth: Compress at least 2 inches (5 cm) but no more than 2.4 inches (6 cm) for adults.
- Appropriate Rate: Maintain a rate of 100 to 120 compressions per minute.
4. Incorporate Automated External Defibrillator (AED) Early
Bringing the AED to the patient and preparing it for use during ongoing compressions helps minimize the pause required for rhythm analysis and shock delivery.
- Prepare AED: Attach pads while compressions continue.
- Charge AED: Charge the AED while compressions are ongoing if a shockable rhythm is anticipated.
5. Monitor Compression Depth and Rate
Using feedback devices or monitoring techniques helps rescuers maintain high-quality compressions and identify deviations promptly, reducing the need for corrective pauses.
- Feedback Devices: Utilize devices that provide real-time auditory or visual feedback on depth and rate.
- Team Monitoring: Encourage team members to monitor and provide constructive feedback to the compressor.
6. Optimize Rescuer Fatigue Management
Fatigue leads to a decline in compression quality (depth and rate) and can increase the duration of pauses during rescuer switches. Proactive management ensures effective compressions are maintained throughout the arrest.
- Regular Switches: Switch compressors approximately every 2 minutes, or sooner if signs of fatigue appear.
- Efficient Transition: Ensure the incoming rescuer is ready to take over immediately.
7. Use a CPR Board or Firm Surface
Performing compressions on a firm surface or with a CPR board under the patient's back ensures that the force of compressions is transmitted effectively to the chest, rather than being absorbed by a soft mattress or surface. While this primarily impacts compression depth, it can contribute to overall compression effectiveness, reducing the likelihood of needing to pause to adjust patient position or technique.
- Placement: Place the patient on the floor or position a CPR board under their upper back.
By implementing these strategies, resuscitation teams can significantly increase the compression fraction, thereby improving the overall quality and effectiveness of CPR delivery during cardiac arrest.
