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Chest Compressions

Indications
1. Newborn Resucitation
2. Pediatric Resuscitation
3. Adult Resuscitation
Technique for newborns
1. Sternal Compressions
  1. General
    1. Depress one third chest depth
    2. Do not lift fingers from chest between compressions
  2. Technique 1: Thumbs depress sternum
    1. Hands encircle torso
    2. Fingers support spine
    3. Preferred (less tiring)
  3. Technique 2: Two fingers depress sternum
    1. Use Index, Middle Finger placed below nipple level
    2. Preferred for larger newborns
2. Compression rate >90 times per minute
3. Compression to ventilation ratio: 3 to 1
4. Sequence (2 sec): One and Two and Three and Breath
Technique for Infants (age under 1 year)
1. Sternal Compressions
  1. Use Index, Middle Finger placed below nipple level
  2. Depress 1/2 to 1 inch (1/3-1/2 chest depth)
2. Compression rate > 100 times/minute
3. Compression to Ventilation Ratio = 5:1
Technique for Children (1 to 8 years)
1. Sternal Compressions
  1. Use heel of one hand placed above the xiphoid
  2. Depress 1 to 1 and 1/2 inch (1/3-1/2 chest depth)
2. Compression rate = 80-100 times/minute
3. Compression to Ventilation Ratio = 5:1
Technique for Adults
1. Sternal Compressions
  1. Use heel of two hands placed above the xiphoid
  2. Depress 1.5 to 2 inches (1/3-1/2 chest depth)
2. Compression rate = 80-100 times/minute
3. Compression to Ventilation Ratio
  1. Single Rescuer = 15:2
  2. Two Rescuer = 5:1
Prognosis: Adults after CPR
1. Criteria
  1. Witnessed arrest
  2. Initial rhythm
    1. Ventricular Tachycardia or
    2. Ventricular Fibrillation
  3. Pulse regained in first 10 minutes of compression
2. Interpretation: Any of three criteria above met
  1. Predicts survival to hospital discharge
3. References
  1. van Walraven (2001) JAMA 285:1602-6

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This page was written by Scott Moses, MD, and was last revised 1/13/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.