Improving cardiopulmonary resuscitation quality to ensure survival.

PURPOSE OF REVIEW

There is correlation between quality of bystander cardiopulmonary resuscitation and patient survival. Recent developments in defibrillator technology enable recording of cardiopulmonary resuscitation quality, and have shown quality of professional cardiopulmonary resuscitation far from guidelines' levels for factors such as chest compression depth and rate, ventilation rate, and pauses in chest compressions. The effects of cardiopulmonary resuscitation quality factors on patient survival are presently under scrutiny.

RECENT FINDINGS

Factors such as depth of and pauses in chest compressions immediately before defibrillation attempts affect outcome. Both immediate automated feedback on cardiopulmonary resuscitation quality and use of the same quality data during postevent debriefing improve cardiopulmonary resuscitation quality, and the combination appears to improve outcome. The increased awareness of quality problems, particularly unwanted pauses in chest compressions, has caused more emphasis on chest compressions in cardiopulmonary resuscitation protocols including the 2005 Guidelines. There is a growing number of reports of increased survival with these new protocols.

SUMMARY

Cardiopulmonary resuscitation quality affects survival after cardiac arrest. Reporting cardiopulmonary resuscitation quality data should be standard in all studies of cardiac arrest as effects of studied interventions can depend on or influence cardiopulmonary resuscitation quality. These data are also valuable in quality improvement processes both in-hospital and out-of-hospital.