Continuous Chest Compression CPR Versus Standard CPR for EMS
Red Cross Guidelines
For emergency medical services professionals:
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Standard cardiopulmonary resuscitation with a compression-to-ventilation ratio of 30:2 should be used for adults in cardiac arrest without an advanced airway,
OR -
Continuous chest compressions should be provided with positive pressure (bag-valve-mask) ventilations delivered without pausing chest compressions until a tracheal tube or supraglottic device has been placed. NEW
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With an advanced airway in place, healthcare and prehospital professionals should not pause compressions for positive pressure ventilation. REAFFIRMED
Insights
Pauses in chest compressions to deliver ventilations may contribute to reduced coronary artery and aortic blood flow and poor clinical outcomes. Providing positive pressure ventilations asynchronously (without pausing compressions) may improve chest compression quality without compromising oxygenation. Limited evidence suggests no significant difference in clinical outcomes following out-of-hospital cardiac arrest in patients who received either continuous chest compressions with asynchronous positive pressure ventilation or standard 30:2 compression-to-ventilation CPR.