“Push Hard, Push Fast?”

“Push Hard, Push Fast” We all know the mantra. It’s catchy. Compressions not deep enough? Push hard. Not fast enough? Push fast. Great. Except… One thing many of us have learned as professional rescuers is that the bigger issue is not pushing too slow, but pushing too fast. “But…push FAST!” I mean, faster has to be better right? How many times have we witnessed CPR administered in a way that seems like a race to set the world record for fastest compression rate? How many times have we seen someone compress at an appropriate rate only to be chided to go faster? While we know that compressing at a rate <100/min is too slow to provide effective CPR, how fast should we actually compress?  At some point, can fast be too fast? I did not find a lot of definitive research on this. What I did find indicates that the optimal rate of compressions are between 100-120 per minute. If the rate rises above 125, ROSC declines sharply (1). The classic law of diminishing returns kicks in, and bad things start to happen to decrease the chances of a successful outcome: Increased rescuer fatigue Compressions become more shallow and less effective Full recoil of the chest is diminished Clearly, these negative factors work against effective resuscitation and best practices. The only problem is that compression rates often reach the 140-180 range during resuscitative efforts. I conducted an experiment a couple of years back utilizing an instrumented ma...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: ems-topics patient-management Training compression rates CPR resuscitation science Source Type: research