BLS CPR algorithm: Basic life support cardiopulmonary resuscitation

Written by Jessica Munoz DPN, RN, CEN

High quality cardiopulmonary resuscitation

HIGH quality CPR is important in the provision of basic life support to an unresponsive victim without a pulse. High quality CPR possesses the following important characteristics:

1. Compressions should begin within ten seconds of determination of cardiac arrest.
2. The rate of compression should be 100–120 per minute.
3. The depth of compression should be 2”- 2.4” for adults, approximately 2” for children from age one to adolescence, and 1 ½” (4 cm) for infants. The depth of compression should be 1/3 the anteriorposterior(AP) chest diameter for children and infants.
4. There should be complete recoil of the chest after each compression.
5. Interruptions in chest compression should be minimized. When giving shocks, the interval between the last compression and the shock should be kept to less than 10 seconds, as should the interval between the shock and following compression. Charge the defibrillator during ongoing compressions so that, after the brief pulse and rhythm check, a shock can be delivered immediately if a shockable rhythm is present.
6. Chest compressions should be initiated prior to rescue breathing. CPR should be initiated with 30 compressions, followed by 2 breaths.
7. When giving breaths, effectiveness can be ascertained by watching the rise of the chest.
8. All excessive ventilation should be avoided; excessive ventilation may result in aspiration, vomitus or pneumonia. Excess ventilation increases thoracic pressure, reduces venous return, and decreases cardiac output.
9. Rescuer positioning: To improve compression quality, rescuers should position themselves with their knee aligned with the patient's torso (kneeling or using a step stool).

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