You can achieve a high chest compression fraction by compressing the chest at a rate of 100-120 times per minute to a depth of at least 2 inches but no more than 2.4 inches for an adult victim, as recommended by the American Heart Association. Be sure to allow the chest to fully recoil after each compression to maximize blood flow and oxygen delivery to the heart and vital organs.
It is crucial to achieve a high chest compression fraction (CCF) for a patient who is suffering from a life-threatening situation like cardiac arrest, heart attack, or shock. To achieve a high chest compression fraction, rescuers must follow AHA guidelines for CPR.
In this blog, we’ll explore various techniques and best practices to help you achieve a high CCF during CPR. From minimizing interruptions to ensuring proper hand placement and utilizing advanced equipment, we’ll cover all the important aspects contributing to a high chest compression fraction and help you understand what is CCF in CPR. Whether you’re a healthcare professional or a layperson trained in CPR, these latest resuscitation and emergency response guidelines will help you improve your CPR performance and potentially save more lives.
What is Chest Compression Fraction(CCF) in CPR?
Chest Compression Fraction (CCF) is a critical metric in cardiopulmonary resuscitation (CPR) that represents the proportion of time chest compressions are performed during a cardiac arrest resuscitation effort. It is calculated by dividing the total time spent delivering chest compressions by the total time of the resuscitation attempt, then multiplying by 100 to express it as a percentage.
Chest compression fraction formula: CCF = (Total time of chest compressions/Total time of the resuscitation attempt) *100%
A high chest compression fraction is associated with better patient outcomes, as continuous and effective chest compression rates are crucial for maintaining blood circulation to vital organs during cardiac arrest. High CCF targets are typically above 80%. This ensures minimal interruptions in compressions, which helps to maximize the chances of survival and recovery. The emphasis on maintaining a high CCF underscores the importance of efficient CPR techniques and minimizing pauses for activities such as ventilation, defibrillation, or rhythm analysis.
Why is a High Chest Compression Fraction Important?
A high chest compression fraction is strongly associated with improved survival outcomes in cardiac arrest. Studies show that maintaining a high compression fraction increases the return of spontaneous circulation (ROSC), with rates reaching up to 25.6%.” Here are several reasons why maintaining proper compressions is so vital:
- Increases Blood Flow to Vital Organs: Chest compressions pump blood to the heart and brain by artificially maintaining minimal blood pressure during cardiac arrest cases. More time spent compressing means more blood flow reaching these vital organs, which is a key aspect of an effective cardiac arrest response.
- Improves Survival Rates: Numerous studies have found a strong, direct correlation between a high chest compression fraction and an improved survival rate in cardiac arrest patients. For every 1% increase in CCF, survival rates increase by about 2-3%.
- Reduces Interruptions: Long pauses without compressions diminish the efforts of previous compressions. Minimizing these interruptions is key to high-quality cardiopulmonary resuscitation (CPR).
- Follows Resuscitation Guidelines: The AHA guidelines clearly state that maintaining chest compressions is a priority, as interruptions can cause blood pressure to fall rapidly. A CCF ≥60% complies with these recommendations.
- Easier for Bystanders: Simplifying CPR for laypeople to just compressions alone, without ventilations, has achieved higher CCFs that translate to increased survival during a heart attack. This approach also encourages bystander intervention, as it’s easier for untrained individuals to step in and perform effective CPR until emergency medical services arrive.
Evidence of High Chest Compression Fraction (CCF)
In the United States and Canada, data from 13,000 cardiac arrest patients were studied to measure survival and hospital discharge outcomes. According to NIH.gov, the research showed:
1. The median Chest Compression Fraction (CCF) was 74%, showing awareness of the importance of high CCF, even though it was below the ideal 80%.
2. 25.6% of patients achieved ROSC (Return of Spontaneous Circulation), meaning their heart started beating again.
3. Only 2.4% survived to hospital discharge, which is similar to other studies on out-of-hospital cardiac arrest (OHCA) where bystander CPR and AED use were not provided.
3. A higher CCF increased the chances of achieving ROSC, but it did not improve survival to discharge.
What Are the Factors That Directly Lowers Chest Compression Fraction (Ccf)?
Several factors influence Chest Compression Fraction. Each factor plays a significant role in determining the quality of CPR delivered in hospital cardiac arrest. Understanding and addressing these factors are essential for rescuers aiming to maximize Chest Compression Fraction(CCF) and improve patient outcomes. Let’s explore these factors in detail:
1. Pauses for Ventilation
If there are any Interruptions in providing breaths, then it can reduce CCF. If the rescuer can minimize the duration and frequency of ventilation pauses, then it helps maintain a higher CCF. Using advanced airway management devices like supraglottic airways or endotracheal tubes can help because they allow you to improve chest compression while giving breaths. This way, you reduce interruptions and make CPR more effective.
Also read: What is the Correct Volume of Air to Deliver During BVM Ventilations?
2. Defibrillation Pauses
The time taken to deliver shocks with a defibrillator can lower CCF. To keep interruptions short, it’s important to coordinate efficiently and optimize defibrillation timing to perform defibrillation quickly. Using automated external defibrillators (AEDs) that charge fast and provide clear voice prompts can help speed up the process, minimize pauses, and improve overall CCF.
3. Rhythm Analysis
Pauses to check the heart rhythm can lower the Chest Compression Fraction (CCF). To keep these pauses short, it’s crucial to assess the rhythm quickly and efficiently. Using protocols that allow for rhythm analysis while chest compressions continue, like the “pit-crew” approach, can help reduce interruptions. This way, you can maintain continuous compressions and optimize CCF.
4. Fatigue of Rescuers
When rescuers get tired, their compressions can become less frequent and less effective, which leads to longer pauses. To keep compressions strong and steady, it’s important to regularly switch out the person doing them. This way, everyone stays fresh, and the quality of CPR remains high.
5. Training and Experience
Well-trained and experienced rescuers, such as emergency responders, are more efficient at minimizing pauses. This efficiency helps improve the Chest Compression Fraction (CCF) and overall effectiveness of CPR.
6. Equipment Availability and Use
The presence and use of automated CPR devices can help maintain consistent compressions without interruption, thus improving CCF. These devices provide reliable support, especially in high-stress situations, ensuring that CPR efforts are sustained and effective.
7. Patient Movement and Transport
When moving or transporting a patient, there’s a risk that compressions might stop, which can create ineffective Chest Compression Fraction (CCF). It’s important to handle the situation efficiently and try to avoid interruptions as much as possible. Keeping things smooth during transportation ensures that CPR stays effective and gives the patient the best chance of recovery.
8. Environmental Factors
Things like tight spaces, loud noises, and other environmental conditions can impact how well CPR and first aid works and, in turn, the Chest Compression Fraction (CCF). Creating the right environment—quiet, organized, and with enough space—can make a big difference in how effective CPR is and how well the patient responds.
What is the Proper Technique to Achieve High-Chest Compression Fraction?
Proper technique is very important in achieving a high chest compression fraction during CPR. The effectiveness of CPR relies heavily on the quality of chest compressions and the coordination of various tasks involved in the resuscitation effort. By adhering to established protocols and utilizing the best practices, rescuers can optimize CCF and improve the chances of successful patient outcomes. Let’s explore how you can get a high chest compression fraction in CPR:
1. Minimize Interruptions
To achieve a high Chest Compression Fraction (CCF), minimizing interruptions in CPR is crucial. This means working together smoothly to handle things like giving breaths, using the defibrillator, and checking heart rhythms without stopping compressions too much. Minimal interruptions lead to better blood flow, improved oxygen delivery to vital organs, and a higher chance of successful resuscitation. compression.
Related: What is Recommended to Minimize Interruptions in Compressions?
2. Proper Hand Placement
Proper hand placement is crucial for effective chest compressions and achieving a high CCF. To do it right, place the heel of one hand in the center of the adult patient’s chest, on the lower half of the sternum. Put your other hand on top and interlock your fingers. Keep your arms straight and position your shoulders directly over your hands. This way, you can use your body weight to deliver strong and effective compressions.
Also read: How to Make a DIY CPR Manikin at Home?
3. Proper Compression Depth and Rate
When it comes to CPR, chest compressions are like the heartbeat of the rescue effort. They keep the blood pumping and oxygen flowing to the brain and heart. So, when you’re on compression duty, aim to complete an effective compression cycle, going deep about 2 inches for adults and maintaining a steady rhythm of 100 to 120 compressions per minute. This way, you’re ensuring that blood keeps flowing to all the vital parts, giving the person the best chance of coming back strong with proper chest compression depth.
4. High-Quality Ventilation
Effective ventilation plays a crucial role in CPR, especially when rescue breaths are included in the protocol. Rescuers should deliver breaths quickly and efficiently. So, when you’re giving breaths, make sure to do it fast and with purpose, watching for that chest rise with each one. Maintain the proper compression-to-ventilation ratio to ensure a balance between chest compressions and oxygen delivery. If you have access to advanced airway devices, utilize them and follow recommended ventilation techniques to help maximize oxygenation and minimize interruptions in chest compressions.
Also read: How is CPR Performed Differently When an Advanced Airway Is in Place?
5. Effective Team Coordination
When it comes to CPR, everyone is putting in their efforts to save a life. Teamwork is key in such a situation. Each person has their part to play. So, before you start, make sure everyone knows their role. Whether you’re performing chest compression or ventilation, every role is crucial. By working together smoothly, you can keep interruptions to a minimum and keep CPR quality high from start to finish. Hence, the team needs to communicate clearly and give it all as a team for successful coordination and high CCF.
6. Role Rotation
When you’re in the middle of CPR efforts, it’s important to keep the energy up and the performance strong. That’s where role rotation comes in. Every couple of minutes, switch up who’s doing what. This way, everyone stays fresh and focused, and there’s always someone ready to jump in with full energy. The team members need to keep the momentum going and ensure those chest compressions never miss a beat. So, when you’re on the team, be ready to switch it up and keep the rhythm going strong to perform high chest compression fraction.
7. Regular CPR Training and Practice
It is essential to stay updated with your CPR skills. That means you must keep up with your training and practice sessions to sharpen your knowledge and life-saving techniques when needed. So, make sure to attend your CPR training sessions regularly. Whether it’s traditional CPR or techniques like Hands-Only CPR in certain situations, regular training ensures you’re prepared to adapt to different scenarios. This preparation will help you jump into action confidently and deliver high-quality CPR when it matters most.
8. Use of Feedback Devices
During CPR, using real-time feedback devices can be super helpful. These devices give you instant information on stuff like how deep your compressions are, how fast you’re going, and if you’re letting the chest recoil properly between compressions. So, when you’re doing cardiac compressions, monitor feedback by keeping an eye on these devices will tell you if you need to adjust your technique to make sure you’re doing the best compressions possible and getting the most out of each one. That way, you can bring out the best possible outcomes in cardiac emergencies.
Related: Which Type of Victim Requires High-Quality CPR?
9. Continuous Evaluation
Assessing how you’re doing during CPR is super important. After each CPR session, rescuers need to take a moment to debrief with their team. The team needs to look at how things went, check out any statistics or data they got on how well you did, and talk about what you can do better next time. It’s better to analyze performance metrics and discuss strategies to enhance CPR quality and maintain a high CCF in future scenarios.
Learn How to Achieve a High Chest Compression Fraction Today!
If you want to maximize your CPR effort, apply the technique we’ve outlined in this blog. By focusing on maintaining continuous chest compressions and promoting steady blood circulation, you can significantly improve the chances of a successful resuscitation during cardiac arrest emergencies. Remember, every second counts during CPR, and keeping interruptions to a minimum is crucial.
If you’re looking to enhance your skills and gain confidence in performing high-quality CPR, join the CPR classes at Heart Start CPR in San Francisco, Bay Area. Our training programs follow CPR guidelines recommended by the AHA. Our program not only focuses on high-quality CPR techniques but also provides comprehensive instruction in Basic Life Support (BLS), resuscitation efforts, and emergency medical procedures. With a strong emphasis on cardiovascular care, we can help you with the knowledge and skills needed to handle critical situations effectively and use advanced airway management tools to improve outcomes. Join us to make a real difference in emergencies and achieve a high chest compression fraction during cpr.
FAQS on High Chest Compression Fraction
What If Interruptions Are Needed for Tasks Like Defibrillation?
It is recognized that occasional pauses will be required for critical interventions like shock delivery or establishing an advanced airway. The CPR guidelines do not mandate never pausing – just to minimize unnecessary or prolonged interruptions as much as possible. The goal is to resume compressions promptly after any clinically indicated cessations.
How Long Should CPR Continue if CCF is Suboptimal?
There is no definitive duration that CPR should continue if the achieved CCF is less than 60%. Rescuers should make every effort to improve the quality and fraction of compressions with coaching, switching providers, or other strategies. However, high-quality compressions remain the priority even if the achieved CCF alone is not ideal. Abandoning resuscitation should rely on the overall clinical assessment and circumstances per standard guidelines.
How does training and simulation help improve CCF?
If you practice regular CPR compression, especially in emergency simulations, it helps build muscle memory and teamwork. When an emergency hits, you and your team can stay focused and keep delivering strong, high-quality compressions without hesitation.
Can the use of an AED affect CCF?
Yes, improper use or delays in applying an Automated External Defibrillator (AED) can reduce chest compression fraction. Ensure the AED is prepared and applied promptly, minimizing any pause in chest compressions before and after shock delivery.
Can bystanders achieve high CCF with Hands-Only CPR?
Yes, Hands-Only CPR (compression-only) often results in a higher CCF compared to traditional CPR with breaths, particularly when performed by lay rescuers. This is because there are fewer pauses for ventilation, which helps maintain continuous chest compressions.
