Chest compressions


JANUARY 13, 2019


To kick off this article, we'd like to offer you a little slice of our history.


In 1740, the Paris Academy of Sciences recommended the use of mouth-to-mouth resuscitation and chest compressions to save drowning victims rescued from the Seine River.


Since then, cardiopulmonary resuscitation techniques have continued to evolve.


Chest compressions

Illustration showing M.Jean-Baptiste Colbert presenting the members of the Académie royale des sciences to King Louis XIV. Illustration from 1667 by M.Henri Testelin.


Formed in 1992, ILCOR (the International Committee on Resuscitation) has become the leader in resuscitation research.


Here's what you'll find in ILCOR's latest CPR guidelines, published in 2020:


- 1 -

The latest studies have shown that it is easy for an untrained rescuer to perform only chest compressions. It's even easier for the EMR (Emergency Medical Dispatcher) to explain the technique over the phone when the first responder dials 911.

Recent studies tend to show that the survival rate after cardiac arrest of cardiac etiology in adults with CPR with compressions only is similar to that observed with CPR combining compressions and insufflations when given before the arrival of EMS (Emergency Medical Services).

Chest compressions only

Are acceptable to all rescuers in the event of cardiopulmonary resuscitation.

For trained non-professional rescuers, we still recommend insufflations in addition to chest compressions, if they feel able to do so.


- 2 -

For victims of cardiac arrest, it is justified that rescuers perform chest compressions at a rate of at least 100 per minute.

The frequency with which chest compressions are performed is a crucial factor in maintaining neurological capacity. It is essential to limit interruptions during continuous compressions so that they can be effective. Most studies show a higher survival rate with higher frequency compressions. However, there is a recommended limit to the frequency of chest compressions. They should not exceed 120 compressions per minute. Preliminary data indicate that extremely rapid compressions (of the order of 140 or more per minute) imply inadequate depth of compressions, which has a negative impact on survival results.

  • Push fast
  • 100 to 120 compressions per minute

Minimize interruptions. Don't waste time:

  • clear the airway
  • recognize cardiac arrest
  • administer ventilations (insufflate)


- 3 -

Rescuers should perform compressions to a depth of at least 2 inches (5 centimeters) in the average adult, avoiding depths greater than 2.4 inches (6 centimeters). In pediatrics, a depth of about one-third (1/3) the depth of the thorax is recommended; about 1.5 inches (4 centimeters) in infants and about 2 inches (5 centimeters) in children.

For adults, a minimum of 2 inches (5 centimetres) of ribcage compression is recommended to allow the heart to compress adequately and eject oxygenated blood throughout the body. Preliminary data indicate that excessive compression depths in adults, greater than 2.4 inches (6 centimetres), have a negative impact on results. Excessive compression does not promote life-threatening injuries. More often than not, statistics show that compressions are not deep enough.

  • Push hard
  • Make sure you're well positioned
  • Give deep enough compressions



- 4 -

Rescuers should avoid leaning on the victim's chest between compressions, to ensure total chest relaxation in cardiac arrest patients.

Total chest relaxation promotes venous return and cardiorespiratory circulation. Total relaxation of the victim's chest allows the heart to gorge itself with as much blood as possible before ejecting it back into the body via the next chest compression.

  • Control your chest compressions
  • Don't lean on the victim's chest


Source: Highlights of the 2020 update of the AHA CPR and ECC Guidelines