Cardiopulmonary Resuscitation (CPR) is a life-saving technique performed during cardiac arrest, a sudden loss of heart function. Its immediate purpose is to manually circulate blood and oxygen to the brain and other vital organs, sustaining them until professional medical intervention can restore normal heart rhythm and function. Immediate action through CPR is important for improving outcomes.
The Foundational Rule of CPR Duration
For a lay rescuer, the primary guiding principle for CPR duration is to continue uninterrupted, high-quality chest compressions. This should persist until one of two events occurs: either the person shows obvious signs of life, such as normal breathing or purposeful movement, or trained medical professionals arrive and assume responsibility for care. The reason for continuous compressions is to maintain a consistent flow of oxygenated blood to the brain, which helps prevent irreversible damage. There is generally no fixed time limit for lay rescuers, emphasizing the importance of sustained effort until these conditions are met.
Specific Moments to Stop CPR
There are distinct scenarios where a lay rescuer should stop performing CPR. When emergency medical services (EMS) or other trained medical personnel arrive and take over, the lay rescuer should cease compressions. These professionals have advanced equipment and training.
Another clear indication to stop CPR is when the person exhibits obvious signs of life, including normal breathing, purposeful movement, or regaining consciousness. It is important to distinguish these true signs of life from agonal breathing, which appears as gasping but is not effective and still requires CPR.
Performing effective CPR is physically demanding, and exhaustion can quickly set in. If a rescuer becomes physically unable to perform high-quality compressions, it is permissible to stop, especially if alone. Rescuer safety also takes precedence; if the environment becomes dangerous (e.g., fire, structural collapse), prioritize your safety and stop CPR.
If an Automated External Defibrillator (AED) advises “no shock advised,” keep the pads in place and continue CPR. This means the AED hasn’t detected a shockable rhythm, but compressions are still necessary until further medical assistance arrives.
Sustaining Effective CPR Until Help Arrives
While CPR duration can be extensive, compression effectiveness is paramount. High-quality CPR involves specific techniques: compressions should be delivered at 100 to 120 per minute, with a depth of 2 to 2.4 inches (5-6 cm) for adults. Allowing full chest recoil and minimizing interruptions are crucial for continuous blood circulation.
If more than one rescuer is present, switch roles every 2 minutes or after five cycles of 30 compressions and 2 breaths. This rotation prevents fatigue and maintains compression quality. Switches should be swift, ideally under 5 seconds, to minimize interruptions.
For a single rescuer, managing fatigue is practical. Using proper body mechanics, like leaning directly over the person with straight arms, can leverage body weight and reduce muscle strain. The overarching goal is to maintain life support with continuous, high-quality efforts until professional medical assistance arrives to provide advanced care.