Cardiopulmonary resuscitation (CPR) is a time-critical intervention performed during cardiac arrest, and clear, decisive communication is paramount for success. The process often requires coordinated action from multiple individuals, even among lay rescuers, where verbal cues ensure that every step is synchronized and executed efficiently. Effective communication minimizes delays, prevents errors, and ultimately helps maintain the quality of chest compressions necessary to sustain blood flow to the brain and other vital organs.
Initial Communication: Establishing Roles and Activating EMS
Before touching the person, the rescuer must confirm the environment is safe, often by verbally stating, “Scene is safe,” to acknowledge the lack of immediate danger. The next verbal step is to check for responsiveness by tapping the individual and asking loudly, “Are you okay?”. If the person does not respond, the rescuer must immediately activate the emergency response system and delegate tasks clearly to bystanders to avoid confusion.
Rather than asking a general question like, “Can someone call 911?”, the rescuer must use a direct, closed-loop command. For example, a rescuer might point and say, “You, in the blue shirt, call 911 and get an AED,” and wait for that person to repeat the instruction back to confirm understanding.
When communicating with the emergency dispatcher, the caller must provide a clear and concise description of the situation, including the exact location with landmarks for prompt arrival of professional help. The dispatcher needs to know the patient’s status, such as unresponsiveness and lack of normal breathing, and if CPR is in progress. This information allows the dispatcher to provide telecommunicator-assisted CPR instructions.
Performance Communication During Compression Cycles
Once CPR begins, continuous verbal communication is required to maintain the high quality of compressions and manage rescuer fatigue. The rescuer performing compressions should count aloud, typically in groups of five or ten, to maintain the correct rate of 100 to 120 compressions per minute. Counting also helps ensure the proper compression-to-ventilation ratio, which is 30 compressions to 2 breaths in conventional CPR.
Other rescuers, or the team leader, must provide constructive feedback to the compressor in real-time to correct technique. Commands like “Push deeper” or “Allow full chest recoil” ensure that the compressions are effective, reaching the required depth of at least two inches in adults.
In a two-rescuer scenario, coordination between compressions and ventilations is maintained through verbal cues. The person managing the airway should announce the pause for rescue breaths by saying, “Stopping for breaths now,” and confirm their delivery with a phrase like, “Breaths delivered,” before compressions resume. To combat rescuer fatigue, which typically decreases compression quality after about two minutes, the compressor must communicate their impending need to switch. The team leader or another rescuer will then call for a clean transition, ensuring minimal interruption to chest compressions, which is a key measure of high-quality CPR.
Critical Communication When Using an Automated External Defibrillator
The introduction of an Automated External Defibrillator (AED) requires a specific set of life-critical verbal commands to ensure the safety of all rescuers and the patient. The rescuer bringing the device must announce the AED’s arrival and the preparation for use. This includes verbally confirming that the chest is exposed and dry, and that the electrode pads are correctly placed before plugging the connector into the AED.
Once the AED begins analyzing the heart rhythm, it is absolutely necessary for all individuals to move away from the patient. The rescuer operating the AED must loudly announce, “Analyzing, everyone clear!” to prevent anyone from touching the patient, which could interfere with the analysis or endanger a rescuer. If the device advises a shock, the most safety-critical communication occurs.
The rescuer must use a standardized call-and-response protocol to clear the patient, such as shouting, “I’m clear, you’re clear, we’re all clear,” before pressing the shock button. Verbalizing the administration of the shock, “Shock delivered,” confirms the action. Immediately following the shock, the final communication is the command to resume CPR without delay, often stated as, “Resume CPR immediately,” to maximize the time spent on compressions.