Cardiopulmonary Resuscitation (CPR) is a life-saving technique performed when someone’s heart stops beating. This emergency procedure involves chest compressions and, in some cases, rescue breaths, to manually pump blood and oxygen to the brain and other vital organs. While CPR can bridge the gap until professional medical help arrives, its effectiveness relies heavily on proper technique.
Common Errors in CPR Application
Performing CPR effectively requires adherence to specific guidelines, yet several common errors can occur. Incorrect hand placement, typically in the middle of the victim’s chest, is a frequent mistake. Compression depth errors are also common; insufficient depth fails to adequately circulate blood, while excessive depth can be problematic.
The compression rate is another common mistake, with rescuers often compressing too slowly or too quickly. The recommended rate is 100 to 120 compressions per minute, roughly two per second. Failing to allow for full chest recoil after each compression means the heart may not completely refill with blood, reducing effectiveness. If rescue breaths are included, improper head positioning—either not tilting the head back enough or tilting it too far—can obstruct the airway, preventing air from reaching the lungs.
Physical Injuries from Incorrect Compressions
Incorrect CPR compressions can lead to specific physical injuries for the patient. Rib fractures are common, occurring in 30-60% of cases, particularly in older adults or those with fragile bones. The sternum, or breastbone, can also fracture, especially if hands are misplaced or excessive force is applied. These skeletal injuries occur because effective chest compressions require considerable force, typically at least 2 inches deep for adults.
Beyond bone fractures, there is a risk of internal organ damage, though this is less common. Incorrect hand placement or excessive force can lead to lacerations of organs like the liver or spleen. Lung injuries, such as pneumothorax (collapsed lung) or hemothorax (blood in the chest cavity), can also develop, often as a secondary complication from fractured ribs or excessive ventilation.
Compromised Effectiveness and Patient Outcome
Incorrect CPR significantly reduces its life-saving effectiveness, directly impacting patient outcomes. When compressions are too shallow or too slow, they fail to adequately circulate oxygenated blood to the brain and other vital organs. This inadequate blood flow can lead to prolonged oxygen deprivation, increasing the risk of severe brain damage or even death. Shorter CPR durations are associated with more favorable neurological outcomes and higher survival rates.
Even without severe physical injuries, CPR performed with an inconsistent rate or without full chest recoil compromises the heart’s ability to pump blood efficiently, diminishing the overall benefit. This can mean the difference between survival and a fatal outcome, or it can lead to long-term neurological impairment due to insufficient oxygen supply to the brain. Brain injury can manifest as memory loss, speech difficulties, or other significant disabilities. This underscores the importance of proper technique for both survival and quality of recovery.
The Importance of Action Over Inaction
Despite the potential for errors and associated injuries, any attempt at CPR in a cardiac arrest situation is better than no CPR at all. If no intervention occurs, the chance of survival for someone experiencing cardiac arrest is near zero, as the brain begins to suffer irreversible damage within minutes without oxygen. Even imperfect CPR offers a chance of survival, providing some blood flow to the brain and other organs until professional help arrives.
Bystander CPR, even with variations in quality, has been shown to significantly increase survival rates for out-of-hospital cardiac arrest victims, with a fourfold increase compared to no CPR. This underscores the importance of quick action and basic CPR training for the general public. Acting promptly, even if unsure of perfect technique, provides a person with their only chance at life and a potential path to recovery.