CPR Chapter Four

A chest compression fraction is the proportion of time that chest compressions are performed during a cardiac arrest. A chest compression fraction of at least 60% is recommended, and a goal of 80% if often achievable with good teamwork.

Roles during a resuscitation attempt, what to communicate, and how to communicate.

In a six-person resuscitation attempt, there is commonly a Team Leader, Administer of Medications, Timer/Recorder, Compressor, AED/Monitor/Defibrillator, and Airway Finder.

~ Assess the patient. ~ Does 5 cycles of chest compressions. ~ Alternates with AED/Monitor/Defibrillator every 5 cycles or 2 minutes (or earlier if signs of fatigue set in).

~ Brings and operates the AED/monitor/defibrillator. ~ Alternates with Compressor every 5 cycles or 2 minutes (or earlier if signs of fatigue set in), ideally during rhythm analysis. ~ If a monitor is present, places it in a position where it can be seen by the Team Leader (and most of the team).

~ Opens and maintains airway. ~ Provides ventilation.

~ Every resuscitation team must have a defined team leader. ~ Assigns roles to team members. ~ Makes treatment decisions. ~ Provides feedback to the rest of the team as needed. ~ Assumes responsibility for roles not assigned.

~An ALS provider role. ~ Administers medications.

~ Records the time of interventions and medications (and announces when these are next due). ~ Records the frequency and duration of interruptions in compressions. ~ Communicates these to the Team Leader and the rest of the team.

~ Provides an ongoing record of treatment. ~ Acts as a way to reevaluate the victim's status, the interventions performed, and the team's progress within the algorithm of care.

Team Leader: ~ Call each team member by name and make eye contact when giving instruction. ~ Don't assign additional tasks unless you are sure that the team member understands the instruction. Team Members: ~ Confirm that you understand each task to which you are assigned by verbally acknowledging the task. ~ Tell the team leader when you have finished a task. Team members and leaders should use concise, clear language that helps prevent misunderstandings. Speaking in a tone of voice that is loud enough to hear, but is also calm and confident, helps keep all team members focused.

Debriefing is the opportunity for team members to identify why certain actions were taken. Debriefing has been shown to help individual team members perform better and aid in identification of system strengths and deficiencies.

Tell the team leader that you are not comfortable in performing that task.

Suggest to resume chest compressions without delay.

Repeat back to the team member the task you were assigned.