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    The Right Depth of Chest Compressions in CPR: How Deep Should You Go?

    Dr. Mary Williams, RN, DC

    About the author

    Dr. Mary Williams, RN, DC
     

    Dr. Mary Williams, R.N., D.C is a Doctor of Chiropractic with an extensive background as a Registered Nurse and experienced Core Instructor for the American Heart Association. She has over 30 years of hands-on medical and instructional experience.

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    When a person goes into cardiac arrest, their heart stops pumping blood—and the brain begins to starve of oxygen. CPR is a simple, very effective procedure that allows a provider to function as the patient’s heart—pumping blood through the body by hand until emergency rescue arrives. Anyone can do CPR, and it’s very easy to learn.

    So, how do you act as the patient’s heart? The answer is chest compressions. In CPR, the rescuer places the heel of one hand on the patient’s chest, between the nipples. The second hand goes over the first, and then the rescuer pushes down, hard and fast, in the center of the chest.

    Ideal depth for CPR chest compressions

    We often get asked the question—what’s the ideal depth for CPR chest compressions? The answer is no deeper than 5.5 centimeters, or about two inches, in adults. Any deeper, and you could damage internal organs. Any shallower, however, and you may not be pumping blood effectively through the body.

    Two inches may not sound like a lot. However, it takes a lot of force to compress a human chest by two inches—about sixty pounds of force. It’s easy to over-deliver if you have a lot of strength, and it’s easy to be too delicate about it as well—especially if you don’t have experience pushing on a human body with that kind of force, and don’t know what it feels like.

    How to know if your chest compressions are the right depth

    In general, it’s better to err on the side of too much force rather than too little. Chest compressions that are too vigorous may cause broken ribs and other internal injuries, but those that are too light won’t pump blood to dying organs—and the patient will almost certainly die. A few broken ribs is not ideal, but it’s better for a patient than dying.

    Ideally, we like to tell people to practice—because that is the only way you’ll really get a feel for how much pressure to deliver. But if you’re not in a healthcare setting, it can be difficult to get that practice in. The amount of force required to adequately pump blood through the human body is more than most people realize, however; CPR should feel vigorous, with the rescuer pushing hard and fast with two hands. Medical professionals typically perform CPR uninterrupted for no more than two minutes before spelling each other, to avoid fatigue.

    Rate of chest compressions

    The 2015 American Heart Association guidelines say that the ideal rate for chest compressions is 100-120 per minute. You may not be able to time yourself with a stopwatch—chances are you won’t be able to, especially if you’re by yourself in an emergency situation. The good news is that there are a number of songs that have the right beat for CPR. These include:

    • Stayin’ Alive by the Bee Gees
    • Cecilia by Simon & Garfunkel
    • I Will Survive by Gloria Gaynor
    • Sweet Home Alabama by Lynyrd Skynyrd
    • Rock Your Body by Justin Timberlake
    • MMMBop by Hanson
    • Another One Bites the Dust by Queen
    • Work It by Missy Elliot
    • Walk Like an Egyptian by the Bangles

    There’s even a Spotify playlist with songs that have the ideal beat for lifesaving CPR. It’s called “Songs to Do CPR To.” Of course, you don’t want to fire up Spotify and pick a song to listen to before you actually do CPR in an emergency situation—but you can always follow the playlist, listen to a few songs to internalize the rhythm, and then get that song in your head when you deliver CPR. Then you’re much more likely to get the rate of chest compressions right.



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