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Patients entering cardiac arrest are more likely to receive good–quality bystander–initiated cardiopulmonary resuscitation if multiple people assist. Among cases of out–of–hospital cardiac arrest, CPR quality is associated with multiple rescuers initiating bystander CPR, being in a central or urban setting, and receipt of bystander–initiated CPR and longer duration of resuscitation as per Dr Hideo Inaba, at Kanazawa University Graduate School of Medicine in Japan in the journal Resuscitation.
Good–quality bystander CPR is less commonly performed by a family member, by older bystanders and in home environments. The key to survival and positive neurological outcomes for those experiencing an out–of–hospital cardiac arrest is the initiation of bystander CPR. This CPR should be performed with chest compressions only, without mouth–to–mouth resuscitation.
In its latest guidelines on high-quality CPR issued in 2015, the American Heart Association (AHA) has recommended chest compression rate to 100-120/ min, chest compression depth for adults to be at least 2 inches (5 cm) but not greater than 2.4 inches (6 cm). AHA further says that chest compression should be started first before rescue breaths (C-A-B rather than A-B-C). The single rescuer should begin CPR with 30 chest compressions followed by 2 breaths.