Patients of 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. Good quality means Appropriate hand positions or finger positions for infants Compression rate of at least 100 per minute Compression depth of at least 2 inches or at least one third of the anterior posterior diameter of the chest Time to arrest or recognition of arrest to initiation of CPR is significantly shorter among those who provided good quality CPR median 3 minutes versus 4 minutes