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Original Research

Open Access

Cardiopulmonary resuscitation: difficulty in maintaining sufficient compression depth at the appropriate rate

  • Dae Sub Lee1
  • Mun Ki Min1,*,
  • Ji Ho Ryu1
  • Min Jee Lee1
  • Mo Se Chun1
  • Taegyu Hyun1
  • Seung Woo Shon1

1Department of Emergency Medicine, Pusan National university Yangsan Hospital, School of medicine Pusan National university, 626-770 Yangsan-si, Republic of Korea

DOI: 10.22514/sv.2023.104 Vol.19,Issue 6,November 2023 pp.79-85

Submitted: 17 January 2023 Accepted: 07 March 2023

Published: 08 November 2023

*Corresponding Author(s): Mun Ki Min E-mail:


Over the last 50 years, the recommended chest compression for cardiopulmonary resuscitation (CPR) has become faster and deeper, but maintaining deep compressions may be difficult at higher rates. Our study aimed to determine whether adequate compression (chest compression at an appropriate depth and rate) is being performed in emergency departments (ED). We also investigated the effect of adequate compression performance on the return of spontaneous circulation (ROSC). This prospective observational study was conducted at the EDs of two urban academic medical centers. We included adult patients (age ≥18 years) with cardiac arrest who underwent CPR in the ED between May and November 2020. We excluded patients with cardiac arrest related to trauma, repeated arrest except the first, and those for whom a monitor-defibrillator (ZOLL X-series) was not used. The following data were obtained from the monitor-defibrillator devices: compression depth, rate, chest compression fraction, CPR time, and percentage of compressions at the recommended rate and, at the recommended depth, at over and below rates, and depth, and at the appropriate depth and rate. Our study included 50 patients, from whom 441 chest compression sequences were obtained and analyzed. The mean compression depth, rate, and fraction were 6.48 ± 0.87 cm, 117 ± 5/min, 92.1 ± 3.70%, respectively. As the compression rate increased, the depth decreased, and most compressions were over-depth. Adequate compression (appropriate depth at recommended rate) was observed in 97 of the 441 compression sequences (21.9%). Below-depth and below-rate percentages were higher in the deceased group than that in the ROSC group (9.7 ± 15.2% vs. 3.3 ± 3.5%, p = 0.27; 2.7 ± 2.6% vs. 1.2± 0.9%, p = 0.06). The global ratio of chest compression showed low compliance with the recommended rate and depth, even when performed by skilled ED staff.


CPR; Compression depth; Compression rate

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Dae Sub Lee,Mun Ki Min,Ji Ho Ryu,Min Jee Lee,Mo Se Chun,Taegyu Hyun,Seung Woo Shon. Cardiopulmonary resuscitation: difficulty in maintaining sufficient compression depth at the appropriate rate. Signa Vitae. 2023. 19(6);79-85.


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