Just Added!

New Videos with Amal Mattu, MD

Watch NowGo

Which Compression to Ventilation Ratio Should You Use?

November 3, 2017

Spoon Feed
According to this large systematic review, in adults a 30:2 compression to ventilation ratio was better than 15:2.  For kids, either ratio was better than compression only CPR, except under 1 year in which ventilations did not improve outcome beyond compression-only (likely due to being underpowered).

Why does this matter?
When you take PALS and BLS, you are taught to do a compression to ventilation ratio of 30:2 when solo; 15:2 with two-rescuer CPR in children.  But does this make a difference in outcome?

30:2, 5:1, 15:2, compression-only – which is it?
Which compression to ventilation ratio is better?  This was an ILCOR BLS task force systematic review of 28 studies.  They concluded that in adults, 30:2 was superior to 15:2.  In children either 30:2 or 15:2 was superior to compression-only CPR. But in children under 1 year, 30:2 or 15:2 and compression-only CPR showed no difference.  However, with only 2 pediatric studies, the infant subgroup analysis was likely underpowered to detect any differences.  The take home for me is to ventilate kids and keep it simple – if you forget, do 30:2 on everyone.  When you take PALS or BLS, make sure you know 15:2 is the answer for two-rescuer CPR in pediatric patients.

Effectiveness of different compression-to-ventilation methods for cardiopulmonary resuscitation: A systematic review.  Resuscitation. 2017 Sep;118:112-125. doi: 10.1016/j.resuscitation.2017.05.032. Epub 2017 Jun 2.

Peer reviewed by Thomas Davis, MD.

What are your thoughts?