During CPR, the rescuers should change their position?

Appeared in: NORCET -4 , 2023

Explanation

The standard guideline for two-rescuer CPR is to switch the compressor role every 2 minutes, which corresponds to about 5 cycles of 30 compressions and 2 breaths.
The primary reason for this is to prevent rescuer fatigue, which is a major cause of decline in the quality of chest compressions.
Maintaining high-quality compressions (adequate depth and rate) is critical for circulating oxygenated blood to the brain and heart, thereby improving survival outcomes.

Option A: Waiting for three minutes is too long and will result in rescuer fatigue and poor compression quality. Two cycles of CPR take less than a minute, making the timing inconsistent.
Option C: An interval of five minutes between switches is far too long. It would lead to severe fatigue and a significant reduction in the effectiveness of chest compressions, making resuscitation efforts futile.
Option D: Switching every minute leads to excessive interruptions. Minimizing interruptions in chest compressions is a key principle of high-quality CPR, as pauses decrease coronary and cerebral perfusion pressure.

Visual 1: Chart: A visual timeline of a 2-minute CPR segment, showing 5 cycles of 30:2 compressions and breaths, with a clear marker for 'Switch Rescuers' at the end.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain CPR Technique and Rescuer Rotation as background academic context rather than a clinical decision trigger.
Adherence to the 2-minute switch rule is a critical component of effective teamwork in resuscitation and directly impacts patient survival.
The team leader in a code situation is responsible for tracking the time and clearly directing rescuers to switch roles to maintain high-quality CPR.
What if? If only a single rescuer is present, they should perform continuous CPR without interruption until another rescuer arrives, an AED is available, or they are physically exhausted. The 2-minute switch rule is specifically for team-based resuscitation.

How to Approach the Question

Identify the question as a test of knowledge about a specific clinical protocol (Basic Life Support/CPR guidelines).
Focus on the core concept: preventing rescuer fatigue during CPR.
Recall the standard time interval recommended by major resuscitation councils (like the American Heart Association) for switching compressors.
Evaluate each option based on the 2-minute/5-cycle standard.
Eliminate options with intervals that are too long (e.g., 3 or 5 minutes), as this would cause significant fatigue.
Eliminate options with intervals that are too short (e.g., 1 minute), as this would cause too many interruptions in chest compressions.

Concept Tested & Keywords

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Practise the full NORCET -4 , 2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.