What is the ratio of chest compression to breaths in adult resuscitation?

Appeared in: BHU NO-2019

Explanation

The standard compression-to-ventilation ratio for adult CPR, as per current BLS guidelines, is 30 compressions to 2 breaths.
This 30:2 ratio applies to adult victims regardless of whether one or two rescuers are present.
High-quality chest compressions should be delivered at a rate of 100-120 per minute to a depth of at least 2 inches (5 cm).
The primary goal is to maximize blood flow to the brain and heart, and the 30:2 ratio balances circulation with oxygenation.

Option A: This ratio is incorrect for adults. It provides too many breaths relative to compressions, which is not optimal for the typical cause of adult cardiac arrest (cardiac origin).
Option B: This is not a standard recommended ratio in any official CPR guideline for any age group.
Option C: This ratio would provide insufficient circulatory support. Pausing for a breath after every compression would severely limit blood flow and coronary perfusion pressure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Cardiopulmonary Resuscitation (CPR) compression-to-ventilation ratio for adults as background academic context rather than a clinical decision trigger.
Performing high-quality CPR with the correct compression-to-ventilation ratio is a critical, non-negotiable skill for nurses that directly impacts patient survival from cardiac arrest.
Minimizing interruptions in chest compressions is as crucial as the ratio itself. Pauses for ventilation should be as brief as possible, ideally less than 10 seconds.
What if? If the patient were a child (from 1 year to puberty) and two rescuers were present, the ratio would change to 15:2 to provide more frequent ventilations, reflecting the higher likelihood of a respiratory cause for arrest in children.

How to Approach the Question

This is a factual recall question testing knowledge of Basic Life Support (BLS) guidelines.
Identify the key patient demographic in the question: 'adult'. This is the most critical piece of information.
Recall the standard CPR compression-to-ventilation ratios for different age groups (adult, child, infant, neonate).
Compare the options to the known standard for adults. The guideline for adults is 30 compressions to 2 breaths.
Eliminate incorrect ratios, noting why they are incorrect (e.g., 3:1 is for neonates, 15:2 is for two-rescuer child/infant CPR).

Concept Tested & Keywords

Concept Tested: Cardiopulmonary Resuscitation (CPR) compression-to-ventilation ratio for adults.
Stem keywords: chest compression, breaths, adult resuscitation, ratio
Lead-in keywords: What is
Clinical cues: The term 'adult resuscitation' is the key clinical cue, as CPR ratios vary significantly with age.

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 45-47

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 763-765

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 610-612

Practise the full BHU NO-2019

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