Version control: This document is current with respect to 2015 American Heart Association® Guidelines for CPR and ECC. These guidelines are current until they are replaced on October 2020. If you are reading this page after October 2020, please contact ACLS Training Center at for an updated document.

High quality cardiopulmonary resuscitation

HIGH QUALITY CPR is important in the provision of basic life support to an unresponsive victim without a pulse. High quality CPR possesses the following important characteristics:
  1. Compressions should begin within ten seconds of determination of cardiac arrest.
  2. The rate of compression should be 100-120 per minute.
  3. The depth of compression should be 2”- 2.4” for adults, approximately 2” for children from age one to adolescence, and 1 ½” (4 cm) for infants. The depth of compression should be 1/3 the AP chest diameter for children and infants.
  4. There should be complete recoil of the chest after each compression.
  5. Interruptions in chest compression should be minimized. When giving shocks, the interval between the last compression and the shock should be kept to less than 10 seconds, as should the interval between the shock and following compression.
  6. Chest compressions should be initiated prior to rescue breathing. CPR should be initiated with 30 compressions, in order to shorten any delay to the first compressions.
  7. When giving breaths, effectiveness can be ascertained by watching the rise of the chest.
  8. All excessive ventilation should be avoided; excessive ventilation may result in aspiration, vomitus or pneumonia.