Can You Compress the Chest Too Fast During CPR?

How to Deliver the Right Number at the Right Speed

woman doing CPR on a man
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In 2010, the American Heart Association (AHA) issued new guidelines for the appropriate delivery of cardiopulmonary resuscitation (CPR). It advised would-be rescuers to "push hard and fast" when performing the life-saving procedure and to increase the chest compressions from "about 100 per minute" to "at least 100 per minute."

In 2015, the American Heart Association further updated its CPR guidelines to recommend chest compressions at a rate of 100 to 120 per minute. The narrower standard is meant to improve blood flow during CPR by keeping the blood moving fast enough while also giving the heart enough time to adequately fill between chest compressions.

Reasons for the Update

When the AHA originally released the 100 per minute standard in 2005, it wasn't intended to deliver 100 chest compressions per minute. What the AHA meant was that the average rate of compression was 100 per minute but that the actual time delivering the compressions would be interspersed with mouth-to-mouth resuscitation.

The prescribed 30:2 ratio meant that after every 18 or so seconds of chest compressions (the length of time it takes to do 30 compressions at a rate of 100 per minute, rescuers would stop to deliver two breaths over a period of no longer than 10 seconds. A proficient rescuer could easily get two cycles of 30:2 performed every minute, leading to a total of around 60 compressions per minute with ventilation.

By 2008, hands-only CPR became the alternative standard when research demonstrated that mouth-to-mouth resuscitation offered no survival benefit to people with cardiac arrest when performed by a lay rescuer.

In its current guidelines, the AHA recommends hand-only CPR for lay rescuers with the aim of delivering that high-quality chest compressions at the prescribed speed. Hands-only CPR is intended for use on teens and adults only.

Conventional CPR involving chest compression and breaths should be used for:

  • Infants and children up to puberty
  • Anyone found unresponsive and not breathing normally
  • Any victims of drowning, drug overdose, or collapse due to breathing problems or prolonged cardiac arrest

What the Changes in CPR Mean

No pause for ventilation means more time pumping on the chest. This increases the rate of 100 compressions per minute and an actual 100 compressions per minute or more. However, there is a growing body of evidence that chest compressions have a maximum speed as well as a minimum speed.

A 2012 study involving 3,098 cardiac arrest cases concluded that pumping too fast—over 125 compressions per minute—offered diminishing returns when compared to the recommended rate of 100 to 120 compressions per minute. According to the researchers, pumping too fast does not allow the heart chambers to refill properly once the blood is pushed from the heart during compression.

Most CPR trainers will tell you to compress the chest to the rhythm of the Bee Gee's song "Staying Alive." If compressions are delivered in tandem with the song beat, there should be roughly 100 to 120 compressions per minute.

A Word From Verywell

For most people, CPR will be a once-in-a-lifetime event and one that is approached with understandable fear and panic. If you are faced with such an event, try to remain calm and don't worry too much if "Staying Alive" is playing too fast or too slowly in your head. Generally speaking, faster compressions are better than slower ones.

Don't be afraid to vocalize the song to keep the rhythm or to ask others around you to do the same. They can then tell you if you are going to fast or slow.

To ensure you deliver the right amount of pressure during chest compression, take a CPR class or a refresher course if you haven't taken a class in years. Many are provided free of charge by the Red Cross and other non-profit health charities.

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Article Sources

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  2. Sayre MR, Berg RA, Cave DM, et al. Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association emergency cardiovascular care committee. Circulation. 2008;117(16):2162-7. doi:10.1161/CIRCULATIONAHA.107.189380

  3. American Heart Association (AHA). Highlights of the 2015 American Heart Association guidelines for CPR and ECC. Dallas, TX: AHA; 2015.

  4. Idris AH, Guffey D, Aufderheide TP, et al. Relationship between chest compression rates and outcomes from cardiac arrestCirculation. 2012 Jun 19;125(24):3004-12. doi:10.1161/CIRCULATIONAHA.111.059535

  5. American Heart Association. Helping people 'Stay Alive' is easy with hands-only CPR. March 31, 2017.