Effective compression ratio-A new measurement of the quality of thorax compression during CPR

Greif, Robert; Stumpf, Dominik; Neuhold, Stephanie; Rützler, Kurt; Theiler, Lorenz; Hochbrugger, Eva; Haider, Dominik; Rinösl, Harald; Fischer, Henrik (2012). Effective compression ratio-A new measurement of the quality of thorax compression during CPR. Resuscitation, 84(5), pp. 672-677. Shannon: Elsevier Science Ireland 10.1016/j.resuscitation.2012.10.016

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PURPOSE: Computer-based feedback systems for assessing the quality of cardiopulmonary resuscitation (CPR) are widely used these days. Recordings usually involve compression and ventilation dependent variables. Thorax compression depth, sufficient decompression and correct hand position are displayed but interpreted independently of one another. We aimed to generate a parameter, which represents all the combined relevant parameters of compression to provide a rapid assessment of the quality of chest compression-the effective compression ratio (ECR). METHODS: The following parameters were used to determine the ECR: compression depth, correct hand position, correct decompression and the proportion of time used for chest compressions compared to the total time spent on CPR. Based on the ERC guidelines, we calculated that guideline compliant CPR (30:2) has a minimum ECR of 0.79. To calculate the ECR, we expanded the previously described software solution. In order to demonstrate the usefulness of the new ECR-parameter, we first performed a PubMed search for studies that included correct compression and no-flow time, after which we calculated the new parameter, the ECR. RESULTS: The PubMed search revealed 9 trials. Calculated ECR values ranged between 0.03 (for basic life support [BLS] study, two helpers, no feedback) and 0.67 (BLS with feedback from the 6th minute). CONCLUSION: ECR enables rapid, meaningful assessment of CPR and simplifies the comparability of studies as well as the individual performance of trainees. The structure of the software solution allows it to be easily adapted to any manikin, CPR feedback devices and different resuscitation guidelines (e.g. ILCOR, ERC).

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Greif, Robert, Theiler, Lorenz


600 Technology > 610 Medicine & health




Elsevier Science Ireland




Jeannie Wurz

Date Deposited:

04 Oct 2013 14:33

Last Modified:

05 Dec 2022 14:10

Publisher DOI:


PubMed ID:


Web of Science ID:



https://boris.unibe.ch/id/eprint/13001 (FactScience: 219501)

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