The team leader of an in-hospital cardiac arrest wants to improve the quality of CPR being delivered. Which measure most directly increases coronary perfusion during compressions?
- A Rhythm analysis lasting 30 seconds to confirm the rhythm precisely before each shock
- B Limiting pauses for rhythm checks to under 10 seconds and rotating compressors every 2 minutes ✓
- C Switching the compressor every 5 minutes to reduce fatigue
- D Increasing ventilation rate to 20 breaths per minute to improve oxygen delivery
Correct answer: B. Limiting pauses for rhythm checks to under 10 seconds and rotating compressors every 2 minutes
Explanation
Coronary perfusion occurs during the relaxation phase of compressions, so every interruption abolishes it and several compressions are needed to rebuild pressure after each pause. Rhythm checks should take under 10 seconds, shocks delivered promptly, and the compressor rotated every 2 minutes, since fatigue degrades depth within that time even when the rescuer feels able to continue. Rapid ventilation and prolonged pauses both reduce cerebral and coronary blood flow.
Reference: AHA Guidelines for CPR and Emergency Cardiovascular Care, 2020 ed.
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Written and medically reviewed by the StethoPrep medical team.