Chapter 7: 2 person CPR method | American CPR Care Association

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chapter 7: 2-Rescuer CPR and Bag-Mask Ventilation

When two trained rescuers are available, CPR should be performed as a coordinated team. One rescuer should take a leadership role to coordinate tasks, monitor quality, and direct compressor switches. Team-based CPR improves compression quality, reduces fatigue, and supports effective ventilation.

Adult 2-Rescuer CPR

Rescuer 1 – Compressions

  • Begin chest compressions immediately.
  • Compress at least 2 inches (5 cm), but no more than 2.4 inches (6 cm).
  • Maintain a rate of 100–120 compressions per minute.
  • Allow full chest recoil after each compression.
  • Minimize interruptions (no more than 10 seconds).
  • Switch compressors about every 2 minutes (or sooner if fatigued).

Compression-to-Ventilation Ratio (Adults)

  • 30 compressions to 2 breaths (30:2)

Rescuer 2 – Airway and Ventilation

  • Open the airway using the head-tilt, chin-lift (unless spinal injury suspected).
  • Deliver breaths using a bag-mask device.
  • Provide 2 breaths after each compression cycle.
  • Each breath should last about 1 second and produce visible chest rise.
  • Avoid excessive ventilation.
  • Monitor compression quality and prepare the AED.
  • Coordinate compressor switches efficiently to limit pauses.

Using a Bag-Mask Device (BVM)

A bag-mask device is commonly used in healthcare settings to deliver assisted ventilation.

  • Select the correct mask size to create a proper seal over the nose and mouth.
  • Use the E-C clamp technique to hold the mask:
    • “C” forms a seal with a thumb and index finger.
    • “E” lifts the jaw to maintain airway position.
  • Attach the bag to oxygen when available (up to 15 L/min).
  • Squeeze the bag just enough to produce visible chest rise.
  • Deliver each breath over 1 second.
  • Provide only enough volume to produce visible chest rise.
  • If the chest does not rise:
    • Reposition the head.
    • Re-establish the mask seal.
    • Check for visible airway obstruction.

Bag-mask-ventilation-checking-acca

High-quality CPR in a team setting works best when everyone communicates clearly, keeps interruptions short, uses proper ventilation technique, switches roles often to prevent fatigue, and encourages one another to stay strong and focused.