CPR training can come from several outfits.

For most people who have healthcare-related jobs, they need to take a AHA (American Heart Ass'n) certified course.

Now then, here's what is most important in CPR:

1. The depth of compression (2 inches) is most important. Studies show that the #1 failure in doing CPR (even my MD's and RN's) is a lack of achieving the proper depth of stroke. On everyone but infants, you need to get 2" of stroke, and then full release. The rate of compressions should be 100 to 120 compressions per minute. Lots of people go too fast. The heart needs time to recoil and re-fill.

NB that when you do CPR with a 2" stroke, especially on folks from 45 years of age and older, you typically break their sternum or you break some ribs. You'll feel crepitation (bones clicking/rubbing against each other) with every stroke. Keep going. I've broken the sternum of little old ladies who were someone's grandmother. It sucks, but what I'm telling you is the brutal truth. They won't/don't tell you these sorts of things in the class. I've pumped on the chests of several people in the last three years - sometimes, the very first stroke I push into I can feel the sternum split.

2. Understand that if you're doing solo CPR, it is essential to maintain compressions with the fewest interruptions, for the shortest amount of time you can achieve.  The heart is a like a pump that loses its prime. If you stop CPR compressions for (eg) 15 seconds, it might take another 30 seconds of compressions to get the heart actually pumping blood again.

3. The AHA will probably move to compression-only CPR in the future. This means that, rather than stop compressions to breath for the patient, people will be coached to just make sure there is an open airway on the patient, and then start compressions, and keep doing compressions. Enough air is moved into the patient's lungs with an open airway and only compressions. This is done because issue 2 above, it is essential to interrupt compressions as few times as possible. There are even some areas where they're experimenting with not interrupting compressions for the AED shock. They've found that wearing a double set of gloves, and having the patient on a non-conductive surface (eg, on the carpet) means that they can shock the patient without stopping compressions. But this is pretty hard-core, and you're better off stopping for AED shocks just now.


How often does it work? Without an AED or medications to administer, CPR-only recovery rates are about 7%. Add in an AED and you might get to 12 to 13%. 


Oh, last item, and know this well: CPR is some of the hardest work you will ever do. For those of you who are older yourselves, know your limitations. The idea that you're going to pump on someone's chest for 30 minutes, non-stop, all by yourself? Unless you're in absolutely amazing physical condition, doing 30 minutes by yourself is likely not possible. I've pumped on someone's chest solo for about 12 minutes before the calvary arrived, and I was soaked with sweat and the guys coming through the door half-wondered whether they should put the AED on me. It is hard, hard work to pump on someone's chest at 100 beats per minute, non-stop. When we're doing it on a scene and we have more than three guys, we're setting up a compression relay line, and we do at most two minutes per man before we switch.