When you’re performing CPR, every second counts—and so does every compression. But how do you know your efforts are actually helping? Recognizing the signs of effective CPR is crucial for any responder, from trained laypeople to experienced healthcare professionals.
1. Chest Recoil After Each Compression
One of the most basic yet essential indicators is full chest recoil. After each compression:
- The chest should fully return to its normal position.
- This allows the heart to refill with blood, improving circulation with the next compression.
2. Visible Chest Rise with Ventilations
If you’re providing breaths:
- Watch for the chest to rise and fall with each breath.
- This confirms that air is reaching the lungs, not just the stomach.
Inadequate ventilation can lead to gastric inflation or ineffective oxygenation.
3. Improvements in Skin Color
If CPR is effective:
- Bluish or pale skin may begin to pink up, especially around the lips or fingertips.
- This change indicates improved perfusion and oxygen delivery.
4. Capnography Readings (If Available)
In a hospital or advanced setting:
- Continuous capnography may be used to monitor exhaled CO₂.
- A reading of ≥10 mmHg during compressions suggests adequate perfusion.
- A sudden increase in CO₂ may signal ROSC (Return of Spontaneous Circulation).
5. Pupillary Reaction
During prolonged resuscitation, responders may observe the pupils:
- Constriction or reaction to light can indicate brain perfusion.
- Fixed, dilated pupils may suggest poor cerebral oxygenation, though not always definitive.
6. Palpable Pulse with Compressions
In some cases, especially in infants or small adults:
- You might be able to feel a pulse generated by your compressions—particularly in the carotid or femoral artery.
- While not a perfect indicator, it suggests some blood flow is reaching vital organs.
7. Return of Spontaneous Circulation (ROSC)
The ultimate sign that CPR is working is ROSC:
- The patient regains a palpable pulse.
- They may start breathing spontaneously or show signs of consciousness.
Once ROSC occurs, switch to post-resuscitation care immediately.
In Summary
Effective CPR is more than just going through the motions. Whether you’re on the street or in the ICU, watch closely for signs that what you’re doing is making a difference. High-quality CPR saves lives—and knowing it’s working keeps you going when seconds matter most.
