NPLQ Cardiopulmonary Resuscitation (CPR) 2 — Questions and Answers

Question 1: When performing adult CPR, what is the recommended compression-to-ventilation ratio for a single rescuer?

15:2
30:2 (Correct answer)
5:1
10:2

Correct answer: 30:2

The internationally recommended compression-to-ventilation ratio for adult CPR is 30:2 — 30 chest compressions followed by 2 rescue breaths. This ratio is used for single-rescuer adult CPR.

The 30:2 ratio for adult CPR was adopted to minimise interruptions to chest compressions while still providing ventilation. Thirty compressions at the correct depth (5–6 cm) and rate (100–120/min) maintain coronary and cerebral perfusion pressure. Two rescue breaths are then delivered over approximately 5 seconds. For infants and children a 15:2 ratio applies when two healthcare providers are present, but adult single-rescuer CPR always uses 30:2 per Resuscitation Council UK and ERC guidelines.

Question 2: What is the correct compression depth for adult CPR according to RLSS and Resuscitation Council UK guidelines?

2–3 cm
3–4 cm
5–6 cm (Correct answer)
7–8 cm

Correct answer: 5–6 cm

Compressions should be delivered to a depth of 5–6 cm for adults. Compressions that are too shallow are ineffective; too deep risks rib or organ injury.

Adequate compression depth is critical for generating sufficient cardiac output during CPR. For adults, the Resuscitation Council UK specifies a compression depth of 5–6 cm (approximately one-third of chest depth). After each compression, full chest recoil must be allowed so the heart refills with blood. Rescuers should place the heel of one hand on the centre of the chest (lower half of the sternum) and the heel of the other hand on top, with fingers interlaced and off the chest wall.

Question 3: Which term describes the phase in CPR when you allow the chest to fully expand upward between compressions?

Decompression recoil
Full chest recoil (Correct answer)
Passive ventilation
Systolic recovery

Correct answer: Full chest recoil

Full chest recoil occurs between compressions, allowing the thoracic cavity to expand and venous blood to return to the heart. Leaning on the chest between compressions reduces effectiveness.

Full chest recoil is essential for allowing negative intrathoracic pressure to draw venous blood back into the right heart. If a rescuer leans on the chest between compressions (incomplete recoil), cardiac filling is reduced and CPR output drops significantly. Studies show incomplete recoil is common in fatigued rescuers, so RLSS NPLQ training emphasises rotating compressors every 2 minutes to maintain quality.

Question 4: At what compression rate should CPR be delivered for an adult casualty?

60–80 per minute
80–100 per minute
100–120 per minute (Correct answer)
120–140 per minute

Correct answer: 100–120 per minute

The recommended compression rate is 100–120 compressions per minute. This rate optimises cardiac output during CPR.

A compression rate of 100–120 per minute (roughly 1.5–2 per second) is recommended by the Resuscitation Council UK. Rates below 100/min reduce perfusion; rates above 120/min are associated with inadequate depth and incomplete recoil. Metronome feedback devices or practising with a song of 100–120 BPM help rescuers maintain the correct rate during training and drills.

Question 5: When should an AED be applied to a casualty in cardiac arrest in a pool environment?

Only after 5 minutes of CPR
As soon as it is available, with minimal interruption to CPR (Correct answer)
Only if the casualty is dry and out of the water
After 3 cycles of CPR have been completed

Correct answer: As soon as it is available, with minimal interruption to CPR

AED should be applied as soon as available. Early defibrillation significantly increases survival rates. The casualty should be moved away from poolside water and dried quickly before pads are placed.

Early defibrillation is one of the Chain of Survival links with the greatest impact on outcome. In aquatic environments, the casualty must be removed from the water and the chest quickly dried before pad placement to prevent current arcing and ensure effective shock delivery. AED pads should not overlap with a pacemaker scar or medication patch. Once attached, CPR continues until the AED analyses, with a brief pause only during analysis and shock delivery.

Question 6: In the RLSS NPLQ protocol, how long should a rescuer spend checking for normal breathing before confirming cardiac arrest?

Up to 5 seconds
Up to 10 seconds (Correct answer)
Up to 20 seconds
Up to 30 seconds

Correct answer: Up to 10 seconds

A breathing check should take no more than 10 seconds. Agonal gasps should not be mistaken for normal breathing.

After opening the airway (head-tilt chin-lift), rescuers should look, listen, and feel for no more than 10 seconds to determine if breathing is absent or abnormal. Agonal gasps — occasional, irregular, gasping breaths — occur in up to 40% of cardiac arrests and should be treated as absent breathing. Spending longer than 10 seconds on the breathing check introduces unnecessary delay to starting CPR and activating the emergency response system.

NPLQ Cardiopulmonary Resuscitation (CPR) 2

When performing adult CPR, what is the recommended compression-to-ventilation ratio for a single rescuer?