Quality of Cardiopulmonary Resuscitation During In-Hospital Cardiac Arrest

5]678 Conversely, interruptions in CPR or failure to provide compressions during cardiac arrest ("no-flow time") have been noted to have a negative impact on survival in animal studies. 7Consensus guidelines clearly define how CPR is to be performed, 9 but the parameters of CPR in actual practice are not routinely measured, nor is the quality known.There are multiple reasons for concern regarding the quality of CPR.Even though CPR training programs are ubiquitous, a number of studies demonstrate that these learned resuscitation skills deteriorate over time. 10,11Furthermore, issues such as translation of skills from training environments to actual cardiac arrest settings, as well as rescuer fatigue during resuscitation, 12 may limit CPR quality.Recent investigations have revealed that patients may be hyperventilated during out-ofhospital arrest, 13 and that low chest compression rates are present during in-hospital arrest. 14,15iven the proven survival benefit of high-quality CPR and the lack of data on actual performance, we sought to de-termine whether well-trained hospital staff perform CPR compressions and ventilations according to guideline recommendations.The in-hospital environment was selected because it offers the added advantage of thorough prearrest documentation as well as resus-