Is it normal to break ribs during CPR?
Cardiopulmonary Resuscitation (CPR) involves the delivery of chest compressions and rescue breaths to victims of a cardiac arrest.
CPR works by keeping oxygenated blood flowing around the body in order to keep vital organs (such as the heart and brain) alive. Chest compressions are a vital part of CPR, the rescuer should provide 100 – 120 chest compressions a minute at a depth of 5 – 6cm.
A common question on first aid courses is about breaking ribs during CPR and whether this can cause harm.
Chest compressions must be at the correct depth and speed in order to be effective. Shallow or slow chest compressions are unlikely to provide any benefit to the victim.
Chest compressions are delivered in the centre of the chest over the sternum. Ribs connect to the sternum and provide protection to the organs in the chest.
Ribs are connected to the sternum by cartilage (costal cartilages). This gives ribs a certain degree of flexibility – this explains why our chest wall can move when we breath in and out.
Breaking ribs during CPR
It is common for ribs to be broken during CPR. One study found the prevalence of rib fractures in adult victims who received CPR was over 80%
The rescuer may feel ribs break when they deliver chest compressions. This can be an unpleasant experience for the rescuer, but it is important to continue to deliver high quality chest compressions.
If you do feel ribs break, you should ensure your hands are in the correct position in the middle of the chest and carry on. Rib fractures can be treated after the event, however cardiac arrest is not survivable without CPR.
Remember to adjust your chest compression technique when performing CPR on children and infants. One hand should be used for children, and two fingers for infants when delivering chest compressions.
