By: Emergent Team
When seconds count, CPR is one of the most critical interventions first responders can deliver. But not all CPR is equally effective. High Quality CPR (HQ-CPR) is a coordinated, team-based approach designed to maximize the effectiveness of chest compressions and improve survival outcomes in cases of cardiac arrest. It combines rigorous training, clear role assignments, real-time feedback, and continuous improvement, raising the standard for life-saving care.
What Is High Quality CPR?
High Quality CPR (HQ-CPR) is an evidence-based approach to cardiac arrest care that emphasizes consistent, high-quality compressions, minimal interruptions, and well-coordinated team actions to maximize blood flow and survival. It’s built on the principles of high-quality CPR–like proper rate, depth, and recoil–but goes further by integrating these techniques into a structured team response with strict adherence to time-sensitive benchmarks.
HQ-CPR is all about team choreography. Everyone involved, from airway manager to compressor to AED operator, has a defined role, and the emphasis is on seamless transitions and optimal compressions from the moment care begins.
Why High Quality CPR Is Important
Traditional CPR can be effective, but it often falls short in real-world settings due to fatigue, disorganization, or inconsistency. Numerous studies have shown that HQ-CPR can dramatically improve survival rates from sudden cardiac arrest when compared to standard CPR.
A study published in the Journal of Clinical Medicine found that implementation of high performance resuscitation strategies significantly increased out-of-hospital cardiac arrest survival with good neurological outcomes Consistent compressions at the correct rate and depth, fewer pauses, and strategic use of defibrillation all contribute to better circulation and oxygen delivery during cardiac arrest, which improves the chance of return of spontaneous circulation (ROSC) and long-term recovery.
How to Perform High Quality CPR
While different agencies may have unique protocols, the fundamentals of HQ-CPR typically include:
1. Defined Roles and Rotation Schedule
Assign clear responsibilities to each responder (compressor, AED operator, airway manager, recorder, etc.) with rotations every two minutes to prevent fatigue.
2. Compression Quality and Consistency
Maintain a compression rate of 100–120 per minute, with a depth of 2–2.4 inches and full chest recoil after each compression. Avoid leaning or shallow compressions.
3. Minimized Interruptions
Keep pauses to under 10 seconds. Pre-plan compressor switches, integrate airway management without halting compressions, and anticipate defibrillation to reduce downtime.
4. Use of Real-Time Feedback Tools
Many agencies use automated CPR feedback tools or defibrillators with built-in monitors to track and improve compression quality in real time.
5. Continuous Training and Review
Teams that drill HQ-CPR techniques regularly and review performance after actual calls are more likely to sustain high-quality results. Simulation-based training and post-event debriefings are essential.
How Technology Enhances High-Quality CPR
Modern EMS software platforms can make HQ-CPR easier to execute and evaluate. Tools like automated timers, electronic patient care reports, and synchronized audio prompts can help teams stay on track during high-stress calls. Data collected from AEDs and CPR feedback devices can be reviewed post-incident to refine technique and identify areas for improvement.
Departments using digital tracking for CPR metrics can spot trends across shifts, crews, or regions, driving training and resource decisions with actual performance data.
Why More EMS Agencies Are Embracing HQ-CPR
As more research supports the impact of HQ-CPR, it’s becoming more common for cardiac arrest response. For fire-based EMS systems especially, where teams must work in dynamic and sometimes chaotic scenes, HQ-CPR provides a replicable model for delivering consistent care.
Integrating this approach can transform not only outcomes but also the confidence and cohesion of your crews. With structured roles, rehearsed timing, and live feedback, teams can truly perform and save lives.
Raising the Bar for Cardiac Arrest Care
High Quality CPR marks a cultural shift in emergency medical response. It asks departments to hold themselves to the highest standards and to build systems where every resuscitation effort is treated with urgency, precision, and teamwork. As more departments integrate HQ-CPR into their protocols, the path forward is clear: survival depends not just on doing CPR, but on doing it better.
Emergent’s EMS tools are designed to help your crews document, track, and improve resuscitation efforts in real time. From automated timestamps to customizable protocols, we make it easier to deliver and measure lifesaving care. Reach out today to see how our EMS platform can support your department’s cardiac arrest response.
