What Is Prolonged CPR: Everything You Need to Know


The first few minutes after a cardiac arrest are the most important ones. Waiting for the emergency teams to intervene on the scene is often too late, so bystanders need to take the initiative and offer help. CPR is the first thing that needs to be done so the victim has a fighting chance.

However, there are cases where a bystander provides CPR, but the casualty doesn’t respond. So, should you stop? Knowing when to give CPR is vital; however, knowing when to stop is as crucial.

Then, what is the optimal time before a person shows signs of life after CPR? What is prolonged CPR, and is it beneficial? What do the experts say? These are the main topics of this article. Keep reading to stay informed.

What Is Prolonged CPR?

Prolonged CPR, as the name suggests, refers to performing CPR more than the average time. According to a study, there is no fixed time duration for performing CPR, but the National Association of EMS Physicians determined it to be 20 minutes. If a person does not respond to CPR in this time frame, then there is not much else you can do.

Have there been cases where a person got back to life after 30 minutes of CPR or even 40? Absolutely! A study shows that prolonged CPR—CPR that lasts more than half an hour—is helpful and can increase the chances of survival. Moreover, an unpublished Japanese study has found that providing continuous CPR, even after 40 minutes, may improve the survival chances of the victim.

When to Stop Giving CPR to a Victim of Cardiac Arrest?

Although prolonged CPR is advised, it doesn’t always have the best results—in some cases, it may not have any, for that matter. To understand prolonged CPR, you need to know when to stop giving it first.

There are several standard rules that suggest it’s time to stop giving CPR. Below we elaborate on each in more detail.

The Victim Shows Signs of Life

CPR is a technique that helps bring back the heart rhythm, and it should stop as soon as the person shows any signs of life. That means if the victim opens their eyes, starts breathing, or moves, they are no longer dependent on CPR. But remember that in case the victim becomes unconscious again, you need to continue with the CPR until they show signs of life again.

When You Get Tired

CPR is not an easy technique, and in some cases, it could take longer for the victim to show signs of life. Needless to say, it is highly important that you keep up with the chest compression and not stop until the victim is conscious or the emergency team arrives. In fact, this is something all CPR instructors point out during the theoretical part of the CPR class.

However, in theory, this doesn’t sound difficult—it’s the practical part that differs. Giving CPR for more than 20 minutes can tire you out, and you may end up giving incorrect compressions. This may lead to other unwanted consequences.

If someone provides CPR incorrectly, it’s the same as if they did not respond to the situation at all. To prevent such unfortunate events, step back when you feel tired, and let someone else do it. In case you are alone with the victim, stop the compressions for a minute and rest, but once you feel better, keep providing CPR while waiting for the medical team to take over the case.

The Patient Suffers From Fatal Illnesses

You should consider stopping with the CPR technique as soon as someone informs you the patient suffers from a terminal illness. Granted, bystanders can’t know whether a victim has some underlying condition or not.

Usually, patients with bad health profiles suffer cardiac arrests, and if they are revived, it’s likely that they will have severe brain damage. To avoid falling into an even more difficult situation than the current one, some patients sign an order that says they do not wish to be saved in such situations.

Nonetheless, the Good Samaritan Law protects you from ever being sued for trying to help a person in need. If you aid someone during a cardiac arrest without having prior knowledge of their health, but they end up dying, you are absolved of any legal burden—taken that you’ve done the deed in good faith.

Your Life Is in Danger

Last but not least, you should stop giving CPR in case you put your life in danger. If there is a flood, electrical danger, or fire, you prioritize your life if you’re not a doctor. Therefore, in these cases, it’s advised you step away, call an emergency team and wait on their instructions.

What the Experts Say on Prolonged CPR

Once you have the answer to the question, “What is prolonged CPR?” and know when to stop it, it’s good to continue your education and back it up with some scientific evidence.

The situations discussed above are clear signs that it’s time to stop giving CPR. But not all cases are that black and white. As we have mentioned, there are some studies that claim prolonged CPR is highly effective and it should not last only 20 minutes.

Below, we provide some additional papers that show why prolonged CPR can be really beneficial.

The CPR Duration Should Include Monitoring of Physiological Parameters

According to a study, there are cases where a victim showed signs of life after 20 minutes with no brain damage. Plus, there are also situations where a victim survived even after 40 minutes of CPR.

However, the study suggests that it’s important to monitor physiological parameters. This significantly simplifies the process of CPR without having the person giving it guess when it’s time to stop or not.

Of course, not all cardiac arrest cases can include this step. Monitoring the physiological parameters can only be done with the help of a few machines. This means that cardiac arrests in a hospital or nearby where an emergency team can come and scan the situation are the ones that can utilize this.

Regardless, if a person does not have the needed equipment, they should at least continue to give CPR for about 20–30 minutes.

Collected Statistics for Prolonged CPR

Many studies share interesting findings that go above the suggested 20 minutes of giving CPR. In one study, 82 patients aged 21–43 survived cardiac arrest after 75 minutes of CPR on average. The aforementioned Japanese study also finds that patients, after nearly 38 minutes of CPR, resulted with favorable brain conditions.

Given these papers, we can conclude that 20 minutes are not the optimal high limit. CPR should definitely go for another 20 minutes, reaching 40 at least, and not give up until the patient starts to show signs of life. This case situation is especially important to remember if you are a bystander and find yourself in a situation where a person does not show any signs of life.

Can CPR Courses Help?

It may seem simple, but CPR has many intricate details. That is why some states in the US require all high school students to pass a CPR class in order to graduate. Moreover, some jobs, like teachers or babysitters, require you to hold a CPR certificate or have basic CPR knowledge in the least.

The American Heart Association and the American Red Cross have many training centers around the country. If you’re in Toledo, Ohio, you can find AHA-credited CPR courses of all types—sign up and learn how to properly give CPR and when to stop it.

Prolonged CPR 101: Key Takeaway

After the National Association determined the 20 minutes rule before ceasing CPR, many medical organizations and faculties disagreed with the statement and supported it with facts and studies. For now, giving CPR, even after that time frame, is highly advised.

In fact, there have been many patients, regardless of age or gender, that survived cardiac arrest after 40+ minutes. Some have even made a full recovery. However, it can be difficult for a bystander to determine when to continue or when to stop giving CPR.
If you’re in Toledo, Ohio, the best way you can learn about prolonged CPR and when to seize any connected actions is to sign-up for a CPR course.