When one stops breathing, vital oxygen leaves the body and can lead to death within eight to 10 minutes.

Cardiopulmonary resuscitation (CPR) is a technique performed by a certified individual to save someone's life in the event that the person stops breathing. This could be due drowning, choking, or a heart attack. However, not all of those certified may perform CPR the same.

A new study indicates that the variability of CPR performance by emergency medical technicians can create a great difference in survival after cardiac arrest.

CPR is characterized by its chest compressions, followed by rescue breaths, where a trained CPR professional will compress the patient's chest and then breath into the patient's mouth. This keeps the lungs from collapsing, as the rescuer is providing the air an inhaler would, and also keeps blood flowing.

The point of CPR is to keep the blood pumping throughout the body in the time before emergency personnel arrive or before arriving at the hospital. A rescuer should provide at least 100 to 120 compressions to the chest per minute. Maintaining blood flow with chest compressions is crucial, as it makes up for the heart's inability to beat adequately, while maintaining circulation to prevent brain or other tissue damage.

New research indicates that because the situations in which CPR is most needed can be chaotic, the quality of CPR can vary. This is not based on a rescuer's ability to perform CPR properly, but rather his or her reaction to the given situation. As a result, the rescuer may not provide enough chest compressions, or enough breaths, causing a variability in survival after CPR. The researchers have found that outside of hospitals, between three and 16 percent of patients survive after cardiac arrest when CPR was given. This 13-percent difference in survival may be based entirely on the quality of CPR provided.

Peter Meaney, M.D., M.P.H., assistant professor of anesthesia and critical care at Children's Hospital of Philadelphia and lead author of this study, commented, "There have been huge advances in CPR and there's no question that high-quality CPR saves lives," but given the difference in the number of people who survive after being given CPR, he added, "However, right now there is wide variability in the quality of CPR — and we can do better."

CPR survival after it is administered in a hospital is a bit higher, ranging from 12 to 22 percent, but the 10-percent difference is still indicative of a difference in quality among each person providing CPR.

"If we focus on improving CPR quality we can save lives. We always need to be better, always need to be pushing the needle, because lives are at stake," Meaney explained.

In the effort to heed Meaney's advice, the American Heart Association (AHA) intends to improve people's awareness of CPR and teach everyone to do it properly. The AHA reports that 70 percent of Americans feel helpless in the event of a cardiac emergency that calls for CPR, and may not know how to perform it properly. Poor administration of CPR can injure a victim; they may suffer broken ribs, damaged lungs, or an irregular heartbeat as a result.

The AHA provides a one-minute video — see below — on hands-only CPR, in order to instruct more people on how to effectively perform the lifesaving act. Notably, hands-only CPR has proven to be just as effective as CPR with rescue breaths in emergency situations. The AHA trains 12 million people to perform CPR each year and hopes the video will educate more people about CPR so they can help others in emergencies by performing the proper procedures.

In the effort to improve the quality of CPR in hospitals, Meaney's group advises that hospitals have a team leader oversee and evaluate CPR performance, provide checklists to ensure everyone follows the same steps, and provide refresher courses for professionals.

Source: Meaney P, Bobrow BJ, Mancini ME, et al. CPR Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital: A Consensus Statement From the American Heart Association. Circulation. 2013.