How should compression team members be rotated during CPR and how long should pauses be?

• A. Switch every 2 rounds; breaks less than 10 seconds
• B. Switch every round; breaks more than 30 seconds
• C. Switch every 5 minutes; breaks 60 seconds
• D. Never switch; continuous compression

Answer: (D)

The key idea is keeping chest compressions at a consistently high quality by preventing rescuers from fatiguing. Fatigue lowers compression depth and rate, which reduces blood flow during CPR. The practical way to handle this is to rotate the person delivering compressions about every two minutes and keep any pause to a bare minimum—ideally under 10 seconds—so you can resume compressions quickly.

Short, frequent rotations help maintain effective chest recoil, depth, and rate, preserving coronary and cerebral perfusion. Pauses longer than about 10 seconds interrupt blood flow and are detrimental to outcomes. Conversely, never switching or waiting multiple minutes between switches leads to rapid fatigue, worsening compression quality. So the approach that emphasizes a quick switch about every two minutes with very brief pauses best maintains CPR effectiveness.