Many studies show that majority of people do not push on the sternum with enough force in order to properly administer CPR compressions. These findings include trained and untrained personnel. The American Heart Association recommends that you push down at least 2 inches for an adult, which requires approximately 125 pounds of pressure.

Pushing with more than 125 pounds increases the potential for rib fractures. Nevertheless, the chances of survival increase tremendously. The idea of ribs breaking sometimes makes rescuers hesitant to push hard. The rescuer needs to focus on pushing hard and fast in order to increase chances of resuscitation, even if it is more likely that ribs will break.

Fracturing ribs is quite normal during CPR, especially on older victims or people with osteoporosis. To avoid ribs cracking use only the heel of your hand to push down on the sternum; directly in between the nipples. Some of the cracking noises could be ribs fracturing but a lot of the noise can also be cartilage.

So, what should you do if you hear ribs cracking? Check your position and keep going. Never Stop! You can heal from a broken rib but if you stop compressions the victim has almost no chance to survive.

At CPR Choice our manikins provide “light-up” feedback to show class participants if they are pushing down with enough pounds of pressure to adequately compress the heart. Sign up for a CPR class today!

Springer. “CPR: More Rib Fractures, But Better Survival Rates.” ScienceDaily. ScienceDaily, 1 June 2007.