You achieve a high chest compression fraction (CCF) during high‑quality CPR by keeping your hands on the chest as continuously as possible while still meeting guideline standards for depth, rate, recoil, and brief, necessary pauses.

What “high CCF” means

  • Chest compression fraction is the proportion of total resuscitation time during which compressions are actually being delivered.
  • Many training programs and recent articles emphasize aiming for compressions during at least about 80% of the resuscitation time to improve survival.

Core compression technique

To maintain both high CCF and high quality, focus on:

  • Compression rate of 100–120/min with a depth of about 5 cm (at least 2 inches) in adults.
  • Allow full chest recoil after each compression and avoid leaning on the chest, which preserves blood return and effectiveness.
  • Keep your hands in the correct position and minimize shifting or readjusting that would create micro‑pauses.

Minimizing interruptions

High CCF is primarily about cutting down pauses:

  • Limit any necessary pause (rhythm checks, pulse checks, defibrillation, airway interventions) to under 10 seconds whenever possible.
  • Plan actions so compressions continue while others prepare equipment (e.g., charge the defibrillator or set up airway tools during ongoing compressions).
  • Resume compressions immediately after shock delivery or rhythm analysis—do not wait to recheck a pulse unless specifically indicated.

Teamwork and role organization

A “pit‑crew” style approach strongly supports high CCF:

  • Assign clear roles: one person on compressions, one on airway/ventilations, one on defibrillator/monitor, plus a team leader when available.
  • Switch compressors roughly every 2 minutes (or sooner if exhausted), using a practiced, rapid switch that takes less than about 5–10 seconds.
  • Communicate out loud about upcoming rhythm checks, compressor switches, and shocks so everyone anticipates and shortens pauses.

Ventilation and devices

Managing breathing and technology without stealing time from compressions is essential:

  • Use strategies that allow mostly continuous compressions, such as advanced airways when available and appropriate, so ventilations do not require long pauses.
  • For adult out‑of‑hospital cardiac arrest with limited rescuers, “hands‑only” CPR (compressions without mouth‑to‑mouth) can help keep CCF high until professional help arrives.
  • When available and appropriate, consider mechanical compression devices that can provide consistent, uninterrupted compressions and maintain high CCF, especially during transport or prolonged resuscitation.

In short: High CCF during high‑quality CPR comes from planning and practicing to keep compressions deep, fast, and as uninterrupted as possible, using tight teamwork, rapid switches, brief checks, and smart use of ventilation and devices.