What indicates the need for improvement in CPR quality?

A chest compression fraction of 35% indicates a need for improvement in CPR quality because it reflects the percentage of time that compressions are being performed during the cardiac arrest event. The ideal chest compression fraction should be at least 60%, with some guidelines recommending targets of 80% or higher. A low fraction suggests that there are prolonged interruptions in compressions, which can significantly reduce the chances of survival due to the critical need for continuous blood flow during resuscitation efforts.

A high chest compression depth is actually desired, as deeper compressions are associated with better outcomes. Frequent switching of compressing providers can be beneficial to maintain compression quality and minimize fatigue, provided that the switches are executed efficiently without significant interruptions. High ventilatory volumes can also be counterproductive, leading to complications like hyperventilation and reduced blood return to the heart, but they do not directly indicate a failure in CPR quality in the same way a low chest compression fraction does.