How often should the rescuer providing chest compressions be switched?

The recommendation to switch the rescuer providing chest compressions every 2 minutes or sooner if fatigued is based on the evidence that high-quality chest compressions are essential for effective CPR. Maintaining the quality of compressions is critical because fatigue can lead to a decrease in the effectiveness of compressions, which is measured by factors like rate, depth, and full chest recoil.

By changing rescuers every 2 minutes, it allows for a brief assessment of the airway and ventilation, along with the opportunity for the incoming rescuer to take over while the outgoing rescuer can recuperate for a moment. This strategy aims to keep the quality of compressions high throughout the resuscitation effort, which ultimately improves the chances of returning spontaneous circulation and survival for the child in cardiac arrest.

For optimal performance, switching rescuers more frequently—whenever the current compressor starts feeling fatigued—is also encouraged. This ensures that both rescuers remain effective and can sustain high-quality CPR efforts over a longer duration.