I worked as a RN in various ICU's for over a decade......loved being on the code team! The biggest mistake folks make with adult CPR is that they are too slow and don't use enough force. First time I did CPR it was on a little old lady, I broke her ribs on the first compression! The doc must have seen the look on my face when I paused for a second......."don't worry that crunch means your doing it right!" She lived. Gave me a huge hug and never once mentioned the broken ribs. Now that does not mean you need to hit everyone like a ton of bricks! This only happened to me a couple of times but you do have to push hard and fast.........humming the song satyin alive is a perfect tempo.
I will never forget this one intern on his first code, Im pushing away when he hollers "wait I have a femoral pulse!" I stop "Damn it's gone start CPR again"! I do a few more compressions "got it hold the CPR for a minute"........this happens three or for times. I finally looked up from what I was doing and the resident doc has a big grin on his face. Then it dawns on me that this kid is feeling the pulse from MY compressions. I clear my throat loud look him in the eye and start compressions again, "whats going on here I have a pulse again" So I start altering the rhythm "now she has a weird rhythm" I finally gave me a whack on the back of the head and said "watch me and feel her pulse"............look of light bulb followed by stepping away from the bedside.
That one and the grandma who jolted her own heart back when she fell on the commode are two of many that will always be in my memory.