There was disagreement among the COVID-19 BLS guidelines on the level of PPE. Optimizing chest compression rate, depth, recoil, and fractionPrevious studies suggested that the quality of chest compression delivered was mainly associated with chest compression rate, depth, recoil, and fraction [20, 21, 24]. Chest compression should have the following parameters [11, 23,24,25]: chest compression rates between 100 and 120 per minute and a chest compression depth of about 5–6 cm. A chest compression fraction (CCF) is the proportion of time spent providing chest compressions while the patient is pulseless and in cardiac arrest. According to the 2021 and 2022 interim COVID-19 adult BLS guidelines, maximize CCF and pause to intubate only if needed [5, 12].