LOC or ABC first? - page 2

by Caffeinated RN

6,184 Views | 39 Comments

I feel like this is a silly question, but it is a topic that recently came up in class (I am just about to finish nursing school), and it is driving me off-the-wall CRAZY! We all know that our ABCs are paramount to our... Read More


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    The point is it depends on the situation. Routine assessment yes it is ABC then LOC. Person dumped out of a car at the ED door then it's responsiveness/LOC first.
  2. 4
    In reality you do it all at the same time in about 15 seconds. It's not a long process you think through and do in order.

    If you are choosing an order for BLS everyone saying ABC is not correct. The newest version of CPR is actually CAB CHEST COMPRESSIONS come before breathing! In bystander CPR they don't even recommend breathing anymore.


    I think it depends on what setting you are in and who your resources are. In the ER a tech does compressions and respiratory does airway and and the RN assesses. they happen at the same time.

    You have to establish nonresponsiveness before doing CPR or you will get punched in the face by an angry patient. To the person that says you would never do CPR until the monitor showed asystole is very incorrect. They are rarely on the monitor yet when CPR starts in the ER. You don't take the time to put a monitor on a look at the rhythm. No signs of life....go directly to CPR. Then you worry about the monitor and iv's and airways.
    azhiker96, Ir15hd4nc3r_RN, Meriwhen, and 1 other like this.
  3. 1
    Quote from bjaeram
    In reality you do it all at the same time in about 15 seconds. It's not a long process you think through and do in order.

    Eeek, took too many posts to get to the correct answer.
    danisweetcheeks likes this.
  4. 0
    Quote from bjaeram

    You have to establish nonresponsiveness before doing CPR or you will get punched in the face by an angry patient. To the person that says you would never do CPR until the monitor showed asystole is very incorrect. They are rarely on the monitor yet when CPR starts in the ER. You don't take the time to put a monitor on a look at the rhythm. No signs of life....go directly to CPR. Then you worry about the monitor and iv's and airways.
    Just to clarify, I didn't say you wouldn't do CPR until the monitor showed asystole. I said "N
    o sane person is going to see asystole on the monitor and start popping ribs without further assessment." There is a big difference in my meaning. More of a patient already on the monitor, and it goes off showing a flat line.
  5. 0
    Quote from FlorenceNtheMachine
    Just to clarify, I didn't say you wouldn't do CPR until the monitor showed asystole. I said "N
    o sane person is going to see asystole on the monitor and start popping ribs without further assessment." There is a big difference in my meaning. More of a patient already on the monitor, and it goes off showing a flat line.
    Agreed.
    Monitor can show a flat line for all sorts of reasons, nobody is going to start CPR without actually looking at the patient first. Most times its just a lead disconnected, presence of artifact, or some other unhelpful technical glitch.
    Asystole is never a true flat line anyway, more a sort of wavy random line, but even then you look at the patient not the monitor : )
  6. 0
    ABC should always come first in your assessment. But of course you should not overlook LOC- as this will provide additional cues that will support your ABC assessments.
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    Will you all stop it with the ABC'S......a bjaream posted it is now CAB.

    But anyway as someone else posted checking if they are responsive (which you always do first) could be the same as checking their LOC?

    You say potatoe....I say potatoe......you say tomatoe....I say tomatoe.....(I'm showing my age, an old song, comes out better hearing it than typing it).
    SalChina, ♪♫ in my ♥, and Esme12 like this.
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    Technically you always start with "Annie Annie are you ok??? Look listen and feel..."Somebody call 911!!!!"

    But.....regardless of their LOC....if they aren't breathing they aren't leaving.
    TLCfromSC, Pixie.RN, Pets to People, and 2 others like this.
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    Quote from brownbook
    Will you all stop it with the ABC'S......a bjaream posted it is now CAB.

    But anyway as someone else posted checking if they are responsive (which you always do first) could be the same as checking their LOC?

    You say potatoe....I say potatoe......you say tomatoe....I say tomatoe.....(I'm showing my age, an old song, comes out better hearing it than typing it).

    Lets call the whole thing off....!
    ZenLover and cardiacrocks like this.
  10. 1
    Wow! I was not expecting so many responses! Thank you! I am no longer going crazy. Haha
    Esme12 likes this.


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