LOC or ABC first? - page 3

by Caffeinated RN

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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    We are still taught ABC first in school for assessment because the NCLEX will probably not be updated. It all about the NCLEX during school.
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    Always ABC, in real life situations, and to answer NCLEX scenarios. Your patient may have altered LOC for various reasons (delerium, coma) to name a few, but they still have a patent airway.
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    You always have your rare situations as well. When someone is hypoglycemic/hyperglycemic, they can lose consciousness and if it's too low you won't be able to wake them. So, in that situation you need to assess their breath, etc. then check BS, you are most likely not going to start chest compression's on this person, just saying. Anyway, I know this is off topic. Basically, when you are taking the NCLEX you need to think like a nurse not an EMT.
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    It was never LOC before ABC/CAB... at least back to 1981 when I first became an EMT and started teaching CPR.
    scrubsandasmile and Altra like this.
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    ABCs...and to be honest, you're won't be able to help but notice the patient's LOC--or at least get a general idea of it--as you're checking for airway, breathing and circulation.
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    nursing theory vs actual practice
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    [QUOTE=FlyingScot;7199119]Except to the person you start chest compressions on who was really just asleep.

    QUOTE]

    This wouldn't happen unless you skipped C and so didn't check the persons pulse before starting chest compressions :/ It would be pretty important to make sure their heart isn't actually beating before you start pumping on their chest lol
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    Quote from cardiacrocks
    You always have your rare situations as well. When someone is hypoglycemic/hyperglycemic, they can lose consciousness and if it's too low you won't be able to wake them. So, in that situation you need to assess their breath, etc. then check BS, you are most likely not going to start chest compression's on this person, just saying. Anyway, I know this is off topic. Basically, when you are taking the NCLEX you need to think like a nurse not an EMT.
    You completely skipped over PULSE/HEART BEAT. If they are breathing you do not then check their BS lol aka BG, you check thier pulse! You know, ABC, not AB then BG. If you check their ABC and they are within normal range and they are unconcious then you could check BG.

    If a pt is unconcious, for whatever reason, and they are completely unresponsive, you check airway, then breathing THEN pulse. You give them only rescue breaths if they have a heart beat but no respiration and rescue breaths and chest compressions if they have no resp and no beat.
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    Yes, yes I know, I still haven't gotten in the habit of the CAB, my bad.

    And I just realized, it is LOC first! If you see someone unconcious you don't just walk up and lay your head on their chest or put your hand under their nose to check for pulse and respirations. It's "hey are you ok?!", give a little shake, no response then sternal rub then CAB. Of course this all happens in a matter of seconds but it's still LOC first.
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    In my experience, ABC is always first but LIC simultaneously tues into that. If a person can't breath or isn't profuse ing, you will immediately notice the alteration I their LOC. if you can't breath, you can't think or speak. You will get an initial feel for their LOC but it may change depending on how quickly and successfully you address their ABC


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