LOC or ABC first?

Specialties Emergency

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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 practice as healthcare professionals. My instructor, who is a wonderful, very knowledgable ICU/recovery room nurse, recently insisted, in a nutshell, that the ABCs come before establishing the level of consciousness.

Now, as an EMT, I have always been trained to think that LOC comes before ABCs in major part because this can help dictate the airway adjunct. Are they semi-conscious? Well, then, they likely have a gag reflex, so drop an NPA. Are they unconscious? Drop an OPA. That sort of thing....And of course, if they are unconscious, we may very well not have any breathing or circulation, and we need to initiate CPR.

In real life, healthcare professionals can multitask, and we are not sitting there going, "OK - I just evaluated his airway. Now, let me assess his breathing and circulation. Hmm..." In other words, we make several assessments at once regarding LOC, ABCs, what have you.

So, why is this whole thing driving me crazy??? Well, in addition to not feeling like a dummy, I'd like to one day become a Certified ER nurse. And I suppose the NCLEX is important, too ;p

I feel as though my teacher has a slightly different perspective as an ICU nurse, which is why she states this is the correct answer. She, after all, usually receives the patient with an airway in place, etc.

Feedback would be great! Thanks so much!!

I assess LOC while doing my ABC. That's what I have learned, and it works faster in emergent situations.

If a patient is symptomatic with a HR of less than 60 it is appropriate to start chest compressions. Thought I'd throw that one in there

I'm pretty sure that's only on infants. Even if a person is symptomatic and has a heartbeat of 30, you don't start compressions unless they are pulse less, at least with adults.

Specializes in being a Credible Source.
I'm pretty sure that's only on infants. Even if a person is symptomatic and has a heartbeat of 30, you don't start compressions unless they are pulse less, at least with adults.

It's for peds in general, not just infants... check out PALS.

The only adults who get compressions are those without a pulse.

Specializes in Emergency Nursing.

OP is still in nursing school.

"It's whatever the instructor says is correct".:***:

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