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NEW guidelines for CPR - ABC to CAB

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so does it also apply now to NCLEX when you are getting one?

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

This has all come about from the tedious efforts of Arizona's firefighters and EMS personnel when they began implementing a study on this a few years ago for purposes of testing and found out in fact that it works. Now that it's been established that chest compressions alone for the first few minutes can sustain a person better then the traditional breath and chest let's see how long it takes the Red Cross and the AHA to implement it into their certification process.

So what will happen since it's proven that this way definitely gives the person a better fighting chance? There needs to be policy changes and very quickly I might add. Remember it's only applies to adults in cardiac arrest.

http://www.arizona.edu/features/statewide-study-arizona-published-jama-show-chest-compression-only-cpr-improves-survival

Edited by tyvin

whichone'spink, BSN, RN

Has 3 years experience.

Some commenters are bringing up the point that what if the problem is related to the airway? Furthermore, what if the person who went down actually has a pulse? Do you think the old arrangement, ABC, should stay as is?

Some commenters are bringing up the point that what if the problem is related to the airway? Furthermore' date=' what if the person who went down actually has a pulse? Do you think the old arrangement, ABC, should stay as is?[/quote']

yeah, that's what I'm confused!

klone, MSN, RN

Specializes in Women's Health/OB Leadership. Has 15 years experience.

Wow, three weeks ago, when I took my BLS recert, it was rescue breathing first, then chest compressions.

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

Anyone else notice the bent fingers in the article's photo?? :rolleyes:

What about them?

highlandlass1592, BSN, RN

Specializes in Critical Care. Has 13 years experience.

You are very rarely going to find an airway issue being the reason that an adult would arrest. And, for sake of arguement, if you have a choking victim and need to clear the airway, how do you clear it? Compressions. The data is listed in circulation to support the new approach. As to "commentators" I doubt they've completely read the updates yet..they just came out yesterdy. I just printed up copies and there is over 200 pages and that's only part of it.

I guess my only question is this - Has anybody else verified the validity of the results? Don't get me wrong, I'm all for finding out the best way to treat patients, but some of it just seems a little odd, maybe just because I've thought of ABC for such a long time. I mean, how long does it really take to open the airway and provide 2 breaths *in MOST situations? It doesn't seem to me like that minimal time might make a huge difference in the grand scheme of things. And sure it would get blood circulating faster, but does that really even matter if it's oxygen deficient blood? Just some things I think about... but like I said, I'm all for improving patients chances of survival, just as long as it gets more testing to approve its effectiveness and we don't change policies prematurely.

OttawaRPN

Specializes in acute care med/surg, LTC, orthopedics. Has 5 years experience.

I didn't read the article but from my understanding the new chest compression guidelines are for the layperson ONLY, to encourage more people to attempt CPR during a crisis instead of twiddling theirs thumbs wondering what to do. There's nothing that's going to deter a person more from putting their mouth over someone else's than seeing vomit dribbling down the cheek, and how many laypeople carry a mask in their back pocket?

Certified health professionals would remain status quo, using ambu-bags, intubation, etc.

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

I guess my only question is this - Has anybody else verified the validity of the results? Don't get me wrong, I'm all for finding out the best way to treat patients, but some of it just seems a little odd, maybe just because I've thought of ABC for such a long time. I mean, how long does it really take to open the airway and provide 2 breaths *in MOST situations? It doesn't seem to me like that minimal time might make a huge difference in the grand scheme of things. And sure it would get blood circulating faster, but does that really even matter if it's oxygen deficient blood? Just some things I think about... but like I said, I'm all for improving patients chances of survival, just as long as it gets more testing to approve its effectiveness and we don't change policies prematurely.
Statewide Study in Arizona Published in JAMA Show Chest-Compression-Only CPR Improves Survival | The University of Arizona, Tucson, Arizona

Did you read this all the way through. It has been proven that the time those breaths are taken for is actually very important to survival rate. This was not just some hap hazard study but very big business and proved beneficial. It will eventually change things.

Edited by tyvin

there are 2 issues being discussed here.

the original post referred to the recent changes in the sequence of events in basic life support. the 2010 american heart association guidelines for ecc and cpr now recommends chest compressions first, then airway, then breathing. this is for all patients other than neonates and/or newly born. this recommendation was taken from the 2010 ilcor guidelines for ecc and cpr.

although this c - a - b concept is new here, it was the standard in the netherlands from the early 1980's through either the 2000 or 2005 ilcor recommendations. at that time the netherlands changed to the a - b - c format we are familiar with. they did not do this necessarily because they thought this was the best format, they did it so they were not completely removed from the issues and discussions regarding cpr and ecc.

in the adult, if you think about this it makes a lot of sense as most adult cardiac arrests are a sudden event as the result of a cardiac issue. what this means is that the blood in the circulatory system should be fairly well oxygenated and all that is required is to circulate it. although only about 85% - 95% of the cardiac arrests in children are respiratory related, the decision was made to implement the c - a - b format in children for consistency across all age groups.

for more information on these, and the other changes the both the

highlights of the 2010 changes and the entire 2010 american heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care are available for download/review.

as to compression only cpr, this is not a new concept. in a 1997 article which reevaluated the [color=#606420]effectiveness of mouth-to-mouth ventilation during bystander cpr stated the following: clearly provision of chest compression without mouth-to-mouth ventilation is far better than not attempting resuscitation at all. again, in 2008 the aha published an article regarding [color=#606420]hands only cpr which stated:

when an adult suddenly collapses, trained or untrained bystanders should--at a minimum--activate their community emergency medical response system (eg, call 911) and provide high-quality chest compressions by pushing hard and fast in the center of the chest, minimizing interruptions.

although this wasn't a new concept, the agencies in arizona that were involved in this project all deserve a big round of applause. they identified a problem, developed a solution, and implemented it with amazing results.

Otessa, BSN, RN

Has 19 years experience.

Wow, three weeks ago, when I took my BLS recert, it was rescue breathing first, then chest compressions.

New guidelines just came out and won't be implemented by instructors until 2011.