NEW guidelines for CPR - ABC to CAB

tyvin, BSN, RN · Oct 19, 2010

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.

chare · Oct 19, 2010

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.

ImThatGuy, BSN, RN · Oct 19, 2010

Boy, that's been a long time coming.

Otessa, BSN, RN · Oct 20, 2010

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.