Paradigm shift: 'ABC' to 'CAB' for cardiac arrests

Khalid, Umair; Malik, Amyn A.

doi:10.1186/1757-7241-18-59

Cited by 12 publications

(11 citation statements)

References 3 publications

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“…[ 20 ] A decade back, the priority sequence of Airway ⇒ Breathing ⇒ Circulation (ABC) was replaced by Circulation ⇒ Airway ⇒ Breathing (CAB). [ 21 22 ] The regular use of cricoid pressure is not suggested in these guidelines. [ 23 ] There are differing views on the need, type and equipment for airway management during CPR.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive cardiopulmonary life support (CCLS) for cardiopulmonary resuscitation by trained paramedics and medics inside the hospital

Garg

Kapoor

Rao³

et al. 2017

Indian J Anaesth

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The cardiopulmonary resuscitation (CPR) guideline of comprehensive cardiopulmonary life support (CCLS) for management of the patient with cardiopulmonary arrest in adults provides an algorithmic step-wise approach for optimal outcome of the patient inside the hospital by trained medics and paramedics. This guideline has been developed considering the infrastructure of healthcare delivery system in India. This is based on evidence in the international and national literature. In the absence of data from the Indian population, the extrapolation has been made from international data, discussed with Indian experts and modified accordingly to ensure their applicability in India. The CCLS guideline emphasise the need to recognise patients at risk for cardiac arrest and their timely management before a cardiac arrest occurs. The basic components of CPR include chest compressions for blood circulation; airway maintenance to ensure airway patency; lung ventilation to enable oxygenation and defibrillation to convert a pathologic ‘shockable’ cardiac rhythm to one capable to maintaining effective blood circulation. CCLS emphasises incorporation of airway management, drugs, and identification of the cause of arrest and its correction, while chest compression and ventilation are ongoing. It also emphasises the value of organised team approach and optimal post-resuscitation care.

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Section: Discussionmentioning

confidence: 99%

Comprehensive cardiopulmonary life support (CCLS) for cardiopulmonary resuscitation by trained paramedics and medics inside the hospital

Garg

Kapoor

Rao³

et al. 2017

Indian J Anaesth

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“…Email: jokotriatmojo1@gmail.com. Mobile: +6281393319000 BACKGROUND Cardiovascular disease remains the leading cause of death worldwide, with half the incidence being sudden heart attacks (Khalid et al, 2010). In the United States, every year 330,000 people die of coronary heart disease and of that number, 150,000 cases are sudden heart attacks that occur outside the hospital (Thom et al, 2006).…”

Section: Correspondencementioning

confidence: 99%

“…Other changes in the 2010 to 2015 implementation guidelines are as follows: a. 'Look, Listen and Feel' has been removed from the basic life support (BLS) algorithm as it was found to be inconsistent and a waste of time (Khalid, Abdul and Juma, 2010;. b.…”

Section: Changes To the Cpr Guidelinesmentioning

confidence: 99%

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Cardiopulmonary Resuscitation Guideline Update: A Systematic Review

Atmojo¹,

Widiyanto²,

Handayani³

2019

INDONES J MED

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Background: Every five years, the American Heart Association (AHA) releases new guidelines on CPR. Previous guidelines have focused on Airway-Breathing-Circulation (ABC) advocacy. However, in 2010 guidelines for CPR recommended changes in the sequence of BLS steps to CAB (chest compression, airway, and breathing) for adults, children and infants (excluding newborns). The purpose of this review is to explain the reasons and provide scientific evidence about the results of CAB actions compared to ABC. Subjects and Method: Systematic reviews were done by searching the database through PubMed, Google Scholar, and Science Direct. Key words for this review include: AHA Guideline AND CPR 2010, CAB in CPR, CAB, and RCT (Randomized Controlled Trial) guidelines and why does ABC turn into CAB? The inclusion criteria are systematic reviews, clinical reviews and guidelines. Results:The results are in the form of 3 review articles and 1 RCT study. The basic reasons for changing ABC to CAB are (1) The most common case of cardiac arrest in adults, and the initial element of critical BLS (basic life support) is chest compression and early defibrillation by changing sequentially to CAB, chest compression will start faster; (2) Most victims of cardiac arrest outside the hospital do not get CPR observers, this is an obstacle to opening the airway and exhaling; and (3) Chest compression provides vital blood flow to the heart and brain. One RCT study showed that the time to do the first resuscitation with the CAB technique (mean = 25; SD = 10) was faster than the ABC technique (mean = 32; SD = 12) and statistically significant (p = 0.002). Conclusions: Chest compression is the most important aspect of heart attack management because airway maneuver takes a long time. The time to complete the first resuscitation cycle on CAB action is shorter than using ABC actions.

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“…[ 1 ] Immediate cardiac compression by bystander can help buy time till medical help reaches and can improve the outcomes. [ 2 3 ] For India, availability of a larger number of CPR-trained laypersons is the need of the hour, as medical help may take time to reach the site of cardiopulmonary arrest. Advanced CPR management outside the hospital is limited by lack of advanced equipment, expertise and workforce, making resuscitation outside the hospital a difficult task.…”

Section: Preamblementioning

confidence: 99%

Basic cardiopulmonary life support (BCLS) for cardiopulmonary resuscitation by trained paramedics and medics outside the hospital

Garg

Kapoor

Mishra³

et al. 2017

Indian J Anaesth

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The cardiopulmonary resuscitation guideline of Basic Cardiopulmonary Life Support (BCLS) for management of adult victims with cardiopulmonary arrest outside the hospital provides an algorithmic stepwise approach for optimal outcome of the victims by trained medics and paramedics. This guideline has been developed considering the need to have a universally acceptable practice guideline for India and keeping in mind the infrastructural limitations of some areas of the country. This guideline is based on evidence elicited in the international and national literature. In the absence of data from Indian population, the excerpts have been taken from international data, discussed with Indian experts and thereafter modified to make them practically applicable across India. The optimal outcome for a victim with cardiopulmonary arrest would depend on core links of early recognition and activation; early high-quality cardiopulmonary resuscitation, early defibrillation and early transfer to medical facility. These links are elaborated in a stepwise manner in the BCLS algorithm. The BCLS also emphasise on quality check for various steps of resuscitation.

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Paradigm shift: 'ABC' to 'CAB' for cardiac arrests

Cited by 12 publications

References 3 publications

Comprehensive cardiopulmonary life support (CCLS) for cardiopulmonary resuscitation by trained paramedics and medics inside the hospital

Comprehensive cardiopulmonary life support (CCLS) for cardiopulmonary resuscitation by trained paramedics and medics inside the hospital

Cardiopulmonary Resuscitation Guideline Update: A Systematic Review

Basic cardiopulmonary life support (BCLS) for cardiopulmonary resuscitation by trained paramedics and medics outside the hospital

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