October 18th, 2010
New CPR Guidelines Replace A-B-C with C-A-B
Larry Husten, PHD
Chest compressions gain pride of place (and trump alphabetical order) in the newly published and much-anticipated updated guidelines for CPR from the AHA. The new guidelines replace the traditional A-B-C (Airway-Breathing-Compressions) with C-A-B (Compressions-Airway-Breathing), recommending that “chest compressions be the first step for lay and professional rescuers to revive victims of sudden cardiac arrest.” The 16-part guidelines are published online in Circulation. (The AHA has also made available a document summarizing the key changes from the 2005 recommendations.)
The new guidelines recommend that compressions should be started immediately on people who are unresponsive and not breathing. In addition, chest compressions should be performed at a rate of at least 100 times per minute ─ slightly faster than previously recommended. The rescuers should push deeper into the chest, should not stop compressions, and should avoid excessive ventilation.
“For more than 40 years, CPR training has emphasized the ABCs of CPR, which instructed people to open a victim’s airway by tilting their head back, pinching the nose and breathing into the victim’s mouth, and only then giving chest compressions,” said Michael Sayre, co-author of the guidelines and chairman of the American Heart Association’s Emergency Cardiovascular Care (ECC) Committee, in an AHA press release. “This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating through the body. Changing the sequence from A-B-C to C-A-B for adults and children allows all rescuers to begin chest compressions right away.”
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