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From ABC to CAB

Discussion in 'Break Room' started by Cameron, Jan 6, 2011.

  1. Cameron

    Cameron Well-Known Member


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    The newest set of guidelines pertaining to CPR and emergency cardiovascular care were published by the American Heart Association (AHA) in a supplement issue of Circulation, recently. Apparently only a minority of cardiac arrest victims receive bystander CPR. It is believed that a significant obstacle to bystanders performing CPR is their fear of doing mouth-to-mouth breathing. The AHA recommend changing the initial focus of resuscitation to chest compressions rather than airway maneuvers, it is thought that more patients will receive important bystander intervention, even if it is limited to chest compressions.

    There are several reasons for this change. Most survivors of adult cardiac arrest have an initial rhythm of ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), and these patients are best treated initially with chest compressions and early defibrillation rather than airway management.
    Airway management, whether mouth-to-mouth breathing, bagging, or endotracheal intubation, often results in a delay of initiation of good chest compressions. Airway management is no longer recommended until after the first cycle of chest compressions -- 30 compressions in 18 seconds. According to the AHA the 30 compressions are now recommended to precede the 2 ventilations, which previous guidelines had recommended at the start of resuscitation.

    Reference
    Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Circulation. 2010; 122(18 Suppl 3):S640-56
     
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