ABC versus CAB for cardiopulmonary resuscitation: a prospective, randomized simulator-based trial
Author(s)
Marsch, Stephan U
Semmer, Norbert
Zobrist, Roger
Hunziker, Patrick R
Hunziker, Sabina
Date issued
September 6, 2013
In
Swiss Medical Weekly
Vol
13856
No
143
From page
1
To page
11
Abstract
QUESTIONS UNDER STUDY: After years of advocating
ABC (Airway-Breathing-Circulation), current guidelines
of cardiopulmonary resuscitation (CPR) recommend CAB
(Circulation-Airway-Breathing). This trial compared ABC
with CAB as initial approach to CPR from the arrival of
rescuers until the completion of the first resuscitation cycle.
METHODS: 108 teams, consisting of two physicians each,
were randomized to receive a graphical display of either the
ABC algorithm or the CAB algorithm. Subsequently teams
had to treat a simulated cardiac arrest. Data analysis was
performed using video recordings obtained during simulations.
The primary endpoint was the time to completion
of the first resuscitation cycle of 30 compressions and two
ventilations.
RESULTS: The time to execution of the first resuscitation
measure was 32 ± 12 seconds in ABC teams and 25 ±
10 seconds in CAB teams (P = 0.002). 18/53 ABC teams
(34%) and none of the 55 CAB teams (P = 0.006) applied
more than the recommended two initial rescue breaths
which caused a longer duration of the first cycle of 30
compressions and two ventilations in ABC teams (31 ± 13
vs.23 ± 6 sec; P = 0.001). Overall, the time to completion
of the first resuscitation cycle was longer in ABC teams (63
± 17 vs. 48 ± 10 sec; P <0.0001).
CONCLUSIONS: This randomized controlled trial found
CAB superior to ABC with an earlier start of CPR and a
shorter time to completion of the first 30:2 resuscitation
cycle. These findings endorse the change from ABC to
CAB in international resuscitation guidelines.
ABC (Airway-Breathing-Circulation), current guidelines
of cardiopulmonary resuscitation (CPR) recommend CAB
(Circulation-Airway-Breathing). This trial compared ABC
with CAB as initial approach to CPR from the arrival of
rescuers until the completion of the first resuscitation cycle.
METHODS: 108 teams, consisting of two physicians each,
were randomized to receive a graphical display of either the
ABC algorithm or the CAB algorithm. Subsequently teams
had to treat a simulated cardiac arrest. Data analysis was
performed using video recordings obtained during simulations.
The primary endpoint was the time to completion
of the first resuscitation cycle of 30 compressions and two
ventilations.
RESULTS: The time to execution of the first resuscitation
measure was 32 ± 12 seconds in ABC teams and 25 ±
10 seconds in CAB teams (P = 0.002). 18/53 ABC teams
(34%) and none of the 55 CAB teams (P = 0.006) applied
more than the recommended two initial rescue breaths
which caused a longer duration of the first cycle of 30
compressions and two ventilations in ABC teams (31 ± 13
vs.23 ± 6 sec; P = 0.001). Overall, the time to completion
of the first resuscitation cycle was longer in ABC teams (63
± 17 vs. 48 ± 10 sec; P <0.0001).
CONCLUSIONS: This randomized controlled trial found
CAB superior to ABC with an earlier start of CPR and a
shorter time to completion of the first 30:2 resuscitation
cycle. These findings endorse the change from ABC to
CAB in international resuscitation guidelines.
Publication type
journal article