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ABC versus CAB for cardiopulmonary resuscitation: a prospective, randomized simulator-based trial.
MedLine Citation:
PMID:  24018896     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
S Marsch; F Tschan; N K Semmer; R Zobrist; P Hunziker; S Hunziker
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Publication Detail:
Type:  Journal Article     Date:  2013-09-06
Journal Detail:
Title:  Swiss medical weekly     Volume:  143     ISSN:  1424-3997     ISO Abbreviation:  Swiss Med Wkly     Publication Date:  2013  
Date Detail:
Created Date:  2013-09-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100970884     Medline TA:  Swiss Med Wkly     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  w13856     Citation Subset:  IM    
Affiliation:
Klinik für Intensivmedizin, Universitätsspital, Basel, SWITZERLAND; smarsch@uhbs.ch.
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