Why did CPR change from A-B-C to C-A-B

? Why did CPR change from A-B-C to C-A-B

The 2010 CPR Guidelines rearranged the order of CPR steps. Now, instead of A-B-C, which stands for airway and breathing first followed by chest compressions, the American Heart Association wants rescuers to practice C-A-B: chest compressions first, then airway and breathing. Some have asked, why did CPR change?1

Answer: Just like you can hold your breath for a minute or two without having brain damage, victims of cardiac arrest can go a minute or two (actually a lot longer than that) without taking a breath. What cardiac arrest victims really need is for that blood to get flowing again

When rescuers are worried about opening the airway and making an adequate seal, plus the "ick" factor and possibly digging a CPR mask out of a purse or briefcase, the delay can be significant. All that extra time is getting in the way of real help: Chest compressions

In its summary of the changes, the American Heart Association explained it this way:1

In the A-B-C sequence chest compressions are often delayed while the responder opens the airway to give mouth-to-mouth breaths or retrieves a barrier device or other ventilation equipment. By changing the sequence to C-A-B, chest compressions will be initiated sooner and ventilation only minimally delayed until completion of the first cycle of chest compressions (30 compressions should be accomplished in approximately 18 seconds)

AHA Recommendations (Changes):

According to the new guidelines, some of the IMPORTANT recommendations include:

Those carrying out CPR need to increase the speed at which they administer of chest compressions to a minimum rate 100 times a minute

The depth of these compressions must be increased to at least 2 inches in adults and children and to 1.5 inches in infants

The rescuers are advised to avoid leaning on the patient’s chest and to continue compression without too much ventilation

Teamwork techniques should be learned and put to effective practice on a regular basis

Quantitative waveform capnography, (which is used to measure carbon dioxide output) must be used to confirm CPR quality

Therapeutic hypothermia (decreased body temperature) should be considered after resuscitation, as a part of an overall inter-disciplinary system of after-care

Atropine is no longer recommended for the management and treatment of pulse less electrical activity (asystole), on a regular basis

The new guidelines also strongly advise that the untrained rescuers confine themselves to providing Hands-Only CPR ;in other words they provide just the chest compression for unresponsive, non-breathing adults