In its original form it stands for Airway, Breathing, and Circulation. The protocol was originally developed as a memory aid for rescuers performing cardiopulmonary resuscitation, and the most widely known use of the initialism is in the care of the unconscious or unresponsive patient, although it is also used as a reminder of the priorities for assessment and treatment of patients in many acute medical and trauma situations, from first-aid to abc of first aid pdf medical treatment.
Airway, breathing, and circulation are all vital for life, and each is required, in that order, for the next to be effective. In 2010, the American Heart Association and International Liaison Committee on Resuscitation changed the recommended order of CPR interventions for most cases of cardiac arrest to chest compressions, airway, breathing or CAB. The ‘ABC’ method of remembering the correct protocol for CPR is almost as old as the procedure itself, and is an important part of the history of cardiopulmonary resuscitation.
Throughout history, a variety of differing methods of resuscitation had been attempted and documented, although most yielded very poor outcomes. In 1957, Peter Safar wrote the book ABC of Resuscitation, which established the basis for mass training of CPR.
This new concept was distributed in a 1962 training video called “The Pulse of Life” created by James Jude, Guy Knickerbocker and Peter Safar. Jude and Knickerbocker, along with William Kouwenhouen developed the method of external chest compressions, while Safar worked with James Elam to prove the effectiveness of artificial respiration.
Their combined findings were presented at annual Maryland Medical Society meeting on September 16, 1960, in Ocean City, and gained rapid and widespread acceptance over the following decade, helped by the video and speaking tour the men undertook. The ABC system for CPR training was later adopted by the American Heart Association, which promulgated standards for CPR in 1973. At all levels of care, the ABC protocol exists to remind the person delivering treatment of the importance of airway, breathing, and circulation to the maintenance of a patient’s life. The three objectives are so important to successful patient care that they form the foundation of training for not only first aid providers but also participants in many advanced medical training programs.
Hypoxia, the result of insufficient oxygen in the blood, is a potentially deadly condition and one of the leading causes of cardiac arrest. For this reason, maintaining circulation is vital to moving oxygen to the tissues and carbon dioxide out of the body.
The basic application of the ABC principle is in first aid, and is used in cases of unconscious patients to start treatment and assess the need for, and then potentially deliver, cardiopulmonary resuscitation. These two steps should provide the initial assessment of whether the patient will require CPR or not. Previously, the guidelines indicated that a pulse check should be performed after the breathing was assessed, and this made up the ‘circulation’ part of the initialism, but this pulse check is no longer recommended for lay rescuers. Some trainers continue to use ‘circulation’ as the label for the third step in the process, since performing chest compressions is effectively artificial circulation, and when assessing patients who are breathing, assessing ‘circulation’ is still important.