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

           After a review of the available research published over a 5 year period, the American Heart Association released its 2010 CPR Guidelines. As expected, the focus for CPR is on good quality chest compressions. Here are the differences between the 2005 and the 2010 CPR Guidelines:

• A-B-C is for babies; now it's C-A-B!
           It used to be follow your ABC's: airway, breathing and chest compressions. Now, Compressions come first, only then do you focus on Airway and Breathing. The only exception to the rule will be newborn babies, but everyone else -- whether it's infant CPR, child CPR or adult CPR -- will get chest compressions before you worry about the airway.

Why did CPR change from A-B-C to C-A-B?
• No more looking, listening and feeling.
           The key to saving a cardiac arrest victim is action, not assessment. Call 911 the moment you realize the victim won't wake up and doesn't seem to be breathing right.
Trust your gut. If you have to hold your cheek over the victim's mouth and carefully try to detect a puff of air, it's a pretty good bet she's not breathing very well, if at all.
I have a secret to share: paramedics have been doing it this way for years. Rarely have I seen an EMT or a paramedic put her ear to a victim's nose and listen for air movement. We just get to work.

• Push a little harder. 
How deep you should push on the chest has changed for adult CPR. It was 1 1/2 to 2 inches, but now the Heart Association wants you to push at least 2 inches deep on the chest.

• Push a little faster. 
AHA changed the wording here, too. Instead of pushing on the chest at about 100 compressions per minute, AHA wants you to push at least 100 compressions per minute. At that rate, 30 compressions should take you 18 seconds.
Besides the changes under the 2010 CPR Guidelines, AHA continues to emphasize some important points:

• Hands Only CPR. 
This is technically a change from the 2005 Guidelines, but AHA endorsed this form of CPR in 2008. The Heart Association still wants untrained lay rescuers to do Hands Only CPR on adult victims who collapse in front of them. My biggest problem with this campaign is what's left unsaid. What does AHA want untrained lay rescuers to do with all the other victims? In other words, what do you do with the victims that aren't adults or that didn't collapse right in front of you? AHA doesn't provide an answer, but I have a suggestion: Do Hands Only CPR, because doing something is always better than doing nothing.

• Recognize sudden cardiac arrest. CPR is the only treatment for sudden cardiac arrest and AHA wants you to notice when it happens.

• Don't stop pushing. Every interruption in chest compressions interrupts blood flow to the brain, which leads to brain death if the blood flow stops too long. It takes several chest compressions to get blood moving again. AHA wants you to keep pushing as long as you can. Push until the AED is in place and ready to analyze the heart. When it is time to do mouth to mouth, do it quick and get right back on the chest.

Question: 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?

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:
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).
           So as you can see, by starting chest compressions first, the victim only has to hold his breath an extra 18 seconds while blood gets flowing again. In my opinion, that's a good trade.

(phtrx24)