ABC of CPR/BLS: Airway Breathing Circulation

By Cristiano Antonino Last updated Apr 6, 2023

The ABC in Cardiopulmonary Resuscitation and Basic Life Support ensures that the victim receives high-quality CPR within the shortest time possible

What is ABC in CPR: The ABC are abbreviations for Airway, Breathing, and Circulation

It refers to the sequence of events in Basic Life Support.

Airway: Open the victim’s airway using a head-tilt chin-lift or jaw thrust maneuver
Breathing: Provide rescue breathing
Circulation: Perform chest compression to restore the blood circulation

The Airway and Breathing will provide the initial assessment of whether the victim will need CPR or not.

Basic life support refers to the assistance professional first responders give to victims with an obstructed airway, respiratory distress, cardiac arrest, and other medical emergency situations.

These skills require knowledge of CPR (cardiopulmonary resuscitation), AED (automated defibrillator) skills, and knowledge of relieving airway obstruction.

We often hear about these medical abbreviations.

But how about ABC (Airway Breathing Circulation)? What does it mean, and how is it related to CPR and BLS certification meaning?

Key Takeaways

Symptoms of cardiac arrest include light-headedness, chest pain or discomfort, shortness of breath, and difficulty breathing.
Rescuers should use mouth-to-mouth ventilation, bag-mask ventilation, or mouth-to-mask ventilation until an advanced airway is in place.
The normal respiratory rate in healthy adults with a regular pattern and depth is between 12 to 20 breaths per minute.
The correct chest compression rate for adults is 100 to 120 compressions per minute.
Ensure the chest rises and falls with each breath.
The first aid for obstruction varies depending on the degree of obstruction.
For severe obstruction, apply abdominal thrusts, otherwise known as the Heimlich maneuver.

ABC, What is Airway Breathing Circulation?

The ABC are abbreviations for Airway, Breathing, and Compressions.

It refers to the steps of CPR in order.

The ABC procedure ensures that the victim receives proper CPR within the shortest time possible.

The Airway and Breathing will also provide the initial assessment of whether the victim will need CPR or not.

Research findings by the American Heart Association show that beginning the chest compressions earlier improves the victim’s chances of survival. Responders should not take more than 10 seconds to check for a pulse.

Wherever in doubt, bystanders should begin CPR.

Little harm is likely to occur if the victim does not need CPR.

Earlier CPR procedures advised for listening and feeling for breathing, which might take more time for non-medical professionals.

If the victim is unresponsive, gasping for air, or without a pulse, it’s best to begin CPR within the shortest time possible.

Airway

A is for Airway Management.

Rescuers should use mouth-to-mouth ventilation, bag-mask ventilation, or mouth-to-mask ventilation until an advanced airway is in place.

For adults, each 30 chest compressions should be followed by two rescue breaths (30:2), while for infants, 15 chest compressions alternate with two rescue breaths (15:2).

Mouth-to-mouth rescue breathing

A pocket or bag mask should always be given priority when doing mouth-to-mouth ventilation as it lowers the risks of transmitting infections.

Mouth-to-mouth ventilation provides 17% oxygen which is usually expelled during normal breathing.

This oxygen level is sufficient to keep the victim alive and maintain normal body functions.

When providing ventilation, avoid doing it too rapidly or forcing air too much into the airway as it might result in more complications if the air moves to the victim’s stomach.

In most cases, respiratory arrest precedes cardiac arrest.

Therefore, if you can identify the signs of respiratory arrest, you are more likely to prevent the occurrence of cardiac arrest.

Wherever the victim has a pulse but no signs of breathing, start rescue breathing immediately.

Breathing

B in ABC is for breathing assessment.

Depending on the rescuer’s skill level, this may involve steps like checking for general respiratory rate by using accessory muscles to breathe, abdominal breathing, the patient’s position, sweating, or cyanosis.

The normal respiratory rate in healthy adults with a regular pattern and depth is between 12 to 20 breaths per minute.

ABC, How to Perform Rescue Breathing?

According to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, tilt the victim’s head slightly backward and open the airway.

For adults, pinch the nose and breath into the mouth at 10 to 12 breaths per minute.

For infants and smaller children, cover the mouth and nose with your mouth and breath in at 12 to 20 breaths per minute.

Each breath should last for at least one second, and ensure the chest rises and falls with each breath.

If the victim doesn’t regain consciousness, begin CPR immediately.

Circulation or Compression

C is for Cicrulation/Compression.

When a victim is unconscious and not breathing normally within 10 seconds, you must perform Chest compressions or CPR immediately to save a life in any emergency situation.

According to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, the correct compression rate is 100 to 120 compressions per minute.

The Chance of Survival

Early initiation of basic life support improves the chances of survival of cardiac arrest victims.

It is essential to recognize the symptoms of cardiac arrest.

The victim might collapse and fall unconscious.

However, before this, they may experience light-headedness, chest pain or discomfort, shortness of breath, and difficult breathing.

Quick administration of CPR provides better chances of survival.

The CPR procedure differs depending on age.

The depth of chest compressions for infants, children, and adults varies.

High-quality CPR is critical for the survival of the victim.

The Automated Defibrillator (AED)

The automated defibrillator (AED) is critical in reviving the heart for cardiac arrest victims.

It is easy to use and accessible in most public places.

The AED should be used as soon as it is available.

Early use of AED improves the outcome.

The machine detects and advises whether or not a shock is necessary for that particular case.

The most common cause of cardiac arrest is ventricular defibrillation.

The condition is reversible by delivering an electric shock to the victim’s heart through the chest wall.

With a team of rescuers, as one person performs the chest compressions, the other should prepare the defibrillator.

The use of the AED requires training.

What makes the device even simpler to use is that it is automated.

Precautions when using the AED:

The pads shouldn’t touch or get in contact with each other.
AED shouldn’t be used around water.
Bring the victim to a dry surface and ensure the chest is dry.
Don’t use alcohol to wipe the victim as it is flammable.
Avoid touching the victim while the AED is attached.
Motion affects the analysis of the AED. It, therefore, shouldn’t be used in moving vehicles.
Do not use the AED while the victim is lying on a conductor such as a metal surface.
Avoid using the AED on a victim with a nitroglycerine patch.
While using the AED, avoid using a cellphone within 6 feet distance as it might affect the accuracy of the analysis.

Choking

Choking results from the obstructed airway and can potentially lead to cardiac arrest.

The treatment for obstruction varies depending on the degree of obstruction.

It can be severe or mild obstruction.

First aid for obstruction is the same for children older than a year and adults.

For mild obstruction, the victim may have symptoms of coughing, not breathing, or wheezing.

For this case, the rescuer should encourage the victim to cough and calm them down.

If the obstruction persists, call for emergency medical services.

For severe obstruction, the victim has the following symptoms: clutching the neck, little or no breathing, little or no coughing, and unable to make talk or make a sound.

In other cases, the victim might make a high-pitched sound.

Other signs include bluish color on the lips and fingertips (cyanotic).

For cases of severe obstruction, apply abdominal thrusts, otherwise known as the Heimlich maneuver (for both children one year and older and adults).

How to Perform Heimlich Maneuver?

Stand behind the victim, and wrap arms around them just below their rib cage.
Without pressing on the lower sternum, place the side of your fist in the middle of the victim’s belly just above the navel.
Hold the fist with your other hand and push it into the abdomen and upwards towards the chest.
Continue performing the thrusts until the victim is relieved or regains consciousness. If you can see the object causing the obstruction, use your fingers to remove it.
If you cannot remove the object or the victim becomes unresponsive, begin CPR and continue until specialized help arrives.
Infants less than a year old do not attempt blind finger swift.
Call for specialized help (Emergency Number).
Use back blows or chest thrusts to clear the obstruction.
If the infant falls unconscious, start the basic life support procedure.