Basic Life Support Part II: Airway/Breathing and Continued Cardiopulmonary Resuscitation
Source: Julianna Jung, MD, FACEP, Associate Professor of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA
High-quality cardiopulmonary resuscitation (CPR) and defibrillation are the most important interventions for patients with cardiac arrest, and should be the first steps that rescuers perform. This is reflected in the American Heart Association's new "CAB" mnemonic. While rescuers were once taught the "ABCs" of cardiac arrest, they now learn "CAB" - circulation first, followed by airway and breathing. Only once CPR is underway (and defibrillation has been performed, if a defibrillator is available) do we consider providing respiratory support. This video will describe the correct technique for providing respiratory support to a patient in cardiac arrest, and how to continue basic life support over the period of time until help arrives.
This video assumes that all the steps described in "Basic Life Support Part I: Cardiopulmonary Resuscitation and Defibrillation" have already been completed. This video does NOT depict the initial steps taken when arriving at the scene of a cardiac arrest.
Please note that ventilation requires a second rescuer. While the first rescuer performs continuous, high-quality chest compressions, the second rescuer performs all the steps needed to ventilate the patient. Ventilation should never be allowed to interfere with chest compressions. If there are insufficient personnel to do both, then compressions are the priority.
1. While chest compressions are in progress, prepare ventilation equipment
- Obtain a bag-valve-mask (B
Quality CPR is absolutely essential to cardiac arrest survival, and must be perfected by all healthcare providers. While chest compressions and defibrillation are more important than respiratory support, patients with prolonged resuscitations will benefit from ventilation, and it should be performed whenever there is sufficient manpower and equipment to do so. BVM ventilation is a much more difficult skill than it would seem at first glance, and rescuers must perfect their technique in order to be effective. Knowledge
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