ABC (first aid)

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First Aid

ABC (and extensions of this acronym) is a mnemonic for memorizing essential steps in dealing with an Unconcious or unresponsive patient. It stands for Airway, Breathing and Circulation. Some protocols add additional steps, such as an optional "D" step for Disability (not as in 'are they in a wheelchair', but 'have they caused themselves a temporary disability, by breaking a leg') or Defibrillation (whien used as a CPR protocol). It is a reminder of the priorities for assessment and treatment of many acute medical situations, from first-aid to hospital medical treatment. Airway, breathing and circulation are vital for life, and each is required, in that order, for the next to be effective.

1 A - Airway
2 B - Breathing
3 C - Circulation
4 Variations
5 Discussion
6 See also
7 Links

[edit] A - Airway

If the patient's airway is blocked, oxygen cannot reach the lungs and so cannot be transported round the body in the blood. Ensuring a clear airway is the first step in treating any patient. Common problems with the airway involve blockage by the tongue or vomit.

Initial opening of the airway is often achieved by a "head tilt - chin lift" or jaw thrust technique, although further manouvers such as intubation may be necessary. (See Airway)

[edit] B - Breathing

The patient is next assessed for breathing. Common findings during an assessment of breathing may include normal breathing, noisy breathing, gasping or coughing. The rescuer proceeds to act on these based on his/her training. Generally at this point it will become clear whether or not the casualty needs supportive care (such as the recovery position) or Rescue Breathing.

[edit] C - Circulation

Once oxygen can be delivered to the lungs by a clear airway and efficient breathing, there needs to be a circulation to deliver it to the rest of the body. This can be assessed in a number of ways, including a pulse check, ECG analysis, or Capillary refill time.

In some protocols, this step stands for Cardiopulmonary Resucitation, which is effectively artifical circulation. In this case, this step should only apply to those patients who are in Cardiogenic or other form of Shock, and therefore not breathing normally and with an unsatisfactory heart rhythm.

[edit] Variations

Nearly all first aid organization use at the ABC acronym, but some incorporate it as part of a larger acronym.

[edit] ABCD

The final D stands for Defibrillation.

[edit] ABCDE

The D stands for Disability - the patient must now be checked on the Glasgow Coma Scale (GCS) for their level of consciousness.

The E stand for Environment - only after assessing ABCD does the responder deal with environmentally-related symptoms or conditions, such as cold and lightning.

Another version of ABCDE: ABC as above

D for Deadly Bleeding
E for Escaping Air

This version is used primarily in lifeguarding or advanced first aid situations

[edit] AcBCDEEEFG

The UK Ambulance service Mneumonic. The small c stands for "consider c-spine", the first E is environment, the second and third Es are "Expose & Examine" and the F is for "Fundus", relating to pregnancy. The G is "Go Quickly!"

[edit] DR ABC

A variation of this mnemonic exists, known as DR ABC (often pronounced Doctor A-B-C), which stands for Danger, Response, Airway, Breathing, and Compressions

[edit] Discussion

The techniques employed at each of the 3 stages will differ according to the training, experience and often the nationality of the rescuer. ABC is fast becoming redundant as different national and international bodies change their priorities from this order.