ABC. Airway, Breathing, Circulation. This is the mantra of all CPR courses. Those 3 letters and their respective actions form the basis of all patient assessment. In this article I will attempt to break down these 3 letters into the simplest of parts. This first installment will cover letter A-the airway. Please excuse the simplistic terms I may use in this blog article but remember THIS IS FOR BEGINNERS.
A. Airway. To put it simply this letter comes first because without a passage way for air, specifically oxygen, to make it to your lungs you will die. I can pump on your chest and breathe for you but unless air is filling your lungs compressions and ventilations don’t matter. Think of it like a car and oxygen is the gas. It doesn’t matter if I have new tires and a brand new engine. If there is no gas that engine aint gonna start.
The A in your ABC’s is the step where you try to align and clear the airway of anything that might inhibit air passage to the lungs. Forgive me for being so simple here but this is for beginners. There are two “pipes” exiting the back of your mouth. One goes to the stomach and one goes to the lungs. The “windpipe” or trachea leads from the mouth to the lungs. This is the passage we must protect. The trachea is most often blocked by the patient’s own tongue. One easy way we can correct this blockage is by doing the head-tilt chin-lift maneuver you will learn about in your CPR class. By tilting the head back we “straighten” out the trachea and lift the tongue from the back of the throat. The trachea can also be blocked by countless other things much more nasty than the tongue. Do not be surprised if your patient vomits or drools. Deal with it. You are trying to save a life. You must do whatever is necessary to open that air passage.
I have found that aligning and clearing the airway is the second most common omission while people perform the ABC’s. Often students, even experts, will go directly to the breathing check passing quickly by the obvious need to align and suction a patient’s airway. Then when they realize air isn’t going in they have to go back to the airway step and align and clear the airway. This leads to precious time away from chest compressions and other important tasks. Keep in mind that there is now “hands only” CPR that doesn’t requiring breathing in case you are confronted with an airway issue that is just too gross or intimidating for you to deal with. “Hands only” CPR is okay but it is only meant to buy you a few minutes and it is not for medical professionals. It is not the optimal solution but is better than nothing.
Believe me, these are the airway basics. Whole medical careers and texts have been written on managing airways. But, this explanation of the A in your ABC’s is only meant to briefly explain in the simplest of terms why A comes first and why it is so important. The next installment of the ABC’s –Beginners guide will cover B. Breathing.