Revising the ABC of saving lives

Medical experts say that chest compressions should be the first step for professional rescuers to revive people.

KARACHI: Anaesthesiologists and medical experts said that chest compressions should be the first step for professional rescuers to revive people suffering from sudden cardiac arrest. Airway-breathing-compressions (A-B-Cs) of cardiopulmonary resuscitation should be changed to Compression-Airways-Breathing (C-A-B), they emphasised.

Addressing the workshop on “Latest updates on basic life support and heart-saver courses” organised by the Liaquat National Hospital’s department of skill lab at its convention centre on Saturday.

In his welcome address, Liaquat National Hospital medical director Dr Salman Faridi said new trends are being introduced in medicine and since the world has become a global village, the access to information is very easy.

Apart from Dr Faridi, Dr SM Nadeem, a consultant anaesthetist, Dr Younus Khatri, professor of anaesthesiology at Ziauddin University, and Ahmed Ali, the chief instructor of the Liaquat National’s department of skills lab, gave their presentations.

Medical experts said that for more than 40 years, CPR training has been emphasised the A-B-C procedure, which instructed people to open a victim’s airway by tilting their head back and breathing into the victim’s mouth, giving chest compressions.

“This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating through the body. Changing the sequence from A-B-C to C-A-B allows rescuers to begin compressions right away,” they concluded.

Dr Younus Khatri presented video clippings on advanced cardiovascular life-support update.

“During CPR, rescuers should give chest compressions faster, at a rate of at least 100 times a minute. The rescuers should push deeper on the chest, compressing at least two inches in adults and children and 1.5 inches in infants,” he said.

Besides, rescuers should avoid stopping chest compressions and avoid excessive ventilation, Dr Khatri added.

Dr SM Nadeem said, “In the first few minutes of cardiac arrest, victims will have oxygen remaining in their lungs and bloodstream, so starting CPR with chest compression can pump that blood to the victim’s brain and heart sooner.” Responding to questions, the experts referring to different studies said that effective teamwork techniques should be learned and practised regularly and professional rescuers should use quantitative waveform capnography (the monitoring and measuring of carbon-dioxide output) in order to monitor CPR quality. They said that change in the CPR sequence applies to adult, children and infants, but excludes newborns.

Published in The Express Tribune, January 9^th, 2011.