Emergency Medicine Book

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ABC ManagementAka: Primary Survey, Cardiopulmonary Resuscitation, Adult Resuscitation, Pediatric Resuscitation, Resuscitation, CPR

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  1. See Also
    1. Newborn Resuscitation
    2. Guidelines for Emergency Cardiovascular Care
  2. Management: Initial
    1. Assess Responsiveness
    2. Call for Help
      1. Call for Defibrillator if available
      2. Activate EMS after initial ABC assessment
  3. Management: Emergency Airway
    1. Position
      1. Turn on back as unit
      2. Support head and neck while positioning
      3. Place on hard firm surface
    2. Open airway
      1. Head Tilt-Chin Lift Maneuver
      2. Jaw Thrust (if suspected neck injury)
  4. Management: Emergency Breathing
    1. Look Listen and feel for breathing
    2. Attempt 2 ventilations (each lasting 1-1.5 seconds)
      1. Observe chest rise
      2. Allow deflation between breaths
      3. Reposition if first breath does not go in
    3. Airway Obstruction if ventilations unsuccessful
      1. No blind finger sweeps at any age
      2. Unconscious
        1. Deliver full CPR regardless of airway obstruction
      3. Conscious
        1. Perform Heimlich Maneuver
          1. Infants: 5 chest thrusts and 5 back blows
          2. Children: 5 abdominal thrusts
          3. Adults: 6-10 abdominal thrusts
        2. Attempt ventilation
        3. Repeat cycle until obstruction cleared
  5. Management: Emergency Circulation Management
    1. Assess for Pulse
      1. Brachial pulse in infants
      2. Carotid pulse in children and adults
    2. Pulse Present: Perform Rescue Breathing
      1. Endotracheal Tube: 1 breath/6-8 seconds for all ages
      2. Adult: 12 breaths per minute (every 5 seconds)
      3. Child: 15 breaths per minute (every 3-5 seconds)
      4. Infant: 20 breaths per minute (every 3-5 seconds)
    3. Pulse Absent (or HR<60 in age<14): Chest Compressions
      1. General
        1. Pulse check should be <10 seconds
        2. Focus on pressing hard and fast
        3. Connect Automatic External Defibrillator ASAP
        4. Time interval for lone rescuer calling for help
          1. Sudden Collapse: Call immediately
            1. Minimizes time to AED application
          2. Asphyxial arrest: Perform CPR for 2 minutes
        5. Two rescuers switch places every 2 minutes
          1. Prevents rescuer Fatigue with Chest Compressions
          2. Repeat pulse check with the change
      2. Infants (Under 1 year old)
        1. Place 2 fingers at just below mid-nipple line
        2. Reassess pulse every 2 minutes
        3. Compress over 100 times per minute
          1. Depth: 0.5 to 1 inch
          2. Ratio: 30 compressions to 2 breaths
      3. Children (1-8 years old)
        1. One hand placed over sternum at center of chest (superior to xiphoid)
        2. Compress 100 times per minute
          1. Depth: 1 to 1.5 inches
          2. Reassess pulse every 2 minutes
          3. Compression to ventilation ratio: 30:2 (one or two rescuers)
      4. Adults (over 8 years old)
        1. Two hands places over sternum at center of chest (superior to xiphoid)
        2. Compress 100 times per minute
          1. Depth: 1.5 to 2 inches
          2. Reassess pulse every 2 minutes
          3. Compression to ventilation ratio: 30:2 (one or two rescuers)
  6. References
    1. (2005) Circulation 112:IV

Cardiopulmonary Resuscitation (C0007203)

Definition (MSH)The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE.
Definition (CSP)the artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes; the two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage.
ConceptsTherapeutic or Preventive Procedure (T061)
ICD999.60
MSHD016887
EnglishCardiac resuscitation, CARDIO PULM RESUSCITATION, Cardio Pulmonary Resuscitation, Cardio-Pulmonary Resuscitation, CARDIOPULM RESUSCITATION, Cardiopulmonary Resuscitation, Closed cardiac massage+ventil., CPR, CPR - Cardiopulmonary resuscitation, heart resuscitation
SpanishRCP, reanimacion cardiaca, reanimacion cardiopulmonar
Parent ConceptsResuscitation (C0035273), Electric Countershock (C0013778), Cardiopulmonary Resuscitation (C0007203), Emergency treatment (C0013969), Procedure on cardiovascular system (C0189573), Procedure on heart (C1279986), Ambiguous concept (C1274012)
SourcesAOD, CSP, ICD9CM, LCH, MEDLINEPLUS, MSH, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Resuscitation (C0035273)

Definition (MSH)The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)
Definition (CSP)restoration to life or consciousness.
Definition (NCI)The measures applied for the restoration a person to life and/or consciousness. The act of resuscitation includes such components as artificial respiration and cardiac massage.
ConceptsTherapeutic or Preventive Procedure (T061)
MSHD012151
EnglishFor attempted cardiopulmonary resuscitation, For resuscitation, Resuscitate, Resuscitation, Resuscitations
Spanishpara intento de reanimacion cardiopulmonar, para reanimacion
Parent Conceptsmedical emergency treatment method (C0679623), Emergency Care (C1527398), Emergency treatment (C0013969), Therapeutic procedure (C0087111), Finding of resuscitation status (C1287416)
SourcesAOD, CSP, LCH, MSH, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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