The correct sequence of cardiopulmonary resuscitation includes?

Appeared in: GMCH Chandigarh - 2022

Explanation

The current American Heart Association (AHA) guidelines for Basic Life Support (BLS) recommend the C-A-B sequence: Circulation, Airway, Breathing.
This approach prioritizes starting chest compressions immediately upon identifying cardiac arrest.
The primary goal is to restore blood flow to the brain and heart as quickly as possible, as the blood still has residual oxygen in the first few minutes of arrest.
Delaying chest compressions to open the airway and provide breaths can worsen outcomes.

Option A: This represents the old A-B-C (Airway, Breathing, Circulation) sequence. It has been replaced because it causes a critical delay in starting chest compressions.
Option C: This sequence (Breathing, Circulation, Airway) is not a recognized or effective protocol for CPR. Starting with breathing before ensuring circulation is illogical and ineffective.
Option D: Hydration is not a component of cardiopulmonary resuscitation. Administering fluids orally or otherwise is not part of the immediate life-saving sequence.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Sequence of Cardiopulmonary Resuscitation (CPR) as background academic context rather than a clinical decision trigger.
As a nurse, immediate initiation of high-quality CPR using the C-A-B sequence is a core competency that directly impacts patient survival.
The emphasis is on 'push hard and push fast' with minimal interruptions. Nurses must be able to perform compressions at a rate of 100-120 per minute and a depth of 5-6 cm for adults, and lead the resuscitation team until advanced help arrives.
What if? If the patient is a child or an infant with a witnessed collapse, the C-A-B sequence is still followed. However, if the arrest is suspected to be from a respiratory cause (like choking or drowning), the protocol may slightly differ, sometimes starting with rescue breaths after activating the emergency response.

How to Approach the Question

First, identify the core of the question, which is asking for the 'correct sequence' of CPR.
Recall the current guidelines for Basic Life Support (BLS). The acronym C-A-B should come to mind.
Translate the C-A-B acronym: C = Circulation (compressions), A = Airway, B = Breathing.
Evaluate the options based on this sequence.
Option A (A-B-C) is the old guideline; eliminate it.
Option B (C-A-B) matches the current guideline; this is likely the correct answer.

Concept Tested & Keywords

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 763-765, 762-764

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 45-47

Practise the full GMCH Chandigarh - 2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.