Chapter 3: C-A-B - American CPR Care Association
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chapter 3 : C-A-B

ECC and AHA 2010 updates changed the CPR sequence from A-B-C to C-A-B. Often in the A-B-C method chest compressions were delayed. With the new Compressions – Airway – Breathing method a victim receives compressions faster, providing quicker critical blood flow to the
vital organs.

The sequence of steps for conducting CPR using the C-A-B method (detailed further in following chapters):

    1. “C” for Compressions
  • Rate at which you start chest compressions: Give at least 100-120 chest compressions per minute in cycles of 30 compressions and 2 breaths (30:2).
  • Depth of chest compressions: detailed in following chapters for adult, child and infant
  • Chest recoil is vital after each chest compression.
    1. “A” for Airway
  • Open the airway as you tilt the head and lift the chin for the patient.
    1. “B” for Breathing
  • 2 rescue breaths

2020 Interim Guidance for suspected or confirmed COVID-19 patients:

In these times when everyone is being affected by the Coronavirus disease (COVID-19), many healthcare providers have limited access to adequate PPE.

Below are the primary interim changes to CPR during COVID-19 times.

PPE should be put on before assisting patients in cardiac arrest.

For Adults:

  • Perform at least hands-only CPR after a cardiac arrest event has been identified
  • A face mask or a cloth must cover rescuer’s mouth and nose and/or victim may reduce the risk of COVID-19 transmission to a non-household bystander

For Children:

  • Start chest compressions and give mouth-to-mouth rescue breaths
  • A face mask or cloth must protect or cover the mouth and nose of the lay responder or rescuer and/or victim may reduce the risk of COVID-19 transmission to a bystander.

2015 Chest Compression Update

According to the 2015 updates, you should give at least 100 to 120 chest compressions /minute (previously the same rate was 100 compressions / minute). Recent scientific research indicates that compressions are the most important for higher survival rate. This new update sets an upper limit for the rate of necessary chest compressions, as excessive compressions might wrongly affect a sudden cardiac arrest patient’s recovery.

2014 Hands-Only CPR

The Hands-Only steps of CPR is generally used on teens or adults who suddenly collapse when you encounter them. This is CPR method which does not include the rescue breaths.

You would need to:

  1. Call 9-1-1 and stay on the phone with the paramedics
  2. Push hard and fast to start chest compressions. Hands-only method is effective even when individuals have been trained in CPR before but may not remember all the steps of conventional CPR.

*The Good Samaritan Law is intended to reduce bystanders’ hesitation to assist in an emergency.

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