Төтенше жағдайларда ABC протоколы: Тыныс жолдары, тыныс алу, қан айналымы

Mnemonic for Airway, Breathing, and Circulation

ABC and its variations are initialism mnemonics for essential steps used by both medical professionals and lay persons (such as first aiders) when dealing with a patient. In its original form it stands for Airway, Breathing, and Circulation.

At all levels of care, the ABC protocol exists to remind the person delivering treatment of the importance of airway, breathing, and circulation to the maintenance of a patient's life. These three issues are paramount in any treatment, in that the loss (or loss of control of) any one of these items will rapidly lead to the patient's death. The three objectives are so important to successful patient care that they form the foundation of training for not only first aid providers but also participants in many advanced medical training programs. Hypoxia, the result of insufficient oxygen in the blood, is a potentially deadly condition and one of the leading causes of cardiac arrest. Cardiac arrest is the ultimate cause of clinical death for all animals (although with advanced intervention, such as cardiopulmonary bypass a cardiac arrest may not necessarily lead to death), and it is linked to an absence of circulation in the body, for any one of a number of reasons. For this reason, maintaining circulation is vital to moving oxygen to the tissues and carbon dioxide out of the body. Airway, breathing, and circulation, therefore work in a cascade; if the patient's airway is blocked, breathing will not be possible, and oxygen cannot reach the lungs and be transported around the body in the blood, which will result in hypoxia and cardiac arrest. Ensuring a clear airway is therefore the first step in treating any patient; once it is established that a patient's airway is clear, rescuers must evaluate a patient's breathing, as many other things besides a blockage of the airway could lead to an absence of breathing.

The basic application of the ABC principle is in first aid, and is used in cases of unconscious patients to start treatment and assess the need for, and then potentially deliver, cardiopulmonary resuscitation. In this simple usage, the rescuer is required to open the airway (using a technique such as "head tilt chin lift"), then check for normal breathing. although in some countries, its use is not recommended for lay rescuers for safety reasons. Higher level practitioners such as emergency medical service personnel may use more advanced techniques, from oropharyngeal airways to intubation, as deemed necessary.

In the conscious patient, other signs of airway obstruction that may be considered by the rescuer include paradoxical chest movements, use of accessory muscles for breathing, tracheal deviation, noisy air entry or exit, and cyanosis.

In a conscious patient, or where a pulse and breathing are clearly present, the care provider will initially be looking to diagnose immediately life threatening conditions such as severe asthma, pulmonary oedema or haemothorax. For this reason, lay rescuers proceed directly to cardiopulmonary resuscitation, starting with chest compressions, which is effectively artificial circulation. In order to simplify the teaching of this to some groups, especially at a basic first aid level, the C for Circulation is changed for meaning CPR or Compressions. It should be remembered, however, that health care professionals will often still include a pulse check in their ABC check, and may involve additional steps such as an immediate ECG when cardiac arrest is suspected, in order to assess heart rhythm.

Nearly all first aid organisations use "ABC" in some form, but some incorporate it as part of a larger initialism, ranging from the simple 'ABCD' (designed for training lay responders in defibrillation) to 'AcBCDEEEFG' (the UK ambulance service version for patient assessment).

Some trainers and protocols use an additional (small) 'c' in between the A and B, standing for 'cervical spine' or 'consider C spine'. This is a reminder to be aware of potential neck injuries to a patient, as opening the airway may cause further damage unless a special technique is used.

The military frequently use a CABC approach, where the first C stands for "catastrophic haemorrhage". Violent trauma cases indicate that major blood loss will kill a casualty before an airway obstruction, so measures to prevent hypovolemic shock should occur first. This is often accomplished by immediately applying a tourniquet to the affected limb.

One of the most widely used adaptations is the addition of "DR" in front of "ABC", which stands for Danger and Response. This refers to the guiding principle in first aid to protect yourself before attempting to help others, and then ascertaining that the patient is unresponsive before attempting to treat them, using systems such as AVPU or the Glasgow Coma Score. As the original initialism was devised for in hospital use, this was not part of the original protocol. In some areas, the related SR ABC is used, with the S to mean Safety.

Incorporates the additional S for "shout" (in the UK) or "send for help" (in Australia), and D for "defibrillation".

The 'ABC' method of remembering the correct protocol for CPR is almost as old as the procedure itself, and is an important part of the history of cardiopulmonary resuscitation. Throughout history, a variety of differing methods of resuscitation had been attempted and documented, although most yielded very poor outcomes. In 1957, Peter Safar wrote the book ABC of Resuscitation, which established the basis for mass training of CPR. This new concept was distributed in a 1962 training video called "The Pulse of Life" created by James Jude, Guy Knickerbocker and Peter Safar. Jude and Knickerbocker, along with William Kouwenhouen developed the method of external chest compressions, while Safar worked with James Elam to prove the effectiveness of artificial respiration. Their combined findings were presented at annual Maryland Medical Society meeting on September 16, 1960, in Ocean City, and gained rapid and widespread acceptance over the following decade, helped by the video and speaking tour the men undertook. The ABC system for CPR training was later adopted by the American Heart Association, which promulgated standards for CPR in 1973. As of 2010, the American Heart Association chose to focus CPR on reducing interruptions to compressions, and has changed the order in its guidelines to Circulation, Airway, Breathing (CAB).