Forget your ABCDE, resuscitation is now about DR ABC
Times change, and guidance with it. For many years the ABCDE mnemonic was taught in resuscitation classes for initial assessment (the “Primary Survey”) of a person in a medical emergency: Airway – Breathing – Circulation – Disability – Exposure.
The truth is, these words were shoe-horned into the alphabet to achieve style rather than substance. They ignored personal safety, or assessing the patient’s responsiveness before starting CPR, and implied that loosening clothing (i.e. “exposure”) was a very important step in managing an emergency.
ABCDE was originally designed for secondary care teams like hospital staff (see www.resus.org.uk/...) who had access to full equipment and backup.
Outside hospital, the new mnemonic is DR ABC, or Doctor ABC if you prefer. A much more sensible order of events.
D is for Danger
Make sure you do not put yourself or anyone else in danger when assessing and treating a medical emergency
R is for response
Is the patient responsive when you call them, or shake/pinch them, or are they unconscious? In the old system, this was D for disability (which never sounded right), done near the end. That’s clearly not the right time for initial assessment/primary survey.
A is for airway
Check it is open and clear. If necessary tilt their head back to make sure the tongue does not obstruct their respiration.
B is for breathing
Are they breathing well, wheezing, struggling, or not at all? If they are not breathing normally, and are unresponsive, start cardio-pulmonary resuscitation (CPR) immediately.
C is for circulation
If you have got this far, you don’t need to do immediate CPR, and can check their pulse, colour, and so on, to complete your assessment and make a diagnosis. Most medical emergencies are NOT cardiac arrests.
This new guidance is welcomed. It makes much better sense than ABCDE, and because it makes sense it is easier to remember and put into practice.
So remember - Doctor ABC!
This and much more is covered in detail in our Enhanced CPD courses on Medical Emergencies. GDC Highly Recommended and suitable for all members of the dental team - sign up today!
Text source: Verified Learning
Photo source: Stock Adobe.com