From ABC to CAB for CPR. ABC (airway, breathing, chest compressions), the mnemonic used for decades in cardiopulmonary resuscitation (CPR) training, is out, and CAB (compressions first, followed by clearing of the airway and rescue breaths) is in, according to the newest guidelines from the American Heart Association (read the changes at http://bit.ly/cIzCnB).

According to the guidelines, which pertain to adults, children, and infants (but not newborns), chest compressions should be performed first-at a rate of at least 100 per minute, a change from the previous recommendation of approximately 100 per minute. Compressions should be at least 2 inches deep in adults and children and 1.5 inches deep in infants. The compression-first routine eliminates time wasted opening airways for breaths and makes it more likely that lay bystanders will attempt CPR in public settings.

Following a statewide educational campaign in Arizona, a five-year study of 4,415 out-of-hospital cardiac arrest cases found that compression-only CPR performed by bystanders improved patient outcomes. Compression-only CPR was apparently more appealing, with the annual rate at which bystanders attempted CPR rising from 28% in 2005 to 40% in 2009. Among those attempted rescues, the rate at which bystanders used compression-only CPR also rose, from 20% of rescue attempts in 2005 to 76% in 2009. Patients fared better, too. The rate of survival was 5.2% if no CPR was given, 7.8% when conventional CPR was performed, and 13.3% with compression-only CPR.-Carol Potera