What C.A.B. CPR Means and Why It Replaced A.B.C.
C.A.B. CPR stands for Compressions, Airway, Breathing. It is the sequence recommended for adult and adolescent out-of-hospital cardiac arrest by major resuscitation guidelines. The change from A.B.C. to C.A.B. emphasizes early chest compressions to maintain blood flow to the brain and heart while minimizing interruptions. This evergreen explainer describes when to use C.A.B., how to perform each step, and how an AED fits into the process.
When to Start C.A.B. CPR
Use C.A.B. CPR when you find an unresponsive person who is not breathing normally or only gasping, and you believe the cause is cardiac arrest. Call emergency services (or ask someone else to call) and get an AED if one is available before you begin. Early compressions help circulate oxygenated blood to vital organs and improve survival chances.
How to Perform Chest Compressions (C)
Position your hands on the center of the chest, between the nipples. Compress at least 2 inches (5 cm) deep for adults at a rate of 100 to 120 compressions per minute. Allow full chest recoil between compressions and minimize interruptions. High-quality compressions are the most critical action in the first minutes of cardiac arrest.
Opening the Airway (A)
After 30 compressions, open the airway using a head-tilt, chin-lift maneuver if there is no suspected spinal injury. Look for mouth obstruction and clear visible objects if safe to do so. A clear airway prepares the person to receive rescue breaths and improves the effectiveness of each ventilation.
Giving Rescue Breaths (B)
Seal the person’s nose, provide a steady breath into the mouth until you see chest rise, then deliver a second breath. If you are unable or unwilling to give breaths, perform continuous compressions-only CPR. Use an AED as soon as it arrives to analyze rhythm and deliver shocks if advised.
How AEDs Integrate With C.A.B. CPR
An AED is a portable device that analyzes heart rhythm and can deliver a shock when appropriate. Turn it on as soon as possible; its voice prompts will guide you through CPR and pad placement. Continue CPR until the AED instructs you to stop for analysis, and follow its guidance after each shock or if no shock is advised.
Quick Reference Table: Core C.A.B. Steps and Guidance
| Step | Action | Key Detail | Source Type |
|---|---|---|---|
| Check responsiveness | Tap and shout | Determine if the person is unresponsive and not breathing normally | Guideline consensus |
| Call and get AED | Call emergency services; retrieve AED | Call first if alone with an adult; send someone to call if others are present | Guideline consensus |
| Chest compressions (C) | 100–120/min, 2–2.4 inches deep | Minimize pauses; full recoil improves blood flow | Guideline consensus |
| Airway (A) | Head-tilt, chin-lift | Avoid if spinal injury is suspected; use jaw-thrust alternative | Guideline consensus |
| Breaths (B) | Each breath over 1 second, watch for chest rise | 2 breaths after 30 compressions; compression-only is an option | Guideline consensus |
| AED use | Turn on, follow prompts, attach pads | Pause CPR only when AED advises shock; resume immediately after | Guideline consensus |
Compression-Only CPR as an Alternative
If you are untrained, unwilling, or unable to provide rescue breaths, perform hands-only CPR: continuous chest compressions at 100 to 120 per minute without pauses for breaths. Multiple studies show compression-only CPR can be as effective as conventional CPR for witnessed adult cardiac arrests when performed quickly and effectively until an AED or trained help arrives.
Special Considerations and Limitations
C.A.B. CPR is not suitable for every situation. For newborns and infants, the sequence may differ, and trained providers may use a modified approach with two rescuers. Ongoing bleeding, traumatic injuries, or signs of reversible causes require coordinated care by emergency medical services. Early defibrillation with an AED is strongly encouraged whenever possible.
Key Takeaways
- C.A.B. stands for Compressions, Airway, Breathing and is the standard sequence for adult out-of-hospital cardiac arrest.
- Start with high-quality chest compressions at 100–120 per minute, minimize interruptions, and use an AED as soon as available.
- Compressions-only (hands-only) CPR is a valid option for untrained bystanders for witnessed adult cardiac arrest.
- AEDs integrate with CPR by guiding you through steps and delivering shocks when clinically indicated.
- Call emergency services early; if alone with an adult, call before starting CPR unless the collapse is clearly due to choking.
Summary
C.A.B. CPR focuses on early, high-quality chest compressions followed by airway management and rescue breathing, with AED integration as soon as possible. By understanding when and how to act, bystanders can significantly improve survival and neurological outcomes after out-of-hospital cardiac arrest. These principles are consistent with current international guidelines and intended for general informational purposes only.