How the CAB sequence—Compression, Airway, Breathing—guides cardiac arrest care

What does the acronym "CAB" stand for in cardiac arrest management?

• A. Cardiac, Airway, Breathing
• B. Compression, Airway, Breathing
• C. Compression, Assessment, Breathing
• D. Cardiac, Assessment, Bystander

Answer: (B)

In the context of cardiac arrest management, the acronym "CAB" stands for Compression, Airway, Breathing. This sequence is crucial in the resuscitation process. Compression refers to chest compressions, which are vital for maintaining blood flow to the heart and brain during cardiac arrest. High-quality compressions are essential as they help to artificially circulate blood and deliver oxygen to vital organs. Next is Airway, which involves ensuring that the airway is open. This step is critical to provide adequate ventilation and oxygenation, especially when mouth-to-mouth rescue breaths are utilized or when using an advanced airway in more advanced life support situations. Breathing follows, involving the delivery of rescue breaths or ventilation. This step is important to ensure that the patient is receiving oxygen, especially given that cardiac arrest often leads to a lack of oxygen in the bloodstream. By following this sequence—starting with compressions to immediately restore circulation, then ensuring the airway is clear, followed by providing breaths if necessary—healthcare providers maximize the chances of survival for a patient in cardiac arrest.

Outline: A clear path to understanding CAB in cardiac arrest

• Opening: Cardiac arrest is a high-stakes moment; the right sequence can save lives.

• Section 1: What CAB stands for and why the order matters

• Section 2: Compression — the heartbeat of resuscitation

• Section 3: Airway — keeping the doorway open for breath to reach the lungs

• Section 4: Breathing — delivering the oxygen that tissues crave

• Section 5: Bringing CAB together on scene (AEDs, teamwork, flow)

• Section 6: Common missteps and quick tips for EMTs

• Section 7: Why this sequence matters in professional practice and ongoing learning

• Closing: A simple framework that makes a tough moment a little less overwhelming

Article: CAB in cardiac arrest management — a practical, human guide for EMTs and learners

Let’s break down a moment that’s equal parts frantic and precise: a person in cardiac arrest. It’s one of those scenarios where every second counts, and the steps we take are a path through the chaos. The simple, unforgettable trio is CAB: Compression, Airway, Breathing. That order isn’t random. It’s designed to restore circulation first, then make sure oxygen gets where it needs to go. Think of it as rebooting a stalled system—you restart the heart’s pump, then clear the way for air, then top up with breaths.

Compression: the heartbeat that keeps the brain alive

When a crowd gathers around a patient in arrest, the first instinct is often to check the pulse, call for help, or look for an AED. But the moment those rushes settle, the core action is chest compressions. Why compress first? Because the brain and heart can start to falter within minutes without blood flow. Compressions create a conduit for blood to circulate, delivering a trickle of oxygen to vital organs while you resume the rhythm.

Here’s the practical side you’ll see in the field:

• Rate and depth: aim for about 100 to 120 compressions per minute and a depth of roughly 2 inches (5 centimeters) for adults. It sounds mechanical, but consistency matters more than perfection.

• Full recoil: let the chest rise completely between compressions. It’s tempting to rush, but each full recoil helps blood return to the heart.

• Minimal interruptions: every pause means fewer chances for the brain to get oxygen. If you’re switching rescuers, do it smoothly—switch every two minutes or sooner if fatigue kicks in.

• Hard surface: perform compressions on a firm surface; soft beds or gurneys blunt the force you can deliver.

• Hands placement: the heel of one hand in the center of the chest, with interlaced fingers off to the side. If two rescuers are present, one can do compressions while the other prepares the AED or checks for a pulse.

Airway: opening the doorway for air to reach the lungs

Once the chest is pumping again (or during continuous compressions in some protocols), airway management becomes the next crucial step. An open airway makes it possible for rescue breaths to do their job or for a bag-valve mask to deliver breaths efficiently.

Key points you’ll notice in practice:

• Head position: for a non-traumatic arrest, tilt the head back slightly and lift the chin to open the airway. In trauma or potential spinal injury, use a jaw-thrust maneuver instead.

• Clear the way: suction if there’s clear drainage or vomit that could block the airway. A blocked airway undermines everything you’re trying to achieve with breaths and compression.

• Airway adjuncts: in many EMS settings, rescuers use airway adjuncts or advanced devices. The goal is a patent airway that’s ready to receive breaths or a bag-valve mask, not just an open throat.

• Mouth-to-mouth vs. bag-valve: in the field, you’ll often start with rescue breaths using a bag-valve mask when you have a partner. The airway step helps ensure those breaths actually reach the lungs.

Breathing: oxygen delivery that completes the trio

Breathing in this context isn’t just about puffing air into the lungs; it’s about delivering enough oxygen to sustain tissue viability until the heart can resume pumping effectively.

Real-world breathing considerations:

• Rescue breaths: during CPR for adults, breaths are delivered at a steady rhythm—roughly one breath every five to six seconds when rescuer fatigue isn’t a factor. If two rescuers are present, you can coordinate cycles to keep a steady cadence.

• Ventilation strategy: in some EMS systems, after a rhythm check and chest compressions are established, a bag-valve mask connected to oxygen becomes the primary source of breaths. In others, advanced airways change the breath dynamics, but the principle remains the same: oxygen delivery follows a clear airway.

• Oxygen concentration: you’re aiming to optimize oxygen delivery without causing unnecessary gastric inflation. It’s a balancing act—provide enough oxygen, but avoid pushing air into the stomach.

Putting CAB into action on the scene

CAB is a practical framework you can apply right away, even before you know the exact cause of arrest. It pairs naturally with AED use and team coordination:

• AED integration: as soon as an automated external defibrillator arrives, follow its prompts. Early defibrillation is a critical companion to the CAB sequence. If the device analyzes a shockable rhythm, deliver the shock as advised, then resume compressions immediately.

• Teamwork: the rhythm of the team matters as much as the rhythm of the chest. Use clear, simple commands, switch roles smoothly, and keep the tempo steady.

• Monitoring and relief: while compressions continue, monitor the patient’s response, check for signs of life, and ensure airway and breathing steps remain uninterrupted. If a pulse returns, shift to rescue breathing and ventilations accordingly, always aligned with the latest guidelines.

Common pitfalls and how to avoid them

Even seasoned responders stumble from time to time. Here are a few frequent missteps and simple fixes:

• Stopping too long between cycles: try to limit pauses to under 10 seconds for rhythm analysis and device checks. If you’re alone, perform compressions for about two minutes before taking a quick breath if absolutely necessary.

• Leaning on the chest: you might feel the urge to rest on the chest between pushes, but that reduces blood flow. Maintain good posture and let the chest recoil fully.

• Poor airway management under stress: in a noisy, crowded scene, it’s easy to overlook airway patency. Reassess the head position and suction when you pause.

• Inconsistent breaths: if you’re delivering breaths with too much force or too little, you’re either overinflating or starving tissues of air. A steady, measured breath is better than a powerful, irregular puff.

CAB in the broader EMS landscape

CAB isn’t just a neat acronym; it’s a baseline skill set that underpins national standards of care for cardiac emergencies. EMTs are trained to think in these three steps first, then layer in the rest: defibrillation when indicated, airway optimization, medication administration where appropriate, and rapid transport. The framework helps teams stay aligned, even in chaotic moments.

A few practical habits for ongoing learning and excellence:

• Practice with purpose: drills that focus on keeping a high-quality chest compression rate and minimizing interruptions make a real difference.

• Stay mindful of your own cadence: your beat becomes the patient’s rhythm. If you’re tired, switch out before fatigue drags the quality down.

• Align with updated guidelines: resuscitation science evolves. Keep your knowledge current so the CAB sequence remains effective in real-world cases.

• Reflect after events: a quick debrief helps you notice small improvements—like faster airway checks or smoother rescuer switches—that add up over time.

A note on the human element

Behind every CPR badge, there’s a person—someone’s parent, partner, neighbor. The CAB sequence is not just a set of steps; it’s a commitment to preserving life in the most intense moments. When you’re in the field, it’s easy to feel helpless or overwhelmed. The truth is you’re not alone. You are part of a network of EMTs, paramedics, nurses, and physicians who share a common goal: give the patient every possible chance to come back from a crisis.

What this means for learners and professionals alike

If you’re studying to become an EMT or simply curious about how cardiac arrest is managed, the CAB framework is your first compass. It guides you through the immediate actions you’ll take in the field and sets the stage for more advanced interventions if needed. Mastering compression quality, airway patency, and effective breathing creates a solid foundation upon which you can build more nuanced skills—like rapid airway devices, medication protocols, and post-resuscitation care.

Let me explain why this matters in everyday EMS life. You’ll arrive at a scene that’s tense, perhaps chaotic. By anchoring your response to CAB, you create a predictable, tangible path. That predictability reduces the cognitive load—your brain can focus on the patient’s evolving needs instead of scrambling for the next move. And when the patient regains a pulse, or when you transition care to the hospital team, you’re carrying forward a consistent, evidence-informed approach.

If you’re asked to name the sequence in cardiac arrest management, you’ll be ready with a concise answer: Compression, Airway, Breathing. It’s not just a memory trick; it’s a practical blueprint that helps you act quickly, calmly, and effectively when it matters most.

Bottom line: keep the cadence, protect the airway, and breathe life back where it belongs

CAB is the backbone of cardiac arrest care. It’s simple in theory, powerful in practice. For EMTs and others who stand between crisis and potential recovery, it’s a reliable partner in the field—one that you can trust even when the room is buzzing with urgency. Stay sharp on compressions, ensure the airway is open, and deliver breaths with purpose. Those moves turn a terrifying moment into a life-affirming chance for a patient to turn the corner. And that’s the work that makes a real difference.