Airway, Breathing and Resuscitation
Priorities and sequence
Airway, breathing and circulation remain the organising framework, but resuscitation is time-critical and protocol-driven. Know the current PHECC-aligned sequence for adult cardiac arrest: recognition, high-quality chest compressions, early defibrillation, airway and ventilation, and reversible-cause thinking. Understand compression quality - rate, depth, full recoil, minimal interruptions - because questions often hinge on which element is being compromised.
Concepts to master
- Basic versus advanced airway: when to insert an advanced airway, how ventilation rate changes afterwards, and the risks of hyperventilation and interruption of compressions.
- Defibrillation: shockable versus non-shockable rhythms, safe delivery, and immediate resumption of compressions.
- Airway adjuncts and suction: indications, sizing and limitations.
- Reversible causes: a structured mental checklist for why resuscitation is not succeeding.
- Paediatric and special-circumstance considerations: differences in approach that questions test explicitly.
- Post-resuscitation care: oxygenation, ventilation, monitoring and transport decisions.
Traps
Frequent traps: choosing an advanced airway before adequate basic measures; ventilating too fast or too forcefully; pausing compressions longer than necessary; and misclassifying a rhythm. Another trap is applying adult parameters to a paediatric patient, or forgetting that a non-shockable rhythm still requires high-quality compressions and reversible-cause review.
Rule of thumb
Compressions first, interruptions minimal, ventilate gently. After any advanced airway is placed, deliver continuous compressions with asynchronous ventilation at the guideline rate, and reassess rhythm only at the protocol-defined points.
Worked example
During resuscitation, the team is about to pause compressions to recheck the rhythm and place an advanced airway at the same time. The correct reasoning separates the tasks: minimise the pause, follow the protocol's rhythm-check timing, and avoid combining unnecessary interruptions. Quality of compressions and gentle ventilation are protected throughout.