DRSABCD is a First Aid acronym to remember the steps to revive a non breathing patient. They refer to Danger, Response, Send (for help), Airway, Breathing, CPR, Defibrillation. These resuscitation guidelines are useful for training purposes. It should be noted that during an emergency, should you forget the individual steps in DRSABCD, any actions taken to revive the patient will be better than none. This includes just compressions or even an older guideline.
[D] Danger
In all first aid scenarios you should assess the risk to your personal safety before anything. Then check the safety of the casualty and finally anyone else nearby.
[R] Response
Feel for a response from the casualty by gently touching them on the hand, cheek or shoulders. Talk to the person. For example “if you can hear me open your eyes or squeeze my hand”. Remember to be respectful. If you don’t get a response send for help.
[S] Send for help
It seems so obvious that a call for help is needed. However, often a first aider becomes so intent on the patient’s injuries that they forget to call for assistance. In some situations it may not be easy to stop treatment to request assistance once first aid has begun.
[A] Airway: Check, Clear and Open
Check inside the casualty’s mouth and see if there is anything that may cause a choking hazard or block the airway. If so, clear it out by sweeping with your hand, roll them onto their side to allow fluids to drain out. Once foreign material is removed from the airway open the patient’s airway with one hand on the patient’s forehead and the other supporting their jaw. Gently tilt their head back and open their mouth. DO NOT open the airway before checking and clearing it. Any foreign matter in the mouth would end up in the airway and potentially blocking it.
[B] Breathing: Look, Listen and Feel for Normal Breathing
In earlier guidelines we would have checked for (any) breath sounds. The problem with this is that there are sometimes abnormal breath sounds that indicate that a patient needs urgent attention. To check for normal breath sounds place a hand on the casualty’s chest and bring your ear down towards their mouth. Look to see if the patient’s chest rises and falls by watching your hand on the person’s chest. Listen for ‘normal’ breath sounds and try to feel their breath against your cheek. If they are breathing normally place them in to the recovery position. If not then commence Cardio Pulmonary Resuscitation (CPR).
[C] Start CPR
In times gone by it was recommended to give a casualty recovery breaths before starting chest compressions. Under DRSABCD we now go straight in to compressions. Place your hands on the lower part of the patient’s chest. Compressions should be to a depth of 1/3 of the depth of their chest. Use a ratio of two breaths to 30 compressions with 100 compressions per minute. Aim to deliver breaths with minimal disruptions. When breathing for the patient you should tilt the head back gently, pinch the patient’s nose and deliver the breaths. Aim to reproduce the normal rise and fall of the person’s chest.
With DRSABCD there is more emphasis on the compressions. If when you deliver the breaths you cannot get the rise and fall of the chest, go back to compressions rather than mess around airway. At the end of the cycle try to quickly correct the airway. If you can’t, the most likely causes are either poor head position or a blocked airway. If you can’t clear the airway or you are reluctant to give ‘mouth to mouth’ resuscitation stick with compressions only.
[D] Defibrillation
AED’s (Automatic External Defibrillators) are a lot safer than they once were. They can be found more often in places where people gather such as gymnasiums, airports and shopping centres. They are designed for use by average non medically trained people. They also make a significant contribution towards the chances of survival for anyone experiencing a heart attack. To use these devices simply turn them on, follow the recorded instructions and deliver a shock when told to do so.
When attaching an AED during CPR do not disrupt the delivery of CPR if possible. If there are two first aiders, one works around the other first aider to attach the AED while the first continues to provide CPR.
To wrap it up remember these key points about DRSABCD:
- Any attempt at CPR is better than none at all
- Remember the ‘S’ as in Send for help
- We now check for normal breath sounds
- Focus more on compressions than breathing the patient
- Use Automatic External Defibrillators where available.
The Resuscitation Council recommends that a CPR refresher course be done every year. But to give a casualty the best possible chances of recovery here is the complete DRSABCD protocol broken down in full detail.