Table 1

Overview of the A-A-B-B-C-C-D-D-E-E's in the crashing patient.

A

Aortic Disasters

Do not rely on "typical" symptoms in aortic disasters.

- Use bedside ultrasound before administering thrombolytics.

A

Acidosis (Metabolic)

Metabolic acidosis may worsen into bradycardia, asystole, or tachydysrhythmia.

- Simulate the preintubation rate when setting the ventilation respiratory rate.

B

Bagging/Breathing

Hyperventilation may decrease survival rate.

- Ventilate at a frequency no greater than one breath every 6 to 8 seconds.

B

Baby on Board

Consider normal/ruptured ectopic pregnancy in every female of child-bearing age.

- Manage ventricular dysrhythmia, resuscitation positioning, and perimortem C-section.

C

Compressions

Limit interruptions and maintain a high rate of quality compressions.

C

Cooling (Therapeutic Hypothermia)

Use cooling in unresponsive arresting patients with ROSC.

D

Decline Position (Trendelenburg)

Avoid using the Trendelenburg position for shock.

D

Defibrillation

Use defibrillation early, if indicated.

- Use a single biphasic shock and "hands-on" defibrillation.

E

Effusion

Thrombolytics can worsen a preexisting effusion.

- Utilize bedside ultrasound and administer intravenous fluids judiciously.

E

Embolism

Right heart strain can be made worse with intravenous fluids.

- Utilize bedside ultrasound and limit intravenous fluids.

Baugher and Mattu Patient Safety in Surgery 2011 5:29   doi:10.1186/1754-9493-5-29