Ventilation during cardiopulmonary resuscitation: the right tool for the job.

For the moment, the ABCs of cardiopulmonary resuscitation (CPR) remain in place: Airway, Breathing, and Circulation, and, now, Defibrillation, are the alphabet of CPR. At issue is the relative importance of each. In a recent editorial, Berg eloquently reviewed the questions surrounding the importance of breathing during CPR.1 In a nutshell, the role of ventilation during CPR depends on the cause of cardiac arrest. When arrest is secondary to asphyxia, breathing is essential for successful CPR.2 In cases of ventricular fibrillation, defibrillation jumps to the head of the alphabet and breathing is less important.3 When breathing is performed too vigorously during CPR, this causes a low-flow state and outcomes may be adversely affected.4 The discussion by Berg is excellent, and I refer readers to his paper for details.