x-ABC versus ABC: shifting paradigms in early trauma resuscitation

Exsanguinating hemorrhage is the most common cause of preventable death after trauma. Since the development of cardiopulmonary resuscitation, the airway, breathing and circulation (ABCs) have been applied to early resuscitation in different contexts including trauma. The ABCs have been a pivotal paradigm in the Advanced Trauma Life Support course since its development, but recent data have indicated that prioritizing the management of eXsanguinating hemorrhage (x-ABC) improves outcomes. In this review, we examine the history and evolution of the ABCs in the context of resuscitation research to the recent adoption of x-ABC in trauma.