Explaining ABC2-SPH to families without false precision
ABC/2 is a bedside estimate of how much blood is in an intracerebral hemorrhage on a scan: take the three lengths of the bleed, multiply them, divide by two. Families hear the number and think it is a verdict. It is a ruler. It helps the team talk about size quickly. It is not the whole story of the person in the bed. This page is what the letters mean, what the number does not mean, and why a second look on a later scan can change it. It is not a diagnosis and not a substitute for the team in front of you.
A, B and C are measurements in centimetres on the slice where the bleed looks largest, then on the slices that show how far it runs. Different people can measure a millimetre differently. That is why two honest numbers can disagree a little. A large jump is a conversation. A tiny one may be the ruler, not the bleed.
What to ask — and what not to decide from the number alone
Ask: is this the first scan or a later one? Is the number going up, down, or stable? What else are they watching — breathing, blood pressure, wakefulness? ABC/2 does not see those. A modest volume in a bad place can matter more than a larger one in a quieter place. The team knows that. The number on a scrap of paper does not.
- ABC/2 is size, roughly. Not a destiny score.
- Ask which scan. First and later are different conversations.
- Ask what they are watching besides the number.
- Do not compare your family’s number to a stranger on a forum. Place and person differ.
- If you do not understand the sentence, ask it again. That is not wasting time.
| You hear | It usually means | It does not mean |
|---|---|---|
| «About X ml on ABC/2» | A quick size estimate | The only thing that matters |
| «Stable on the next scan» | The ruler did not jump | Everyone can go home in an hour |
| «We are repeating the scan» | They want another look | Something is already decided against you |
The risk of the number becoming the whole room
Families latch onto millilitres because millilitres feel solid. The person is not a millilitre. Blood pressure, swallow, infection, age, medicines that thin blood — the list is longer than ABC/2. If a relative texts you «anything over N is hopeless», that sentence is not a guideline you should carry into the meeting. Carry questions. Carry the name of the person. Leave the forum number in the corridor.
What the millilitres are allowed to mean
ABC/2 is a ruler for bleed size: ask which scan, whether the number changed, and what else the team is watching. Do not let a single millilitre become the whole story in the room. The team is allowed to be clearer than a formula, and you are allowed to ask until the sentence is human — that is not wasting their time, it is using it.