BHJD DAN BHJL

Syukran

BHJD

Tujuan : Membantu atau mengembalikan oksigenisasi, ventilasi dan sirkulasi yg efektif hingga kembalinya sirkulasi spontan atau intervensi BHJL dapat dilakukan

Universal Algorithm CPR 2010

NEW SEQUENCE FOR 2010

Chest compressions, Airway, Breathing (CAB) is the new order of operations from American Heart Association. This applies for adults, pediatrics and infants, excluding newborns. Newborn arrest are most likely respiratory and should use the ABC sequence. Adult Chain of Survival.

Call for help

Chest Compressi on

Defibrillatio n

Advanced Life Support

PostCardiac arrest Care

RATIONALE OF CHANGES 2010

A large number of witnessed cardiac arrest are patients going into a ventricular fibrillation, or pulseless ventricular tachycardia. Early chest compressions and defibrillation are key components to the patients survival. The CAB method allows the responder to save time, and provide blood flow to the heart muscle quickly. A lay person is more likely to give CPR if chest compressions are the priority.

Rescuer Proficiency

BLS Adult Algorithm

Algoritma nakes 2010

BASIC LIFE SUPPORT

Hands-Only (Compressions only) CPR for the untrained lay person. Can be guided by dispatcher on the phone. Start chest compression before opening the airway. CAB. Allowing the chest to recoil between compressions with a depth of 2 inches. Rate of 100/min.

CARDIOPULMONARY RESUSCITATION AND EMERGENCY CARDIOVASCULAR CARE

Any unnecessary interruptions in chest compressions, decreases the effectiveness of the CPR. CPR should be continued until return of spontaneous circulation (ROSC) or termination of resuscitative efforts. Healthcare providers should take no longer than a 10 second pulse check to determine if pulses are present. Chest compression and rescue breathing at a rate of 30:2.

ROLE OF THE LAY PERSON RESCUER

Initial recognition of the victim is imperative to quick treatment. A patient having a cardiac arrest may have gasping respirations or even have seizure like activity. The rescuer should learn through training these are atypical presentations of a cardiac arrest and alert responders to these findings. Lay persons should call EMS when finding unconscious victim and should not attempt to check for a pulse. The lay person should assume that the victim is in a cardiac arrest; 1. suddenly collapses, 2. person is unresponsive, and 3. not breathing normally or not at all.

CPR DEVICES AND TECHNIQUES

No device other than the defibrillator has proven to have long-term survival from in the field cardiac arrest. Electrical Therapies-Pacing in bradycardia, cardioversion and defibrillation for symptomatic tachycardia are all proven methods to help the chain of survival. No precordial thump. CPR prior to defibrillation improves outcomes in cardiac arrest.

JANGAN MENJADI KORBAN BERIKUTNYA !

Lingkungan Penolong Korban Orang2 disekitar

Pastikan keamanan

Periksa kesadaran
Panggil bantuan / telpon ambulans Kompresi jantung + nafas buatan (30 : 2) Evaluasi setiap 2 menit, cek nafas &sirkulasi Jangan hentikan 30:2 sampai ada indikasi stop BHD

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KOMPRESI DADA
Departemen Anestesiologi RSUP Fatmawati

Letakkan pangkal telapak tangan di pertengahan bawah tulang dada Letakkan tangan yang lain diatas punggung tangan yang satunya Jari-jari boleh dikepal atau dibuka Kompresi dada
Laju kompresi 100x per menit Kedalaman 4-5 cm Kompresi konstan diselingi relaksasi

Jika mungkin, bergantian kompresi setiap 2 menit

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Departemen Anestesiologi RSUP Fatmawati

30 2
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LANJUTKAN BHD

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EVALUASI
Periksa apakah ada tanda-tanda sirkulasi: Bergerak

Bernafas
Batuk dll

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RJP DIHENTIKAN BILA:

Penolong

sudah memberikan pertolongan secara penuh yaitu meliputi BHJD dan BHJL Penolong sudah mempertimbangkan apakah pada pasien terdapat hipotermia Penolong sudah mempertimbangkan apakah pasien terpapar bahan beracun atau overdosis obat yg akan menghambat sistem saraf pusat. Adanya asistol yg lebih dari 10 menit Interval waktu usaha resusitasi pada henti jantung disaksikan yg tdk dpt mengembalikan sirkulasi spontan adalah 25-30 menit.

RJP TIDAK DILAKUKAN BILA:

Kejadian henti jantung yg disaksikan

Permintaan keluarga Usaha RJP membahayakan penolong Kemungkinan RJP dapat mengembalikan sirkulasi spontan dgn kualitas hidup yg dpt diterima sangat kecil Henti jantung setelah usahan terapi yg maksimal untuk proses penyakit terminal

RJP TIDAK DILAKUKAN BILA:

Kejadian henti jantung tidak disaksikan

Ada tanda kematian Sudah ada tanda-tanda pembusukan Penderita mengalami trauma yg tdk bisa diselamatkan seperti hangus terbakar.

JIKA KORBAN MULAI BERNAFAS NORMAL LAGI, TEMPATKAN DALAM POSISI RECOVERY

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REMEMBER!!!
Push

hard, push fast, full chest recoil, minimize interruptions in CPR!