AKADEMI LATIHAN PERTAHANAN AWAM

JABATAN PERTAHANAN AWAM MALAYSIA

Disediakan Oleh:- Pogram Pengurusan Paramedik

Akademi Latihan Pertahanan Awam
Lot 14617, Persiaran Institusi Bangi, 43000 Kajang, Selangor
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 Objektif  CPR (seorang

 Pengenalan CPR penyelamat)
 Sejarah CPR  Protokol CPR
 Jadual CPR
 Anatomi Jantung mengikut kategori
 Peringkat Kematian mangsa
 Konsep kitar  Komplikasi CPR
mandiri (chain of  Kegagalan CPR
survival)  Rumusan
 Definisi CPR
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Pada akhir sesi, peserta akan dapat:-

 Menyenaraikan peringkat-peringkat kematian.

 Menyenaraikan langkah asas CPR
 Melakukan rawatan CPR dengan betul
berdasarkan teknik yang terkini

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1740 The Paris Academy of Sciences officially recommended mouth-to-

mouth resuscitation for drowning victims.
1767 The Society for the Recovery of Drowned Persons became the
first organized effort to deal with sudden and unexpected death.
1891 Dr. Friedrich Maass performed the first equivocally documented chest
compression in humans.
1903 Dr. George Crile reported the first successful use of external chest
compressions in human resuscitation.
1904 The first American case of closed-chest cardiac massage was
performed by Dr. George Crile.

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1954 James Elam was the first to prove that expired air was sufficient to maintain
adequate oxygenation.
1956 Peter Safar and James Elam invented mouth-to-mouth resuscitation.
1957 The United States military adopted the mouth-to-mouth resuscitation
method to revive unresponsive victims.
1960 Cardiopulmonary resuscitation (CPR) was developed. The American Heart
Association started a program to acquaint physicians with close-chest
cardiac resuscitation and became the forerunner of CPR training for the
general public.
1963 Cardiologist Leonard Scherlis started the American Heart Association's CPR
Committee, and the same year, the American Heart Association formally
endorsed CPR.

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1966 The National Research Council of the National Academy of

Sciences convened an ad hoc conference on cardiopulmonary
resuscitation. The conference was the direct result of requests
from the American National Red Cross and other agencies to
establish standardized training and performance standards for
CPR.
1972 Leonard Cobb held the world's first mass citizen training in CPR in
Seattle, Washington called Medic 2. He helped train over 100,000
people the first two years of the programs.
1973 Second National Conference on CPR and ECC.
1979 Advanced Cardiovascular Life Support (ACLS) is developed
after discussions held at the Third National Conference on CPR.

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1981 A program to provide telephone instructions in CPR began in King

County, Washington. The program used emergency dispatchers to
give instant directions while the fire department and EMT personnel
were en route to the scene. Dispatcher-assisted CPR is now standard
care for dispatcher centers throughout the United States.

1983 AHA convened a national conference on pediatric resuscitation to

develop CPR and ECC Guidelines for pediatric and neonatal patients.

1985 Fourth National Conference on CPR and ECC.

1988 AHA introduces first pediatric courses, pediatric BLS, pediatric ALS
and neonatal resuscitation, cosponsored with The American Academy
of Pediatrics (AAP).

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1990s Early Public Access Defibrillation (PAD) programs are developed with
the goal in mind to provide training and resources to the public so they
are able to aid in the successful resuscitation of sudden cardiac arrest
victims

Feb
1992 Fifth National Conference on CPR and ECC.

1992 International Committee on Resuscitation (ILCOR) founded

1999 First task force on first aid was appointed First International
Conference on Guidelines for CPR and ECC

2004 AHA and ILCOR releases a statement regarding the use of AEDs on
children. It is determined that an AED may be used for children 1 to 8
years of age who have no signs of circulation.
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2005 AHA developed the Family & Friends® CPR Anytime® kit, a revolutionary
product that allows anyone to learn the core skills of CPR in just 20 minutes.
The kit contains everything needed to learn basic CPR, AED skills and choking
relief anywhere, from the comfort of your home to a large group setting

2005 The 2005 International Consensus on ECC and CPR Science with Treatment
Recommendations (CoSTR) Conference produces the 2005 American Heart
Association Guidelines for CPR & ECC. These Guidelines reveal a new
compression:ventilation ratio as well as changes to AED usage.

2008 The AHA releases a statement about Hands-Only™ CPR, saying that
bystanders who witness the sudden collapse of an adult should dial 911 and
provide high-quality chest compressions by pushing hard and fast in the middle
of the victim’s chest.

2010 The 2010 International Consensus on ECC and CPR Science with Treatment
Recommendations (CoSTR) Conference produces the 2010 American Heart
Association Guidelines for CPR & ECC; 50th Anniversary of CPR
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organ yang berotot pejal

Mempunyai empat ruang
menyamai saiz penumbuk individu berkenaan.
Terletak dalam bahagian dada, diantara dua
paru-paru, dan dibawah tulang rusuk kiri.

Fungsi utama jantung adalah untuk mengepam

darah yang beroksigen ke seluruh bahagian
tubuh. Tugas ini dilakukan dengan menguncup
sebanyak 60 hingga 90 kali bagi setiap minit.
dengan setiap penguncupan ruang jantung akan
mengepam darah samada ke venrikel atau salur
darah arteri. dalam masa 24 jam jantung anda
berdenyut lebih daripada 100,000 kali, 7,000 liter
darah dipam melalui jarak beribu batu di dalam
sistem saluran darah. 10
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CLINICAL DEATH (KEMATIAN KLINIKAL)

Terhenti pernafasan dan denyutan jantung seketika.

( Dalam masa 0-4 minit, harapan pulih 25-30%)

BIOLOGICAL DEATH (KEMATIAN BIOLOGI)

Kematian sebenar berikut kekurangan oksigen ke otak dan sel-sel

otak mati dan mangsa akan mengalami proses kematian
sebenarnya.
( Selepas 4 minit, harapan pulih 5-10%)

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Kematian
Kematian Biological
Klinikal 5~6 minit
0~4 minit

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MINIT

0 * JANTUNG & PARU-PARU GAGAL BERFUNGSI

1 * SEL-SEL OTAK MENGGUNAKAN SAKI-BAKI OKSIGEN YANG ADA

4 * KEMATIAN KLINIKAL / TIADA LAGI SAKI-BAGI OKSIGEN

5 * SEL-SEL OTAK MULAI MATI

8 (BERIKAN BANTUAN AED DALAM MASA 10 MINIT)

10 * SEMUA SEL-SEL OTAK TELAH MATI

11 * KEMATIAN BIOLOGIKAL
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1. Early 3. Early 5. Post Cardiac

Access Defibrillation Care

2. Early 4. Early
CPR ACLS

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1. Prevention 3. Activated 5. Post Cardiac

of arrest EMS Care

2. Early 4. Early
CPR ACLS

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Satu tindakan bantuan awalan bagi

memulihkan mangsa yang terhenti
pernafasan dengan menggunakan
teknik tekanan di atas dada
(tekanan dari luar)
dan bantuan hembusan pernafasan

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Penilaian dan keselamatan

Penyelamat pertama yang tiba di

tempat kejadian perlulah memastikan
dengan segera bahawa diri, tempat
kejadian dan mangsa bebas dari
bahaya.

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Penilaian Tahap Kesedaran Mangsa

Tepuk bahu mangsa dan soal

mangsa, cth:- “Sir, are you all right”.
Periksa tahap kesedaran mangsa.
Jika mangsa tiada respon, aktifkan
EMS dan minta AED.

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Airway (Membuka saluran

pernafasan mangsa)

Buka saluran pernafasan

mangsa dengan kaedah head
tilt chin lift atau Jaw
Thrust(spinal injury) dan
periksa pernafasan mangsa.
Jika mangsa tidak bernafas,
mulakan CPR.

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Compression(Memberi tekanan di
atas dada mangsa)

Tekan di bahagian tengah

dada mangsa sebanyak 30
kali.

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2 inchi

CENTER
OF
CHEST

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Memberi 2 hembusan pernafasan

Picit hidung mangsa semasa

hembusan diberikan.

Hembus 1 saat bagi setiap

hembusan

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30 TEKANAN : 2 HEMBUSAN
(1 KITARAN)
LENGKAPKAN 5 KITARAN
5 KITARAN = 1 PUSINGAN LENGKAP
SELEPAS 1 PUSINGAN LENGKAP
PERIKSA NADI KAROTID MANGSA
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Pasangkan alat AED dan

berikan kejutan sekiranya
perlu

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1) Baringkan mangsa
dengan selesa jika perlu.
Jika tiada
2) Lindungi mangsa ditempat kecederaan &
yang selamat dan teduh. mangsa
3) Selimutkan mangsa untuk bernafas
kekalkan suhu atau haba dengan baik
panas badan. 27
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DEWASA KANAK- BAYI

KANAK

1 RATIO 30T : 2H 30T : 2H 30T : 2H

KITARAN 5 kitaran 5 kitaran 5 kitaran

1 Pusingan 1 Pusingan 1 Pusingan
TEKANAN & 150T : 10H 150T : 10H 150T : 10H
HEMBUSAN

KEDALAMAN 2 – 2.4 inci 2 inci 1.5 inci

KAEDAH 2 tangan 1 tangan 2 jari

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Unresponsive
No breathing or no normal
breathing

Activate Get
Emergency difibrillator
response

Start CPR
SH

Check rhythm/
Shock if indicated

Repeat every 2 minutes

S
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Unresponsive
No breathing or no normal
breathing

Lone Rescuer: For sudden

collapse, activate emergency
response system,
Get AED/defibrillator

Definite Pulse
•Give 1 breath every 3
Check pulse:
seconds
DEFINITE pulse withn 10
•Add compressions if
seconds?
pulse remain <60/min with
No Pulse poor perfusion despite
adequate oxygenation and
One rescuer: Begin cycles of 30 Compressions and 2 breath ventilation.
Two rescuer: Begin cycles of 15 Compressions and 2 breath •Recheck pulse every 2
minutes

After about 2 minutes, activate emergency response system and get

AED/defibrillator (if not already done). Use AED as soon as available

Check rhythm/
Shockable Shock if indicated Not Shockable
Resume CPR immediately
Give 1 shock For 2 minutes
Resume CPR immediately Check rhythm every 2 minutes;
for 2 minutes 30
continue until ALS providers take
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• Kemungkinan akan berlaku kecederaan pada

tulang rusuk (berlaku kepatahan)

• Kecederaan serius akan berlaku pada bahagian

dalaman terutamanya pada kawasan dada (paru-
paru, limpa) sekiranya tulang rusuk patah
(pendarahan akibat tikaman tulang yang patah)

• Berlaku pendarahan dalaman (internal bleeding)

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• Saluran pernafasan tidak dibuka dengan sempurna

(dongakkan kepala yang tidak betul)
• Hidung tidak dipicit semasa hembusan dilakukan
• Mangsa tidak dibaringkan ditempat yang stabil dan
keras
• Kedudukan tangan penyelamat tidak tepat semasa
tekanan dilakukan
• Kadar tekanan ke atas dada terlalu cepat atau
terlalu lambat
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• Bantuan tiba

• Penyelamat penat

• Mangsa menunjukkan sense of life

• Sudah terlampau lama

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• Pemilik gelang/rantai D.N.A.R

• Mangsa yang kaku/kejang

• Mangsa yang telah lama mati

• Terputus/terkeluar organ penting

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Memberi bantuan CPR dengan secepat mungkin dapat

memberi peluang untuk mangsa terus hidup.

Kelajuan tekanan 100 - 120/minit

Tekanan kedalaman berdasarkan kategori mangsa
Membenarkan penganjalan sempurna setiap tekanan
Meminimakan gangguan
Hembusan yang tidak berlebihan
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