Oleh :Rizki YulitrizaI1A010044

Pembimbing :dr. Mahendratama P. A, Sp. An

DefinisiCardiopulmonary resuscitation(CPR, resusitasi kardiopulmoner) adalah sebuah langkah darurat yang dapat menjaga pernapasan dan denyut jantung seseorang. CPR membantu sistem peredaran darah pasien dengan memasok oksigen melalui mulut pasien dan memberikan kompresi dada untuk membantu jantung memompa darah

Kapan tidak melakukan CPRSituations where attempts to perform CPR would place the rescuer at risk of serious injury or mortal peril

Obvious clinical signs of irreversible death (eg, rigor mortis, dependent lividity, decapitation, transection, or decomposition)

A valid, signed, and dated advance directive indicating that resuscitation is not desired, or a valid, signed, and dated DNAR order

Kapan berhenti ?Restoration of effective, spontaneous circulation

Care is transferred to a team providing advanced life support

The rescuer is unable to continue because of exhaustion, the presence of dangerous environmental hazards, or because continuation of the resuscitative efforts places others in jeopardy

Reliable and valid criteria indicating irreversible death are met, criteria of obvious death are identified, or criteria for termination of resuscitation are met.

Chain of survivalPengenalan cardiac arrest dan aktivasi sistem respon emergensiCPR dini yg menekankan kompresi dadaDefibrilasi cepat jika ada indikasiAdvance life support yang efektifPerawatan post-cardiac arrest yang terintegrasi

Pengenalan arrestMelihat kolaps mendadak atau pada kondisi kritis Panggil dan tepukAwam bila tidak respon aktifkan sistem emergensi tenaga medis tidak respon tidak bernafas atau nafas abnormal asumsi cardiac arrest aktifkan sistem emergensi pemeriksaan nadi tidak ditekankan sukar

ERC 2010

ERC 2010

Kompresi dadaLetakkan korban pd posisi datar dan kerasTelentang & penolong berlutut disamping dada Satu pergelangan tangan penolong dipertengahan dada korban dan pergelangan satunya diatas pergelangan tangan yg pertamaSternum ditekan 2 inchi (5cm)Biarkan rekoil secara penuh, baru ditekan kembaliRate 80x/mnt ROSC120x/mnt meningkatkan tingkat survival minimal > 100x/mnt

ERC 2010

ERC 2010

ERC 2010

Bisa dilakukan oleh 1 penolong namun dianjurkan lebih dari 2 penolong sehingga dapat memberikan rasio kompresi : ventilasi = 30 : 2 selama 5 siklus (2 menit)Hindari interupsi, bila interupsi batasi maksimal

Airway & breathingPasien tanpa trauma servikal headtilt & chinlift

Pasien dengan trauma servikal jawtrust tanpa ekstensi kepala

ERC 2010

ERC 2010

Nafas buatan diberikan 1 detikVolume tidal cukup dada terlihat terangkatVolume tidal normal 8-10 cc/kg 6-7 cc/kg

ERC 2010

ERC 2010

ERC 2010

ERC 2010

ERC 2010

Bradycardia Algorithm.Neumar R W et al. Circulation. 2010;122:S729-S767Copyright American Heart Association, Inc. All rights reserved.

Tachycardia Algorithm.Neumar R W et al. Circulation. 2010;122:S729-S767Copyright American Heart Association, Inc. All rights reserved.

Nafas buatan mouth to mouth mouth to barrier mouth to nose or to stoma bag mask ventilation LMA Jalan nafas bantu (endotracheal tube)

ERC 2010

ERC 2010

Jangan dipakai jika reflex muntah masih (+)(Derajat A dan V dari AVPU atau GCS > 10)

ERC 2010

Tidak merangsang muntahHati-hati pada pasien dengan fraktura basis craniiUkuran u/ dewasa 7 mm atau jari kelingking kanan

ERC 2010

Maternal cardiac arrest algorithm.Vanden Hoek T L et al. Circulation. 2010;122:S829-S861Copyright American Heart Association, Inc. All rights reserved.

Pediatric BLS Algorithm.Berg M D et al. Circulation. 2010;122:S862-S875Copyright American Heart Association, Inc. All rights reserved.

Pediatric BLS Algorithm.Berg M D et al. Circulation. 2010;122:S862-S875Copyright American Heart Association, Inc. All rights reserved.

PALS Pulseless Arrest Algorithm.Kleinman M E et al. Circulation. 2010;122:S876-S908Copyright American Heart Association, Inc. All rights reserved.

RecommendationsComponentAdultsChildrenInfantsRecognitionUnresponsive (for all ages)No breathing, not breathing normally (eg, only gasping)No breathing or only gaspingNo pulse palpated within 10 seconds (HCP Only)CPR SequenceCABCABCABCompression RateAt least 100/minCompression DepthAt least 2 inches (5 cm)At least 1/3 AP Depth About 2 inches (5 cm)At least 1/3 AP Depth About 1 inches (4 cm)Chest Wall RecoilAllow Complete Recoil Between Compressions HCPs Rotate Compressors Every 2 minutesCompression InterruptionsMinimize Interruptions in Chest Compressions Attempt to limit interruptions to less than 10 seconds

RecommendationsAirwayHead tilt-chin lift (HCP suspected trauma: jaw thrust)Compression to Ventilation Ratio (until advanced airway placed)30:2 (1 or 2 rescuers)30:2 Single Rescuer 15:2 2 HCP Rescuers30:2 Single Rescuer 15:2 2 HCP RescuersVentilations: When rescuer Untrained or Trained and Not ProficientCompressions OnlyVentilations with advanced airway (HCP)1 breath every 68 seconds (810 breaths/min) Asynchronous with chest compressions About 1 second per breath Visible Chest RiseDefibrillationAttach and use AED as soon as available. Minimize interruptions in chest compressions before and after shock, resume CPR beginning with compressions immediately after each shock

Bradycardia Algorithm.Tachycardia Algorithm.Maternal cardiac arrest algorithm.Pediatric BLS Algorithm.Pediatric BLS Algorithm.PALS Pulseless Arrest Algorithm.