Basic Life Support (Based on AHA Guidelines 2010) Jajang Sujana Mail, dr., SpAn

Introduction Latest guidelines AHA Guidelines 2010, many changes from guidelines 2005 Sudden cardiac arrest is a leading cause of death in Europe (700,000/year) Early CPR + defibrillation can produce survival as high as 49-75%!!!

Latar Belakang Statistik RJP di USA : • Sistem Emergensi Medis Amerika menangani sekitar 300.000 korban henti jantung di luar RS setiap tahun • Kurang dari 8 % bertahan hidup • Kurang dari 30% menerima RJP orang terdekat. • RJP efektif yang dilakukan orang terdekat dapat meningkatkan 2-3 x kemungkinan korban bertahan hidup.

Objective The Student should be able to; Know about Chain of Survival Know about Basic Life Support steps Perform a CPR (cardiopulmonary resuscitation) adequately

AHA ECC Adult Chain of Survival Immediate recognition of cardiac arrest and activation f the emergency response system Early CPR with an emphasis on chest compressions Rapid defibrillation Effective advance life support Integrated post-cardiac arrest care

Steps AHA Guidelines 2010 Steps AHA Guidelines 2005 1 2 3 4 5 Alertness 1 Airway 2 Breathing 3 Circulation 4 Defibrillation 5

Simplified Adult BLS

Alertness Make sure the scene is safe Check for response tap the victim on the shoulder and ask, "Are you all right?"

1. SAFETY FIRST Are the victim and bystanders safe? Needles Dangerous traffic Slope Electric live circuit Personal safety: Gloves, glasses, gown

2. CHECK VICTIM FOR RESPONSE Be in visual field of victim Gently shake or tap the victim on the shoulder Ask: ‘Are you all right?’

3a. IF RESPONDS Leave the person in position you found him/her unless any danger present Reassess often Find out what’s wrong

3b. IF NO RESPONSE SHOUT FOR HELP If no response, activate emergency system Tell about location, what happened, number and condition of victims, and type of aid provided

Call for Help 118 RUMAH SAKIT RSUP Hasan Sadikin: (022) 2034953, 55 (022) 203 7066 Instalasi Gawat Darurat / Emergency (022) 2551198, 2551191 Paviliun Parahyangan (022) 2031440, 2035986 Paviliun Anggrek (022) 2014545, 088820006011 RS Muhammadiyah : 022 730 1062 RSI Al Islam : 022 755 5588 RS Mata Cicendo ; 022 423 1280 RS Jiwa Bandung : 022 420 3651 RS Advent : 022 203 8008 RS Immanuel : 022 520 1656 RS St. Yusuf : 022 727 9860 RS St. Borromeus : 022 255 2081 RS Sartika Asih : 022 522 9544 RS Rotinsulu : 022 203 4446

Patient Position Turn the victim onto his back if not already in that position Make sure there is no obvious trauma to cervical spine Place the victim on a hard surface in supine position If an unresponsive victim is face down (prone), roll the victim to a supine position

Circulation Check pulse on carotid artery (near side) not more than 10 seconds

Circulation If there is no pulse, compress the chest (at least 100 compressions per minute) Rescuer kneeling beside the victim’s thorax

Circulation Place the heel of the hand on the sternum Place the heel of the second hand on top of the first hand Interlock fingers

Circulation Compression-ventilation ratio of 30:2 5 cycles Depth at least 2’in or 5 cm Complete chest recoil

Airway Head tilt-chin lift maneuver to open the airway of a victim without evidence of head or neck trauma

Airway Suspects a cervical spine injury, open the airway using a jaw thrust without head extension

Breathing No more Look, listen, and feel for breathing Methods: Mouth to Mouth Mouth to Nose

PREPARE AIRWAY Close the nasal airway using your index finger and thumb of your hand on the forehead Maintain chin lift Take a normal breath Make a seal with your lips

GIVE BREATHS 2x Blow for 1sec steadily (rather than 2sec) Give 1 breath every 5-6 sec Watch from the corner of your eye the chest rising Maintaining head tilt and chin lift, take your mouth away and watch the chest fall

IF NO CHEST RISING DON’T PANIC If at initial attempt no chest rise: Check victim’s mouth and remove any visible obstruction Recheck adequate head tilt and chin lift Do not try more breaths than 2 before coming back to chest compressions

Re-evaluation Re-evaluate every 5 cycles Victim with palpable pulses requires support of ventilation, give rescue breaths at a rate of 10 to 12 breaths per minute Each breath should be given in 1 second Reassess the pulse every 2 minutes

Key BLS Components for Adult, Children, and Infants3

Key BLS Components for Adult, Children, and Infants3

QUESTIONS?

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