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Basic Life Support (Based on AHA Guidelines 2010) Jajang Sujana Mail, dr., SpAn
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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%!!!
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Latar Belakang Statistik RJP di USA : • Sistem Emergensi Medis Amerika menangani sekitar 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.
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Objective The Student should be able to; Know about Chain of Survival
Know about Basic Life Support steps Perform a CPR (cardiopulmonary resuscitation) adequately
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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
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Steps AHA Guidelines 2010 Steps AHA Guidelines 2005 1 2 3 4 5
Alertness 1 Airway 2 Breathing 3 Circulation 4 Defibrillation 5
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Simplified Adult BLS
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Alertness Make sure the scene is safe
Check for response tap the victim on the shoulder and ask, "Are you all right?"
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1. SAFETY FIRST Are the victim and bystanders safe? Needles
Dangerous traffic Slope Electric live circuit Personal safety: Gloves, glasses, gown
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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?’
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3a. IF RESPONDS Leave the person in position you found him/her unless any danger present Reassess often Find out what’s wrong
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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
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Call for Help 118 RUMAH SAKIT RSUP Hasan Sadikin: (022) , 55 (022) Instalasi Gawat Darurat / Emergency (022) , Paviliun Parahyangan (022) , Paviliun Anggrek (022) , RS Muhammadiyah : RSI Al Islam : RS Mata Cicendo ; RS Jiwa Bandung : RS Advent : RS Immanuel : RS St. Yusuf : RS St. Borromeus : RS Sartika Asih : RS Rotinsulu :
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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
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Circulation Check pulse on carotid artery (near side) not more than 10 seconds
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Circulation If there is no pulse, compress the chest (at least 100 compressions per minute) Rescuer kneeling beside the victim’s thorax
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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
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Circulation Compression-ventilation ratio of 30:2 5 cycles
Depth at least 2’in or 5 cm Complete chest recoil
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Airway Head tilt-chin lift maneuver to open the airway of a victim without evidence of head or neck trauma
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Airway Suspects a cervical spine injury, open the airway using a jaw thrust without head extension
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Breathing No more Look, listen, and feel for breathing Methods:
Mouth to Mouth Mouth to Nose
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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
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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
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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
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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
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Key BLS Components for Adult, Children, and Infants3
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Key BLS Components for Adult, Children, and Infants3
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QUESTIONS?
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HATUR NUHUN
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