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Basic Life Support (Based on AHA Guideline s 20 10) 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)
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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 menanganisekitar 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
1 2 3 4 5 Alertness Airway Breathing Circulation Defibrillation Steps AHA Guidelines 2010 Steps AHA Guidelines 2005
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 in1 second • Reassess the pulse every 2 minutes