bcls dr. budi

7/22/2019 BCLS Dr. Budi

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antuan Hidup Dasar


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BANTUANHIDUP

DASAR PADAORANG

DEWASA


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Pedoman AHA (American HeartAssociation) tahun 2010 untuk resusitasi

jantung paru dewasa dan ilmu pelayanankegawatdaruratan kardiovaskular


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Rekomendasi 2005 Rekomendasi BLS 2010 penjelasan

Resusitasi cardiopulmoner dengan teori

ABC (airway, breathing, CIRCULATION)

Menggunakan teori CAB (COMPRESSION,

Airway, Breathing)

Pada mayoritas henti jantungm elemen awal

CPR adalahkompresi dan defibrilasi awal,

pada CAB kompresi bisa lebih awal dan

ventilasi hanya sedikit saja tertunda sampaikomplet siklus pertama kompresi dada, pada

ABC lebih sulit prosedurnya (buka jalan

nafas dan menyelamatkan breathing)

Look, listen, and feel termasuk algoritma

bantuan hidup dasar

Look, listen, and feel dihapusdari

algoritma bantuan hidup dasar

Look, listen, and feel tidak konsisten dan

memakan waktu

Kompresi sekitar 100 kali per menit Kompresi paling sedikit 100 kali per menit

Depresi tulang dada sekitar 1,5 sampai 2

inchi (4-5 cm)

Rekomendasi baru kedalaman kompresi

tekan kebawah paling sedikit 2 inchi (5 cm)

Tidak ada perbedaan rekomendasi untuk

yang terlatih ataupun tidak

Jika penolong tidak terlatih, harus

melakukan kompresi saja. CPR untuk

korban yang tiba tiba ambruk dengan

tekanan push hard and fast tekan keras dan

cepat

Bradikardi jika kurang dari nadi 60 kali per

menit

Bradikardi jika kurang darinadi 50 kali per

menit

PERBEDAAN 2005 DENGAN 2010


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Adult Basic Life Support

What IsThe

FundamentalAspects Of

BLS ?


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Immediate recognition of suddencardiac arrest (SCA)

Activation of the emergencyresponse system

Early cardiopulmonary

resuscitation (CPR) Rapid defibrillation With an

automated external defibrillator(AED)

Initial recognition and responseto heart attack and stroke arealso considered part of BLS.


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Adult

BLSSequence


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Pulse Check

Early CPRChest compressions

Rescue Breaths Early DefibrillationWith an AED


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Pulse Check

The lay rescuer should not check for a pulse andshould assume that cardiac arrest is present if anadult suddenly collapses or an unresponsive victim isnot breathing normally.

Healthcare providers also may take too long to checkfor a pulse

The healthcare provider should take no more than10 secondsto check for a pulse and, if the rescuer

does not definitely feel a pulse within that timeperiod, the rescuer should start chest compressions .


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Early CPR Chest compressions Rescue Breaths


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Effective chest compressionsare essential for providingblood flow during CPR.

For this reason all patients in

cardiac arrest should receivechest compressions (Class I).

To provide effective chestcompressions, push hardand

push fast.


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Adult Basic Life Support Compress the adult chest

at a rate of at least 100compressions per minute(Class IIa) with a

compression depth of atleast 2 inches/5 cm (ClassIIa).

Allow complete chest

recoil after eachcompression.(Class IIa).


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Adult Basic Life Support The rescuer should place the

heel of one hand on the center(middle) of the victims chest(which is the lower half of thesternum) and the heel of the

other hand on top of the first sothat the hands are overlappedand parallel (Class IIa).

Chest compression and chestrecoil/relaxation timesapproximately equal (Class IIb).


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Minimize the frequency andduration of interruptions incompressions (Class IIa).

Once chest compressions

have been started, atrained rescuer shoulddeliver rescue breaths bymouth-to-mouth or bag-mask to provide oxygenationand ventilation.


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Adult Basic Life Support Rescuer fatigue may lead to inadequate

compression rates or depth. When 2 or more rescuers are available it is

reasonable to switch chest compressorsapproximately every 2 minutes (or after about 5

cycles of compressions and ventilations at a ratioof 30:2) to prevent decreases in the quality ofcompressions (Class IIa).

Every effort should be made to accomplish this

switch in 5 seconds.


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How can CPR be

effectivewithout rescuebreathing?


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Adult Basic Life Support1. Initially during SCA with VF, rescue breaths

are not as important as chest compressionsbecause the oxygen level in the bloodremains adequate for the first severalminutes after cardiac arrest.

2. In addition, many cardiac arrest victimsexhibit gasping or Agonal breaths, and gasexchange allows for some oxygenation andcarbon dioxide (CO2) elimination.

3. If the airway is open, passive chest recoilduring the relaxation phase of chestcompressions can also provide some airexchange.


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Adult Basic Life SupportManaging the Airway

A significant change in these guidelines is torecommend the initiation of chest compressionsbefore ventilations (CAB rather than ABC).

A healthcare provider should use the head tilt

chin lift maneuver to open the airway of a victimwith no evidence of head or neck trauma .

If healthcare providers suspect a cervical spineinjury, they should open the airway using a jaw

thrust without head extension (Class IIb).


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Head tilt chin lift & Head tilt jaw trust


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Adult Basic Life SupportRescue Breathing

Deliver each rescue breathover 1 second (Class IIa).

Give a sufficient tidal volume

to produce visible chest rise(Class IIa)

Use a compression toventilation ratio of 30 chest

compressions to 2 ventilations(Class IIa).


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Ventilation With Bag and Mask

Rescuers can provide bag-mask ventilation withroom air or oxygen.

This amount is usually sufficient to producevisible chest rise and maintain oxygenation andnormocarbia in apneic patients (Class IIa).

If the airway is open and a good, tight seal isestablished between face and mask.


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Adult Basic Life Support As long as the patient does not have an

advanced airway in place, the rescuersshould deliver cycles of 30 compressionsand 2 breaths during CPR.

The rescuer delivers ventilations during

pauses in compressions and delivers eachbreath over 1 second (Class IIa).

The healthcare provider should usesupplementary oxygen (O2 concentration40%, at a minimum flow rate of 10 to 12L/min) when available.


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Adult Basic Life SupportVentilation With an Advanced Airway

When an advanced airway (ie, endotrachealtube, Combitube, or laryngeal mask airway[LMA]) is in place during 2-person CPR, give 1breath every 6 to 8 seconds without

attempting to synchronize breaths betweencompressions (this will result in delivery of 8to 10 breaths/minute).

There should be no pause in chestcompressions for delivery of ventilations(Class IIb).


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Adult Basic Life Support Excessive ventilation is

unnecessary and can cause gastricinflation and its resultantcomplications, such asregurgitation and aspiration (ClassIII).

Rescuers should avoid excessiveventilation (too many breaths or

too large a volume) during CPR(Class III).


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Adult Basic Life SupportCricoid Pressure

Cricoid pressure might be used in afew special circumstances (eg, toaid in viewing the vocal cords

during tracheal intubation). Routine use of cricoid pressure in

adult cardiac arrest is notrecommended (Class III).


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YouTubeviaamericanheartassoc*Video by
http://www.youtube.com/http://www.youtube.com/user/americanheartassochttp://www.youtube.com/user/americanheartassochttp://www.youtube.com/


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Early

DefibrillationWith an AED


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All BLS providers should be trained toprovide defibrillation because VF is acommon and treatable initial rhythm inadults with witnessed cardiac arrest.

For victims with VF, survival rates arehighest when immediate bystander CPRis provided and defibrillation occurswithin 3 to 5 minutes of collapse.


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AED


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AED


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AED


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