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BASIC LIFE SUPPORT ADVANCED LIFE SUPPORT CODE BLUE RS SOEWANDHIE

Transcript of BASIC LIFE SUPPORT ADVANCED LIFE SUPPORTelearning.surabaya.go.id/upload/materi/1/BLS.pdf · BASIC...

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BASIC LIFE SUPPORTADVANCED LIFE SUPPORT

CODE BLUE RS SOEWANDHIE

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POKOK BAHASAN

Konsep Basic Life Support

(BLS)c

Cara Melakukan Resusitasi

Jantung Paru Dewasa

AED

Konsep Advance Life

Support (ALS)

CODE BLUE RS SOEWANDHIE

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Basic Life Support

CODE BLUE RS SOEWANDHIE

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Resuscitation Council of Southern Africa (RCSA)

Resuscitation Council of ASIA (RCA)

Inter American Heart Foundation (IAHF)

CODE BLUE RS SOEWANDHIE

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Chain Of Survival

CODE BLUE RS SOEWANDHIE

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3 Aman (Diri,Lingkungan,Pasien)

•Cek Respon (AVPU)•Panggil Bantuan / Aktifkan Sistem Gawat

Darurat

Perhatikan apakah

nafas terhenti atau

tersengal dan periksa

denyut nadi secara

besamaanApakah denyut benar –

benar terasa dalam 10 detik?

Bernafas normal, ada denyut

Bernafas tidak normal, ada

denyut

Nafas terhenti, tidak ada denyut

CPR / RJPO30 pijatan : 2 nafas

Konsep

Resusitasi

Jantung Paru

Otak Dewasa

CODE BLUE RS SOEWANDHIE

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Note : Untuk awamtidak perlu cek nadikarotis.

ALUR CPR AHA 2015

CODE BLUE RS SOEWANDHIE

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Pastikan 3A (Aman

Diri,Lingkungan,Pasien)

Cek Respon Korban AVPU

Panggil Bantuan

Bebaskan Jalan Nafas

Cek Pernafasan

Lakukan CPR

Tidak Sadar & Tidak

Bernafas / Tidak Teraba

Nadi Karotis CODE BLUE RS SOEWANDHIE

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➢ Titik tumpu 1/2 bagian bawah sternum

➢ Rasio kompresi dan ventilasi 30:2

➢ Kecepatan 100-120x/mnt

➢ Kedalaman 5-6 cm

➢ Recoil dinding thorakyang sempurna

CODE BLUE RS SOEWANDHIE

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Posisi penolong

tegak lurus diatas dada pasien dengan siku lenganlurus menekan tengah-tengah

tulang dada ,

tekan sedalam 5-6 cm.

Frekuensi 100 – 120 x per menit

Push Hard and Push Fast

Pijat jantung 30 x

disusul dg nafas 2 xCODE BLUE RS SOEWANDHIE

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Rasio Kompresi : Ventilasi30 : 2

CODE BLUE RS SOEWANDHIE

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Saat pijat jantung,

Hitung dengan suarakerasSatu,dua,tiga,empat, lima,enam, tujuh, delapan, sembilan,

SATUSatu,dua,tiga,empat, lima,enam, tujuh, delapan, sembilan,

DUASatu,dua,tiga,empat, lima,enam, tujuh, delapan, sembilan,

TIGA

Total = 30 x pijatan,

disela dengan 2 x tiupan nafas

Pijat Jantung dan Nafas Buatan

CODE BLUE RS SOEWANDHIE

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Dilakukan setelah

• 2 menit CPR• Perubahan ECG

Diantara :

Trachea – musculus

Sternocleidomastoideus

Dilakukan selama 5 – 10 detik

Perabaan Nadi CarotisAwam/Non Medik tidak perlu melakukan CODE BLUE RS SOEWANDHIE

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PERHATIKAN KUALITAS PIJAT JANTUNG (HIGH QUALITY CPR ):

1. KECEPATAN PIJATAN 100-120 X/ MENIT2. KEDALAMAN MEMIJAT 5-6 CM3. PENGEMBALIAN JANTUNG (RECOIL) YANG SEMPURNA4. MINIMAL INTERUPSI5. HINDARI HIPERVENTILASI

CODE BLUE RS SOEWANDHIE

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1. Bantuan yang lebih advance dengan peralatan lebih

lengkap datang

2. Terdapat tanda pasti kematian (lebam mayat, kaku

mayat, pembusukan)

3. Sudah dilakukan tindakan BLS secara baik dan benar

selama 30 menit (RSU Dr.Soetomo Surabaya)

4. Penolong kelelahan

5. Nadi carotis teraba (Return Of Spontanious Circulation/

ROSC)

6. DNR

7. Lingkungan membahayakan penolong

Terminasi

CODE BLUE RS SOEWANDHIE

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AED Program

CODE BLUE RS SOEWANDHIE

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PAD programmesare recommended for locations

where the expected use of an AED for witnessed cardiac

arrest exceeds once in 2 years

A single shock is delivered immediately followed by

two minutes of uninterrupted CPR

CODE BLUE RS SOEWANDHIE

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Automatic External Defibrilator

CODE BLUE RS SOEWANDHIE

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CODE BLUE RS SOEWANDHIE

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CODE BLUE RS SOEWANDHIE

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HIDUPKAN AED

• Beberapa jenis AED otomatis menyala saat tutupnya dibuka

CODE BLUE RS SOEWANDHIE

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• Lakukan pijat jantungsambil menungguAED siap

CODE BLUE RS SOEWANDHIE

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Pasang ‘pads’

CODE BLUE RS SOEWANDHIE

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sternum

apex

Pasang pads pada posisi apex dan parasternal

CODE BLUE RS SOEWANDHIE

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Jangan menyentuh pasien saat AED mendeteksi irama jantung pasien

CODE BLUE RS SOEWANDHIE

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Muncul Peringatan Indikasi SHOCK !!

• Hindari Pasien

• AED melakukan kejutan ‘SHOCK’

CODE BLUE RS SOEWANDHIE

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Setelah Shock ikuti petunjuk AED

30 2CODE BLUE RS SOEWANDHIE

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Bila tidak diperlukan kejutan SHOCKIKUTI PETUNJUK AED

30 2CODE BLUE RS SOEWANDHIE

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Bila Pasien mulai menunjukkan tanda – tanda bernafas posisikan seperti ini sambil menunggu bantuan datang

CODE BLUE RS SOEWANDHIE

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Advance Life Support

CODE BLUE RS SOEWANDHIE

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Unrespon

Buka jalan Nafas

Tidak Bernafas/

Gasping

Tidak teraba nadi karotis

CPR

ECG Monitor

Call For Help

pVT/VF Asystole/PEA

DC Shock

Adrenalin

Konsul

Amiodaron

Lidocain

Manajemen

Cardiac Arrest

ROSC

Adrenalin

1 mg IV

SHOCKABLE UNSHOCKABLE

3 Aman

CODE BLUE RS SOEWANDHIE

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Defibrilation

Digunakan untuk menghentikan Cardiac Arrest type

▪ VT Pulseless

▪ Ventrikel Fibrilation

Kontra Indikasi :

▪ Asistole

▪ PEA

SHOCKABLE

UNSHOCKABLE

CODE BLUE RS SOEWANDHIE

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CODE BLUE RS SOEWANDHIE

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SHOCKABLE UNSHOCKABLE

CODE BLUE RS SOEWANDHIE

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Ventrikel Tachicardi

Ventrikel Fibrilasi

Asistole

PEA/Asistole

Sinus Normal

Cardiac Arrest

CODE BLUE RS SOEWANDHIE

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VENTRIKEL TAKIKARDIA MONOMORFIK

w Morfologi yang sama, terlihat dalam setiap kompleks QRS.

o Kecepatan ventrikel > 100 kali per menit;

khususnya 120-250 kali per menit.

a Irama: regular.

f Gelombang P: jarang terlihat; VT merupakan suatu

bentuk disosiasi AV

gKompleks QRS lebar dan aneh, > 0,12 detik

CODE BLUE RS SOEWANDHIE

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VENTRIKEL FIBRILASI

c Nilai/kompleks QRS tidak dapat ditentukan; tidak ada

gelombang P, QRS, atau T yang dapat dikenali.

E Gelombang pada garis dasar terjadi antara 150-500 kali per

menit.

U Irama tidak dapat ditentukan; pola naik (puncak) dan turun

(palung) yang tajam.

S Amplitudo: diukur dari puncak ke palung; biasa digunakan

secara subjektif untuk menggambarkan VF sebagai halus

(puncak ke palung 2 sampai < 5mm), kasar (> 10 mm)

COARSE VF

FINE VF

CODE BLUE RS SOEWANDHIE

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PULSELESS ELECTRICAL ACTIVITY (PEA))

C

CSuatu kondisi klinis, ada aktivitas listrik / depolarisasi tapi tidak mampu menghasilkan nadi yang dapat dideteksi secara klinis.

BUKAN IRAMA JANTUNG TERTENTU

Irama apapun kecuali VT/VF, ada gelombang

tapi tidak teraba nadi disebut PEACODE BLUE RS SOEWANDHIE

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Asystole

Ventricular standstill, no electrical activity, no cardiac output – no pulse!

Cardiac arrest, may follow VF or PEA

Remember! No defibrillation with Asystole

Rate: absent due to absence of ventricular activity.

CODE BLUE RS SOEWANDHIE

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De-FIBRILLATION / DC shockDC shock sedini mungkin

Monofasik 360 Joules

Biphasic 120-200 Joules

Segera lakukan CPR tanpa melihat hasil, evaluasi tiap

2 menit

CODE BLUE RS SOEWANDHIE

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HipoksiaHipovolemiaHidrogen ion (acidosis)HipotermiaHypo / Hyperkalemia

Tamponade jantungTension pneumothoraxThromboemboli paruToxinsThrombosis, pulmonaryThrombosis coronary

5 H

5 T

Cardiac Arrest membandel ???

CODE BLUE RS SOEWANDHIE

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ROSC ,

lalu cardiac arrest lagi

Ikuti algoritme semula.

Bila Shockable

→ DC shock

→ disusul dengan CPR

CODE BLUE RS SOEWANDHIE

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CODE BLUE RS SOEWANDHIE