Oleh :

Citra Eva Meilyndha

I4A011072
Pembimbing :
dr. Rory Denny Saputra Sp. An

CPR
Resusitasi Jantung Paru (RJP)

Tindakan resusitasi pada penderita henti nafas dan

atau henti jantung dengan tujuan untuk
mempertahankan oksigenasi otak

orang awam (non medis) dan setiap tenaga medis

Situations where attempts to perform CPR would

place the rescuer at risk of serious injury or
mortal peril

Obvious clinical signs of irreversible death (eg,

rigor mortis, dependent lividity, decapitation,
transection, or decomposition)

A valid, signed, and dated advance directive

indicating that resuscitation is not desired, or a
valid, signed, and dated DNAR order

 Restoration

of effective, spontaneous circulation

Care

is transferred to a team providing advanced life

support

The

rescuer is unable to continue because of exhaustion,

the presence of dangerous environmental hazards, or
because continuation of the resuscitative efforts places
others in jeopardy

Reliable

and valid criteria indicating irreversible death

are met, criteria of obvious death are identified, or
criteria for termination of resuscitation are met.

Pengenalan cardiac arrest dan aktivasi sistem

respon emergensi
CPR dini yg menekankan kompresi dada
Defibrilasi cepat jika ada indikasi
Advance life support yang efektif
Perawatan post-cardiac arrest yang
terintegrasi

Melihat kolaps mendadak atau pada

kondisi kritis
Panggil dan tepuk
Awam bila tidak respon aktifkan sistem
emergensi
tenaga medis tidak respon tidak
bernafas atau nafas abnormal asumsi
cardiac arrest aktifkan sistem
emergensi
pemeriksaan nadi tidak ditekankan
sukar <10 detik start CPR

 ERC 2010

 ERC 2010

 Letakkan

korban pd posisi datar dan keras

Telentang & penolong berlutut disamping dada
Satu pergelangan tangan penolong
dipertengahan dada korban dan pergelangan
satunya diatas pergelangan tangan yg pertama
Sternum ditekan 2 inchi (5cm)
Biarkan rekoil secara penuh, baru ditekan
kembali
Rate 80x/mnt ROSC120x/mnt
meningkatkan tingkat survival minimal >
100x/mnt

 ERC 2010

 ERC 2010

 ERC 2010

 Bisa

dilakukan oleh 1 penolong namun

dianjurkan lebih dari 2 penolong sehingga dapat
memberikan rasio kompresi : ventilasi = 30 : 2
selama 5 siklus (2 menit)
Hindari interupsi, bila interupsi batasi maksimal
<10 detik
Kecuali interupsi pemasangan Advance airway
management & defibrilasi
Jika sudah terpasang advance airway
interupsi ventilasi dihilangkan kompresi
100x/mnt & ventilasi 8 10 x/mnt

Pasien tanpa trauma servikal

headtilt & chinlift

Pasien dengan trauma servikal

jawtrust tanpa ekstensi kepala

 ERC 2010

 ERC 2010

 ERC 2010

Nafas buatan diberikan 1 detik

Volume tidal cukup dada terlihat terangkat
Volume tidal normal 8-10 cc/kg 6-7 cc/kg

 ERC 2010

 ERC 2010

 ERC 2010

 ERC 2010

Bradycardia Algorithm.

Neumar R W et al. Circulation. 2010;122:S729-S767

Copyright American Heart Association, Inc. All rights reserved.

Tachycardia Algorithm.

Neumar R W et al. Circulation. 2010;122:S729-S767

Copyright American Heart Association, Inc. All rights reserved.

Nafas buatan
mouth to mouth
mouth to barrier
mouth to nose or to stoma
bag mask ventilation
LMA
Jalan nafas bantu (endotracheal tube)

 ERC 2010

 ERC 2010

Jangan dipakai jika reflex muntah masih (+)

(Derajat A dan V dari AVPU atau GCS > 10)

 ERC 2010

Tidak merangsang muntah

Hati-hati pada pasien dengan fraktura basis cranii
Ukuran u/ dewasa 7 mm atau jari kelingking kanan

 ERC 2010

Maternal cardiac arrest algorithm.

Vanden Hoek T L et al. Circulation. 2010;122:S829-S861

Copyright American Heart Association, Inc. All rights reserved.

Pediatric BLS Algorithm.

Berg M D et al. Circulation. 2010;122:S862-S875

Copyright American Heart Association, Inc. All rights reserved.

Pediatric BLS Algorithm.

Berg M D et al. Circulation. 2010;122:S862-S875

Copyright American Heart Association, Inc. All rights reserved.

PALS Pulseless Arrest Algorithm.

Kleinman M E et al. Circulation. 2010;122:S876-S908

Copyright American Heart Association, Inc. All rights reserved.

Component

Recommendations
Adults

Recognition

CPR Sequence
Compression Rate
Compression Depth

Children

Infants

Unresponsive (for all ages)

No breathing, not
breathing normally
(eg, only gasping)

No breathing or only gasping

No pulse palpated within 10 seconds (HCP Only)

CAB

CAB

CAB

At least 100/min
At least 2 inches (5 At least 1/3 AP Depth At least 1/3 AP Depth
cm)
About 2 inches (5 cm) About 1 inches (4 cm)

Chest Wall Recoil

Allow Complete Recoil Between Compressions HCPs Rotate

Compressors Every 2 minutes

Compression
Interruptions

Minimize Interruptions in Chest Compressions Attempt to limit

interruptions to less than 10 seconds

Airway

Recommendations
Head tilt-chin lift (HCP suspected trauma: jaw thrust)

Compression to
30:2 (1 or 2 rescuers) 30:2 Single Rescuer 30:2 Single Rescuer
Ventilation Ratio
15:2 2 HCP Rescuers 15:2 2 HCP Rescuer
(until advanced airway
placed)
Ventilations: When
rescuer Untrained or
Trained and Not
Proficient

Compressions Only

Ventilations with
advanced airway
(HCP)

1 breath every 68 seconds (810 breaths/min) Asynchronous with

chest compressions About 1 second per breath Visible Chest Rise

Defibrillation

Attach and use AED as soon as available. Minimize interruptions i

chest compressions before and after shock, resume CPR beginning
with compressions immediately after each shock