Resusitasi Kardio Pulmoner

ERY LEKSANA
SMF/BAG. ANESTESI DAN TERAPI INTENSIF
RSUP Dr. KARIADI/FK UNDIP
SEMARANG 1
Bantuan Hidup :
(Life Support)
Usaha untuk mempertahankan kehidupan
saat penderita mengalami keadaan yang
mengancam nyawa
Otak
tidak dapat O2 mati
Jantung

4 - 6 menit
VITAL ORGAN
WAKTU KRITIS

Golden time
Chain of survival (AHA)

6
 Apapun keadaan penderita :

A. Airway ( jalan nafas )

B. Breathing ( pernafasan )
C. Circulation ( jantung dan
pembuluh darah )
R - RESPONSE (conscious)

RESPONSE Tap or gently shake the patient and

shout are you ok
A - AIRWAY

AIRWAY Open the airway (head tilt chin lift)

A - AIRWAY

AIRWAY ( Jaw thrust technique for neck injury )

AIRWAY

Heimlich Abd.thrust
BREATHING

Pernafasan baik :
- Laju pernafasan ( dewasa ) : 12 - 20
- Tanda dispnea \ sianosis (-)
- Pemeriksaan fisik baik
B - BREATHING

BREATHING check for breathing

Look - listen - feel

 BREATHING

Konsentrasi Oksigen
- Udara bebas 21 %
- Kanul hidung dengan O2 2 LPM 24 %
- Kanul hidung dengan O2 6 LPM 44 %
- Face mask ( rebreathing, 6-10 LPM ) 35 - 60 %
- Non rebreathing mask ( 8-12 LPM ) 80 - 90 %
 BREATHING

Artificial ventilation
(pernafasan buatan)

- Mouth to mouth ventilation

- Mouth to mask ventilation
- Bag-valve-mask ( ambu-bag )
B - BREATHING

Mouth to Mouth Method Rescue Breathing by Mask

Method
BREATHING

"Bagging"
 BREATHING

O2=50%
O2

Valve O2>90%
Bag O2
Mask
 BREATHING

Frekuensi Rescue Breathing :

Dewasa 10 - 12 kali / menit

Anak/bayi 12 - 20 kali / menit

C - CIRCULATION

CIRCULATION - check carotid

pulse
 CIRCULATION

Bila jantung berhenti berdenyut

lakukan
Resusitasi Jantung Paru (CPR)
C -CIRCULATION-EXTERNAL COMPRESSION

The right position of our hand Chest Compression

C -CIRCULATION CHEST COMPRESSION

Too to the right Too to the left

The Incorrect hand

Position

Too to the top Too to the bottom

 RJP

Kompresi dada

Neonatus
Bayi Anak
 RJP

Dalamnya Kompresi
Dewasa : 3 - 5 cm
Anak : 2 - 3 cm
Bayi : 1 - 2 cm
 RJP
Perbandingan Kompresi Ventilasi
Bayi / anak :
1 Penolong >>> 30 : 2
2 Penolong >>> 15 : 2

Dewasa : >>> 30 : 2

26
 RJP

Menghentikan RJP ?
Ada respon korban
Ada petugas yang menggantikan
Muncul tanda-tanda kematian pasti
Penolong kelelahan
Danger
D SKEMA RESUSITASI ( CPR)
Response
R Response to
voice and pain
No
yes Check and
Manage major
Other first aid
management
Shout for bleeding

A
help Open and clear
Airway the airway

B
Check Breathing : yes
Breathing Recovery Position
Look, listen and
feel
No

Circulation
C Give 2 initial
breathing
There is
breathing

yes
Check carotid Continued rescue
pulse breathing.

No
There is
CPR pulse
 PEA-ECG ada kompleks tetapi carotis(-)
CPR 3 menit
INTUBASI, IV line,
adrenalin 1 mg/3-5 menit
1-1-1/1-3-5 mg

Asystole/PEA ROSC

CPR 3 menit
BRADYCARDIA/PEA NORMAL

ATROPIN 1-1-1 Sp. 3 MG/OBAT KLAS IIa

 CAROTIS (+) CAROTIS (-)

LIDOCAIN DC-SHOCK
1 mg/kg iv 200 Joules
cepat (Th 2000)
(Th 2005 dosis
tinggi )
 Th 2005
CPR - DC-SHOCK -CPR
 VF/ VT
Intubasi : as soon as possible, without stop CPR Pijat 100x/menit
Nafas 8x/menit

Cardiac adrenalin adrenalin

arrest VF / VT
2 menit 2 menit

2 menit 2 menit
CPR -1 Amiodaron
a single shock a single shock a single shock a single shock
30 : 2 a single shock
CPR-2 CPR-3 CPR-4 CPR-6
CPR-5
CALL adrenalin Amiodaron is the first choice
FOR
HELP 300 mg, bolus. Repeated 150 mg
Adrenaline: 1 mg, iv,
for reccurrent VT/VF. Followed by
PASANG repeated every 3-5
900 mg infusion over 24 hours
MONITOR minutes
LIDOCAIN. Do not exceed
a total dose of 3 mg/kg,
during the first hour.
Evaluasi CPR : tiap 2 menit
POSISI RECOVERY

RECOVERY POSITION
Terima Kasih