DC SHOCK

Dr Buyung SpAn
Dr Ruddi SpAn
 DC shock
Oles dulu paddles
dengan jelly ECG tipis
rata, baru kemudian :

1. Switch ON
Pasang paddles pada posisi
apex dan parasternal sternum
(boleh terbalik)

apex
2. Charge 360 Joules DC shock
(Non-synchronized)
Ucapkan dengan keras :
Awas semua lepas dari pasien!
nafas buatan berhenti dulu
bawah bebas,
samping bebas,
atas bebas, sternum
saya bebas!
3. Shock!! apex apex
(tekan dua tombol paddles bersama)
Lepas paddles dari dada,
lanjutkan chest compression.
4. Segera pijat jantung lagi 2 menit
baru raba lagi/ baca lagi ECG
Position
of the paddles electrodes
on thorax of an infant sternum

apex

Size of paddle electrode

- 4.5 cm diameter for infants and small children
- 8-12 cm diameter larger children
Jelly kurang rata, menekan paddles kurang kuat - luka bakar
INDICATIONS

Defibrillation (Non-Synchronized DC Shock):

VF
Pulseless VT
Recommended joule: 360 J

7
INDICATIONS

Synchronized DC Shock (Only with unstable

hemodynamic):

AF
Atrial Flutter start with 50 J
SVT

VT with pulse
start with 100 J
(despite of
Infant and Children: 2
medication) J/kg

8
 DO NOT SHOCK!!!
Asystole
Pulseless Electrical Activity
Bradicardia
Heart Block
Stable hemodynamic with AF, Atrial Flutter, SVT, &
VT with pulse

9
 VF / pulseless VT

1). a single shock

Biphasic 150-200 Joule
Defibrilation strategy Monophasic 360 Joule
CPR 30 : 2
2 MINUTES, 30 : 2

NO Check ECG
YES
Check pulse

2). a single shock ROSC

Biphasic 150-360
Joule Recovery of
2 MINUTES, 30 : 2 Spontaneous
Monophasic 360 Joule
Circulation
Adrenaline
 VF/ VT
Intubasi : as soon as possible, without stop CPR Pijat >100x/menit
Nafas 8-10x/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
FOR Amiodaron is the first choice
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,
Evaluasi CPR : tiap 2 menit during the first hour.
TERIMA KASIH