VT / Ventricular Tachycardia

carotis (+) carotis (-)

check hemodinamik
buruk baik

Amiodaron 300 mg a single shock

Kardioversi bolus
50 – 100 – 150 atau 360 Joules
Joule Lidocain CPR 30:2 2 menit
ekskalasi 1 mg/kg iv cepat Managemen VT/ VF
9
 Fine VF If there is a doubt about whether
the rhythm is asystole or fine-VF
do NOT attempt defibrilation,
continuous chest compression and
ventilation

chest compression + adrenalin

Fine Ventriculer Fibrilation
NO DC
chest compression + adrenalin
Asystole
NO DC

Coarse Ventriculer Fibrilation DC 10

 UN-SHOCKABLE
Asystole – PEA - EMD
Intubation (LMA):
as soon as possible, Pijat 100-120x/m
without stop compression Nafas 10x/menit

Cardiac evaluasi evaluasi evaluasi evaluasi

arrest = asistol
ASYST = asistol = asistol = asistol

2 menit 2 menit 2 menit 2 menit

CPR -1 CPR-2 CPR-3 CPR-4 CPR-5 CPR-6
30 : 2 Adrenalin-1 Adrenalin-2 Adrenalin-3

CALL
FOR
HELP….CODE BLUE Evaluasi CPR : tiap 2 menit
Adrenaline: 1 mg, iv,
PASANG repeated every 3-5
MONITOR EKG minutes
April_Surabaya 11
 SHOCKABLE
VF/ VT-pulseless
Intubation (LMA): Pijat 100-120x/m
as soon as possible,
Nafas 10x/menit
without stop compression
3’ 3’
adrenalin adrenalin
Cardiac Evaluasi Evaluasi Evaluasi Evaluasi
arrest VF / VT = VF / VT = VF / VT = VF / VT = VF / VT

2 menit 2 menit 2 menit 2 menit

a single shock-I a single shock-II a single shock-III - AMIODARON

- a single shock-IV a single shock-V
CPR -1 CPR-2 CPR-3 CPR-4 CPR-5 CPR-6
30 : 2
Amiodaron is the first choice
CALL 300 mg, bolus. Repeated 150 mg
FOR Adrenaline: 1 mg, iv, for reccurrent VT/VF. Followed by
HELP repeated every 3-5 900 mg infusion over 24 hours
minutes Or LIDOCAIN 1mg/kg. Can be repeated.
PASANG
MONITOR Do not exceed a total dose of 3
Evaluasi CPR : tiap 2 menit mg/kg,during the first hour. 12
April_Surabaya
13
Adrenalin - Lidocain
• Intra-venous
• Intra-tracheal / trans-tracheal Guideline 2010-2015,
dosis 3-10 x intravena tidak merekomendasi

• Intra-osseus

• TIDAK intra-cardial
– menghentikan pijat jantung
– sukar pastikan intra-ventrikuler
• kena miokard : nekrosis
• kena a. coronaria : infark

14
April_Surabaya
15
Defibrilator Pengatur dosis Joules

Paddles

16
 CPR
adrenalin
DC shock 150 Joules

CPR Amiodaron 300mg

10 menit

ROSC

Sikap saudara berikutnya.... ?? 19

Cardiac Arrest membandel ???

Hipoksia
4H Hipovolemia
Hiperkalemia
Hipotermia
Tamponade jantung
Tension pneumothorax
4T Thromboemboli paru
Toxic overdose
B-block, Ca-block
Digitalis, Tricyclic AD
MA Massive MI
Asidosis
23
25
A recent meta-analysis (LOE-1) of 11 studies involving
1914 patients documented 5 clinical signs that were found to strongly
predict death or poor neurologic outcome, with 4 of the 5 predictors
detectable at 24 hours after resuscitation:

● Absent corneal reflex at 24 hours

● Absent pupillary response at 24 hours
● Absent withdrawal response to pain at 24 hours
● No motor response at 24 hours
● No motor response at 72 hours

An electroencephalogram performed 24 to 48 hours after resuscitation

has also been shown to provide useful predictive information (LOE-5) and
can help define prognosis. 26