Professional Documents
Culture Documents
RESUSCITATION
Oleh :
Dr Achmad Syauqi Sp An
an overview
of the
American and the International Liaison Commite
on Recuscitation
( ILCOR) year 2000
recommendation
for
establishing
and
maintaining the ABCDs of
cardiopulmonary
resuscitation
:
airway,
breathing,
circulation,deffibrillation
For the health care provider, deffibrillation using
biphasic
electrical
current
works
best,
endotracheal tube (ETT) placement should be
confirmed with a qualitatife end-tidal CO2 device
bretylium is no longer reccommended but
vasopressin.
Attach
defribilator/monitor
Assess
rhythm
VF/VT
Attempt defribilation
x 3 as necessary
CPR 1 Minute
Chek
pulse
During CPR
-Chek elektrode /paddle position and
contact
- attempt to place, confirm, secure airway
- attempt and ferify IV access
- patient with VF/VT refractory to initial
syocks :
a. ephinephrine 1 mg IV, every 3 to 5
minutes
Or
b. Vassopressin 40 u IV ,single dose, 1
time only
-Patients with non VF/VT rhythms :
ephinephrine 1 mg IV, every 3 to 5
minutes
-Consider : buffers, antiarhytmics, pacing
- search for and correct refersible causes
Non VF/VT
CPR up to 3
minutes
METABOLIK
5.HYPOTHERMIA
6. TABLETS (drug OD, accidents)
7.TAMPONADE, CARDIAC
8.TENSION PNEUMOTHORAX
9.THROMBOSIS, CORONARY (ACS)
10.
THROMBOSIS, PULMONARY (EMBOLISM)
AIRWAY
Although the A of the mnemonic
ABC stands for airway. It should also
stand for the initial assesment of the
patient, before CPR is initiated,
unresponsivenessis established and
the emergency response system
activated.
Person collapses
Possible cardiac arrest
Assess responsiveness
Begin primary
ABCD survey
CPR continues
Assess rhythm
Attempt
defibrilation
CPR for
1 minute
Non VF/ VT
CPR up
to 3
minutes
Or a jaw thrust
Or lying down
CHILD (>
12)
ADULT
Breathing rate
20 breath/min
20 breath/min 10-12
breaths/min
Pulse check
brachial
carotid
carotid
compression rate
> 100/min
100/min
100/min
Compression
methot
Two or three
fingers
Heel of one
hand
Hands
interlaced
Ventilation ratio
5:1
5:1
15 : 2
Foreign body
obstruction
Heimlich
maneuver
Heimlich
maneuver
BREATHING
Assesment of spontaneus breathing should
circulation
after succesful delifery of two initial
breaths,the circulation must be rapidly
assessed health care providers are advised in
the 2000 to continue to check for a pulse.
if the patient has an adequate pulse or
blood presure, breathing is continued at 10-12
breath/ min for an adult or a child older than 8
years, and 20 breaths/min for an infant or a
child up to 8 years of age. guidelines
DEFIBRILLATION
Ventricular fibrillation is found most
commonly in adults who experience
nontraumatic cardiac arest. the time
from collapse to defibrillation is the
single most important determinant of
survival. The chanches for survival
decline 7-10 for every minutes
withoud devibrilation.
SECON
D
THIRD
SUBSEQUE
NT
100200
100-200
100300
360
adult
50
100
200
360
child
0,51/Kg
2/kg
4/kg
4/kg
100
200
200300
360
adult
200
200-300
200360
360
child
2/kg
4/kg
4/kg
4/kg
Monomorphic ventricular
tachicardia
Ventricular vibrilation
---A
A
--B
B
--C
C
--D
D
Focus
Focus :: basic
basic CPR
CPR and
and defibrilation
defibrilation
-- Check
responsivenees
Check responsivenees
activate
activate emergency
emergency response
response system
system
-call
for
defibrilator
call for defibrilator
AIRWAY
:: open
AIRWAY
open the
the airway
airway
BREATHING
:: provide
BREATHING
provide positive-presure
positive-presure ventilation
ventilation
CIRCULATIONS
:
give
chest
compression
CIRCULATIONS : give chest compression
DEFIIBRILATION
DEFIIBRILATION :: asses
asses for
for and
and shock
shock VF/
VF/ pulseless
pulseless VT,
VT, up
up to
to 3
3 times
times if
if necesserry
necesserry
-- ephinephrine
ephinephrine 1
1 mg
mg
IV,
IV, repeat
repeat every
every 3
3 to
to
5
minutes
5 minutes
-- Sopressin
Sopressin 40
40 U
U IV
IV ,,
single
dos
single dos
RESUME
RESUME ATTEMPS
ATTEMPS TO
TO
DEFIBRILATE
DEFIBRILATE
Rhythm after
first 3 shocks
Persistent or
reccurrent
VF/VT
CONSIDER ANTIAAHYMICS
THANKS YOU