12 basic life support

8/12/2019 12 Basic Life Support

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EuropeanResuscitation

Council

Basic Life Support &Automated External

Defibrillation Course


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OBJECTIVES

At the end of this course

participants should be able to demonstrate:

How to assess the collapsed victim.

How to perform chest compression and rescue

breathing.

How to operate an automated external defibrillator

safely.

How to place an unconscious breathing victim in the

recovery position.


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BACKGROUND

Approximately 700,000 cardiac arrests per yearin Europe

Survival to hospital discharge presently

approximately 5-10%

Bystander CPR vital intervention before arrival ofemergency services

Early resuscitation and prompt defibrillation(within 1-2 minutes) can result in >60% survival


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CHAIN OF SURVIVAL


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Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112

30 chest compressions

2 rescue breaths


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APPROACH SAFELY!

Scene

Rescuer

Victim

Bystanders

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths


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CHECK RESPONSE

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths


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Shake shoulders gently

AskAre you all right?

If he responds

Leave as you find him.

Find out what is wrong.

Reassess regularly.

CHECK RESPONSE


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SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths


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OPEN AIRWAY

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths


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CHECK BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths


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CHECK BREATHING

Look, listen and feel

for NORMAL

breathing

Do not confuse

agonal breathing withNORMAL breathing


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AGONAL BREATHING

Occurs shortly after the heart stops

in up to 40% of cardiac arrests

Described as barely, heavy, noisy or

gasping breathing

Recognise as a sign of cardiac arrest


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Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths


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30 CHEST COMPRESSIONS

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths


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Place the heel of one hand in

the centre of the chest

Place other hand on top

Interlock fingers

Compress the chest

Rate 100 min-1

Depth 4-5 cm

Equal compression : relaxation

When possible change CPR

operator every 2 min

CHEST COMPRESSIONS


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RESCUE BREATHS

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths


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RESCUE BREATHS

Pinch the nose

Take a normal breath

Place lips over mouth

Blow until the chest

rises

Take about 1 second Allow chest to fall

Repeat


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CONTINUE CPR

30 2


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Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 11230 chest compressions

2 rescue breaths


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DEFIBRILLATION


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Resuscitation

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Call 112

Approach safely

Check response

Shout for help

Open airway

Check breathing

Attach AED

Follow voice prompts


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Resuscitation

Council

ATTACH PADS TO

CASUALTYS BARE CHEST


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Resuscitation

Council

ANALYSING RHYTHM

DO NOT TOUCH VICTIM


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Resuscitation

Council

SHOCK INDICATED

Stand clear

Deliver shock


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Resuscitation

Council

SHOCK DELIVERED

FOLLOW AED INSTRUCTIONS

30 2


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Resuscitation

Council

NO SHOCK ADVISED

FOLLOW AED INSTRUCTIONS

30 2


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Resuscitation

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IF VICTIM STARTS TO

BREATHE NORMALLY PLACE

IN RECOVERY POSITION


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Resuscitation

Council


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Resuscitation

Council

CPR IN CHILDREN

Adult CPR

techniques can be

used on children

Compressions 1/3 of

the depth of the chest


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Resuscitation

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AED IN CHILDREN

Age > 8 years use adult AED

Age 1-8 years

use paediatric pads /settings if available(otherwise use adultmode)

Age < 1 year use only if

manufacturerinstructions indicate itis safe


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Resuscitation

Council

ANY QUESTIONS?


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Resuscitation

Council Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112


2 rescue breaths

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112

Attach AED

Follow voice prompts


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Resuscitation

Council

obat anasthesi

obat premedikasi

golangan anti kolinerjik

sa

scopolamin

efek

kurangi sekresi

parasimpatolitiknadi meningkat

atropin lebih baik dari scopolamin

atropin baik untuk asma


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Resuscitation

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tersedia sa 0.25-0,5

scopolamin 0.4-0,6

golongan sedatif

penobarabital

-mengurangi cemas dan gelisah

-tidak da efek analgesi

-dosis 10-20 sedatif

100 ml hipnotik

-hipnotik

untuk induksi

pentotal-teo pental-induksi capat intra vena(iv)

kerja singkat

larutan 2,5%

dosisi300 ml


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Resuscitation

Council

Tak ada muntah

tak ada sekresi tak bertambah

depresi miokart

histamin release

ki

-status ab

porpiriakejelekan

bisa depresi respirasi-apneu

cvs depresi-kalau terlalu cepat-tensi menurun

recopolobat anastesi umum yg kerja onset cepat

-hemodinamik relatif stabil

recoveri cepat tanpa hang over

tanpa post op nausea dan muntah


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Resuscitation

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-Dosis 2ccket/kg bb

indikasi

--induksi

-mentenen anastesi

-sedasi pasien yg di respirator

ketalar- dipakai pada pasien ku jelek

-efek disosiasi

-efek disosaisi ini di hilangkn dg memberi sedatif

dan sh sebelum pemberian ketaler-tekana darah meningkat

ki

hipertensi

kelainan sikotik


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Resuscitation

Council

Catatan

halusinasi-dikejar maling

-sexsual

benzodaizepin

diazepan evalium

hilangkan rasa takut, gelisahanti konvulsi

dapat depresi pernapasan dan sirkulasi kalau

dosis tinggi

amnesiatak timbul hang over

efek relaksan otot rangka

tablet 2ml, 5ml

ampuls 10 ml


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Resuscitation

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Golongan analgetik narkotik

morphin

-alkaloid paparin somniferem

-terhadap ssp- analgetik narkotik

analgesi terjadi sebelum tidur

dosis kecil

disporia, muntah,takut, gatal,pupil kecil-depresi pernapasan

g l trek- langsung pda saluran cerna tidak melelui

ssp

lambung sekresi berkurangusus meningkat kan tonus sampai kolik

-teknan darah,irama ferkuensi tak di pengaruhi

kalau terjadi teknan drah menurun karna histamin

rilis


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Dosis

-10 ml

dosis anak 0,1 ml/kg bb

interaksi

MAOI,fenotiazin,trisiklik- depresi

kipenemonia- karna mekan batuk

meperiline/petidin/dumerol

derivat penil piperedin-efek utama di ssp

analgesi: sedasi

euforia: depresi pernapasan

masa kera 2- 4 jam


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Resuscitation

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Beda dengan morfin bisa termor dan kejang

-pernapasan depresi

mengurangi TV tidak frekunsi

-hilangkan reflek kornea

reflek pupil tak di pengaruhi

jg diameter pupil

side efek-muntah

-hipotensi(vasodilatsi peripere karna histamin)

dosis:dewasa 50-100mg

anak anak: 1mg/kg bb


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ResuscitationCouncil

Antagonis

nalorfin 5mg iv

lorfan 1mg iv

3.pentanyl( sublimaze)

analgetik narkotik kuat

-tak ada histamin rilis( hipotensi)-depresi pernapasan

-dosis 0,05-0.1mg/kg bb

efek: 50 mnt

TRANS QUILIZIR

1.fenotiazin- penergan

dulu dipakai untuk premidikasi

efek sedatif anti muntah,anti histamin


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Side efek

eksitrasi,ektra piramidal

ki

epilepsi

2.DBP

efek sperti phenergansedasi,vaskuler perifer baik,alfa bloker lemah,anti

muntah

ki

asma bronkialdosis

2.5 ml-5ml

anak anak-0.3-0.5

digabung dengan na------- nerolet analgesi


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Ada sedian

dbp+ pentalin 4:1

obat pelemas otot(MR)

2 gol mr

1. dp m.relaksan

ex:suksinilpolin2. non dep m.relaksan

-revolak

-tramus

-kurare

gol 1. dep relaksan

kerja: menurunkan aksai pontensial

membran(deporalisai)


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Pos sinaptik sehinga reflakter terhadap

rangsangan

kalau deberikan sak berturut bisa terjadi dual blok

spt efek non dep m.relaksan

obat ini menibulkan

fasikulasi otot

terutma pada wanita,anak-anakpenceghan diberikan non dep sedkt

sblum subsinil di berikan

dosis1-2 mg/kgbb

lma kerja- 4 mnt

2.non dep m.relaksan


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Bekerja spt ach, hanya kerja lebih lama,karna

tidak di hidrolisa

cara kerja menempati reseptor nero muskular

jungtion

anti kolin ektrase---memperpendak kerja ndmr

obat obat inhalasibentuk gas n2o

bentuk volatile:-eter

halotil

isoflurensevorin

n20(gas gelak)

-satu2 nya zat anastesi an organik


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Tak berwarna,tak berbau,tak iritatif

bd 1,5 kali udara

tak mudah meledak

kelarutan dlm plasma100 kali 02 atau 15 X nitrtogen

tak berekasi dg hb yang diangkut dlm plasma

tak di metabolisme, di kelurakan melalui paru

kerja deprsi

efek analgesi 20% n20 dlm 02 sma spt 15ml

morfin

efek hipnotik lemah efek relaksasi tak ada

b analstetik volatile

-zat cair yg mudah menguap

1 eter

Ob i i d h j di k i


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Obat ini sudah jarang di pakai

-merangsang

-mudah terbakar

ketiga kom anastesi tdp pd eter

HALOTAN.FLUTAN

-cairan tak berwarna,tak mudah terbakar,bisa di campr dg

02

-alat kusus untuk mnguap zat ini dsbt vaporizer

-alotin bersifat anti spasme bronkus dan laring

alotan bsa di gunakan untk intubasi

alotan depresi otot jantung

-alotan menekan saraf simpatis shg tensi menurun nadimenurun,hngga bisa tjd anti jantung

-alotan meninggika sentitasi thd atikolamin,-------tjd arytmia

-pemberian adrenalin tk boleh lebih 1:100.000

pengguanan alotil berulang bisa merusak hati


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12 basic life support

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