Basic Life Support Based on AHA Guidelines 2010

Basic Life Support (Based on AHA Guidelines 2010) Jajang Sujana Mail, dr. , Sp. An

Introduction n Latest guidelines ¨ AHA Guidelines 2010, many changes from guidelines 2005 Sudden cardiac arrest is a leading cause of death in Europe (700, 000/year) n Early CPR + defibrillation can produce survival as high as 49 -75%!!! n

Latar Belakang Statistik RJP di USA : • Sistem Emergensi Medis Amerika menangani sekitar 300. 000 korban henti jantung di luar RS setiap tahun • Kurang dari 8 % bertahan hidup • Kurang dari 30% menerima RJP orang terdekat. • RJP efektif yang dilakukan orang terdekat dapat meningkatkan 2 -3 x kemungkinan korban bertahan hidup.

Objective The Student should be able to; n Know about Chain of Survival n Know about Basic Life Support steps n Perform a CPR (cardiopulmonary resuscitation) adequately

AHA ECC Adult Chain of Survival 1. 2. 3. 4. 5. Immediate recognition of cardiac arrest and activation f the emergency response system Early CPR with an emphasis on chest compressions Rapid defibrillation Effective advance life support Integrated post-cardiac arrest care

Steps AHA Guidelines 2005 2010 1 Alertness 2 Airway 3 Breathing 4 Circulation 5 Defibrillation

Simplified Adult BLS

Alertness Make sure the scene is safe n Check for response tap the victim on the shoulder and ask, "Are you all right? " n

1. SAFETY FIRST Are the victim and bystanders safe? o o o Needles Dangerous traffic Slope Electric live circuit Personal safety: Gloves, glasses, gown

2. CHECK VICTIM FOR RESPONSE Be in visual field of victim Gently shake or tap the victim on the shoulder Ask: ‘Are you all right? ’

3 a. IF RESPONDS n Leave the person in position you found him/her unless any danger present n Reassess often n Find out what’s wrong

3 b. IF NO RESPONSE n n SHOUT FOR HELP If no response, activate emergency system Tell about location, what happened, number and condition of victims, and type of aid provided

Call for Help 118 n RUMAH SAKIT RSUP Hasan Sadikin: (022) 2034953, 55 (022) 203 7066 ¨ n n n n n Instalasi Gawat Darurat / Emergency (022) 2551198, 2551191 Paviliun Parahyangan (022) 2031440, 2035986 Paviliun Anggrek (022) 2014545, 088820006011 RS Muhammadiyah : 022 730 1062 RSI Al Islam : 022 755 5588 RS Mata Cicendo ; 022 423 1280 RS Jiwa Bandung : 022 420 3651 RS Advent : 022 203 8008 RS Immanuel : 022 520 1656 RS St. Yusuf : 022 727 9860 RS St. Borromeus : 022 255 2081 RS Sartika Asih : 022 522 9544 RS Rotinsulu : 022 203 4446

Patient Position Turn the victim onto his back if not already in that position n Make sure there is no obvious trauma to cervical spine n Place the victim on a hard surface in supine position n If an unresponsive victim is face down (prone), roll the victim to a supine position n

Circulation n Check pulse on carotid artery (near side) not more than 10 seconds

Circulation If there is no pulse, compress the chest (at least 100 compressions per minute) n Rescuer kneeling beside the victim’s thorax n

Circulation Place the heel of the hand on the sternum n Place the heel of the second hand on top of the first hand n Interlock fingers n

Circulation Compression-ventilation ratio of 30: 2 n 5 cycles n Depth at least 2’in or 5 cm n Complete chest recoil n

Airway n Head tilt-chin lift maneuver to open the airway of a victim without evidence of head or neck trauma

Airway n Suspects a cervical spine injury, open the airway using a jaw thrust without head extension

Breathing n No more Look, listen, and feel for breathing n Methods: ¨ Mouth to Mouth ¨ Mouth to Nose

PREPARE AIRWAY n n Close the nasal airway using your index finger and thumb of your hand on the forehead Maintain chin lift Take a normal breath Make a seal with your lips

GIVE BREATHS 2 x n n Blow for 1 sec steadily (rather than 2 sec) Give 1 breath every 5 -6 sec Watch from the corner of your eye the chest rising Maintaining head tilt and chin lift, take your mouth away and watch the chest fall

IF NO CHEST RISING �DON’T PANIC �If at initial attempt no chest rise: 1. Check victim’s mouth and remove any visible obstruction 2. Recheck adequate head tilt and chin lift 3. Do not try more breaths than 2 before coming back to chest compressions

Re-evaluation Re-evaluate every 5 cycles n Victim with palpable pulses requires support of ventilation, give rescue breaths at a rate of 10 to 12 breaths per minute n Each breath should be given in 1 second n Reassess the pulse every 2 minutes n

Key BLS Components for Adult, 3 Children, and Infants

QUESTIONS?

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