European Resuscitation Council

Basic Life Support & Automated External Defibrillation Course

OBJECTIVES
At the end of this course participants should be able to demonstrate:
How to assess the collapsed victim.

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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.

BACKGROUND
Approximately 700,000 cardiac arrests per year in Europe Survival to hospital discharge presently approximately 5-10% Bystander CPR vital intervention before arrival of emergency services

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

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CHAIN OF SURVIVAL

Approach safely
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Check response
Shout for help

Open airway
Check breathing Call 112 30 chest compressions 2 rescue breaths

APPROACH SAFELY!
Approach safely
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Scene
Rescuer Victim

Check response Shout for help Open airway Check breathing

Call 112

Bystanders

30 chest compressions 2 rescue breaths

CHECK RESPONSE
Approach safely
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Check response Shout for help Open airway Check breathing

Call 112
30 chest compressions 2 rescue breaths

CHECK RESPONSE

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Shake shoulders gently Ask Are you all right? If he responds

Leave as you find him. Find out what is wrong.

Reassess regularly.

SHOUT FOR HELP

Approach safely
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Check response Shout for help Open airway Check breathing

Call 112
30 chest compressions 2 rescue breaths

OPEN AIRWAY
Approach safely
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Check response Shout for help Open airway Check breathing

Call 112
30 chest compressions 2 rescue breaths

CHECK BREATHING
Approach safely
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Check response Shout for help Open airway Check breathing

Call 112
30 chest compressions 2 rescue breaths

CHECK BREATHING

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Look, listen and feel for NORMAL breathing Do not confuse agonal breathing with NORMAL breathing

AGONAL BREATHING

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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

Approach safely
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Check response Shout for help Open airway Check breathing

Call 112
30 chest compressions 2 rescue breaths

30 CHEST COMPRESSIONS
Approach safely
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Check response Shout for help Open airway Check breathing

Call 112
30 chest compressions 2 rescue breaths

CHEST COMPRESSIONS
Place the heel of one hand in the centre of the chest Place other hand on top Interlock fingers

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Compress the chest

Rate 100 min-1 Depth 4-5 cm Equal compression : relaxation

When possible change CPR operator every 2 min

RESCUE BREATHS
Approach safely
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Check response Shout for help Open airway Check breathing

Call 112
30 chest compressions 2 rescue breaths

RESCUE BREATHS

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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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30
CONTINUE CPR

Approach safely
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Check response
Shout for help

Open airway
Check breathing Call 112 30 chest compressions 2 rescue breaths

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DEFIBRILLATION

Approach safely
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Check response
Shout for help Open airway Check breathing Call 112 Attach AED Follow voice prompts

SWITCH ON AED

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Some AEDs will automatically switch themselves on when the lid is opened

ATTACH PADS TO CASUALTYS BARE CHEST

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ANALYSING RHYTHM DO NOT TOUCH VICTIM

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SHOCK INDICATED

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Stand clear Deliver shock

SHOCK DELIVERED FOLLOW AED INSTRUCTIONS

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30

NO SHOCK ADVISED FOLLOW AED INSTRUCTIONS

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30

IF VICTIM STARTS TO BREATHE NORMALLY PLACE IN RECOVERY POSITION

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CPR IN CHILDREN

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Adult CPR techniques can be used on children

Compressions 1/3 of the depth of the chest

AED IN CHILDREN
Age > 8 years use adult AED
Age 1-8 years use paediatric pads / settings if available (otherwise use adult mode)

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Age < 1 year use only if manufacturer instructions indicate it is safe

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ANY QUESTIONS?

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Approach safely Check response Shout for help Open airway Check breathing Call 112

Approach safely Check response Shout for help Open airway Check breathing Call 112

30 chest compressions
2 rescue breaths

Attach AED
Follow voice prompts

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obat anasthesi obat premedikasi golangan anti kolinerjik sa scopolamin efek kurangi sekresi parasimpatolitik nadi meningkat atropin lebih baik dari scopolamin atropin baik untuk asma

tersedia sa 0.25-0,5 scopolamin 0.4-0,6 golongan sedatif

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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% dosisi 300 ml

Tak ada muntah tak ada sekresi tak bertambah depresi miokart histamin release ki -status ab porpiria kejelekan bisa depresi respirasi-apneu cvs depresi-kalau terlalu cepat-tensi menurun recopol obat anastesi umum yg kerja onset cepat -hemodinamik relatif stabil recoveri cepat tanpa hang over tanpa post op nowsia dan muntah

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European Resuscitation Council

-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

Catatan halusinasi-dikejar maling -sexsual

benzodaizepin diazepan evalium hilangkan rasa takut, gelisah anti konvulsi dapat depresi pernapasan dan sirkulasi kalau dosis tinggi amnesia tak timbul hang over efek relaksan otot rangka tablet 2ml, 5ml ampuls 10 ml

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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 berkurang usus meningkat kan tonus sampai kolik -teknan darah,irama ferkuensi tak di pengaruhi kalau terjadi teknan drah menurun karna histamin rilis

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European Resuscitation Council

Dosis -10 ml dosis anak 0,1 ml/kg bb interaksi MAOI,fenotiazin,trisiklik- depresi ki penemonia- 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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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

Antagonis nalorfin 5mg iv lorfan 1mg iv

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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

Side efek eksitrasi,ektra piramidal ki epilepsi

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2.DBP efek sperti phenergan sedasi,vaskuler perifer baik,alfa bloker lemah,anti muntah ki asma bronkial dosis 2.5 ml-5ml anak anak-0.3-0.5 digabung dengan na------- nerolet analgesi

Ada sedian dbp+ pentalin 4:1 obat pelemas otot(MR) 2 gol mr 1. dp m.relaksan ex:suksinilpolin 2. non dep m.relaksan -revolak -tramus -kurare gol 1. dep relaksan kerja: menurunkan aksai pontensial membran(deporalisai)

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European Resuscitation Council

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-anak penceghan diberikan non dep sedkt sblum subsinil di berikan dosis 1-2 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 inhalasi bentuk gas n2o bentuk volatile:-eter halotil isofluren sevorin 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 plasma 100 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

Obat ini sudah jarang di pakai -merangsang -mudah terbakar ketiga kom anastesi tdp pd eter
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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 nadi menurun,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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