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1
all cases accompanied by
hypoxia
extracardiac
Causes of cardiac
arrest
cardiac
Primary lesion of cardiac muscle leading to the
progressive decline of contractility, conductivity
disorders, mechanical factors 2
Causes of circulation
arrest
Cardiac Extracardiac
Ischemic heart disease
(myocardial infarction, airway obstruction
stenocardia)
acute respiratory failure
Arrhythmias of different
origin and character shock
Electrolytic disorders
Valvular disease reflector cardiac arrest
Cardiac tamponade embolisms of different
Pulmonary artery origin
thromboembolism
Ruptured aneurysm of drug overdose
aorta
poisoning
3
ABC CAB
2005 : 2 rescue breaths followed by 30 chest
compressions and then 2 breaths
2010 : initial chest compression before
ventilation
Reasons :
Chest compression deliveres blood to heart and brain
Early compression had good outcome
Elimination Look, Listen, Feel
2005 : Look, listen and feel used to assess
breathing after opening airway
2010 : After 30 compressions the lone rescuer
opened victims airway and delivered 2 breaths
Reasons :
With the new chest compression, first sequence CPR
is performed if the adult is unresponsive and not
breathing or not breathing normaly (C-A-B sequence)
Chest compression at least 100 per minute
2010 :
o Adult stable monomorphic VT responds well
to monophasic or biphasic cardioversion shock
at initial energies of 100 J
o Cardioversion should also not be used for
pulseless VT or polymorphic VT (irregular VT)
New Medication Protocols
Why :
An Oxygen saturation of 100% may correspond
to a PaO2 anywhere between approximately 80
and 500 mmHg
A recent study has documented the harmful
effects of hyperoxia after ROSC
Organized Post Cardiac Arrest Care
1. Switch ON
Pasang paddles pada posisi sternum
apex dan parasternal
(boleh terbalik)
apex
2. Charge 360 Joules DC shock
(Non-synchronized)
Ucapkan dengan keras :
Awas semua lepas dari pasien!
nafas buatan berhenti dulu
bawah bebas,
samping bebas,
sternum
atas bebas,
saya bebas!
apex apex
3. Shock!!
(tekan dua tombol paddles bersama)
Lepas paddles dari dada,
lanjutkan chest compression.
4. Segera pijat jantung lagi 2 menit
baru raba lagi/ baca lagi ECG
Position
of the paddles electrodes
on thorax of an infant sternum
apex
27
INDICATIONS
AF
Atrial Flutter start with 50 J
SVT
VT with pulse
start with 100 J
(despite of Infant and Children: 2
medication) J/kg
28
DO NOT SHOCK!!!
Asystole
Pulseless Electrical Activity
Bradicardia
Heart Block
Stable hemodynamic with AF, Atrial Flutter, SVT, &
VT with pulse
29
TERIMA KASIH
VF / pulseless VT
NO Check ECG
YES
Check pulse
2 menit 2 menit
CPR -1 Amiodaron
a single shock a single shock a single shock a single shock
30 : 2 a single shock
CPR-2 CPR-3 CPR-4 CPR-6
CPR-5
CALL adrenalin
FOR Amiodaron is the first choice
HELP 300 mg, bolus. Repeated 150 mg
Adrenaline: 1 mg, iv,
for reccurrent VT/VF. Followed by
PASANG repeated every 3-5
900 mg infusion over 24 hours
MONITOR minutes
LIDOCAIN. Do not exceed
a total dose of 3 mg/kg,
Evaluasi CPR : tiap 2 menit during the first hour.