MANUAL CPR

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MANUAL MEMBUAT CPR

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  • Presented by: National Health Care Provider Solutions (NHCPS)

    Provider Handbook

    BLSBasic Life Support

    Presented by: National Health Care Provider Solutions (NHCPS)

    Provider Handbook

  • Copyright 2014 Satori Continuum publiShing

    all rightS reServed. exCept aS permitted under u.S. Copyright aCt of 1976, no part of thiS publiCation Can be reproduCed, diS-tributed, or tranSmitted in any form or by any meanS, or Stored in a databaSe or retrieval SyStem, without the prior ConSent

    of the publiSher.

    Satori Continuum publiShing

    871 Coronado Center drive

    Suite 200 #2001

    henderSon, nv 89052

    printed in the united StateS of ameriCa

    eduCational ServiCe diSClaimer

    thiS provider handbook iS an eduCational ServiCe provided by Satori Continuum publiShing. uSe of thiS ServiCe iS governed by

    the termS and ConditionS provided below. pleaSe read the StatementS below Carefully before aCCeSSing or uSing the ServiCe.

    by aCCeSSing or uSing thiS ServiCe, you agree to be bound by all of the termS and ConditionS herein.

    the material Contained in thiS provider manual doeS not Contain StandardS that are intended to be applied rigidly and expliC-itly followed in all CaSeS. a health Care profeSSionalS judgment muSt remain Central to the SeleCtion of diagnoStiC teStS

    and therapy optionS of a SpeCifiC patientS mediCal Condition. ultimately, all liability aSSoCiated with the utilization of any of

    the information preSented here reStS Solely and Completely with the health Care provider utilizing the ServiCe.2

  • TABLE OF CONTENTSGeneral Concepts of Basic Life Support 4

    Initiating the Chain of Survival 4

    2010 BLS Guidelines Changes 5

    BLS for Adults 6

    One-Rescuer Adult BLS/CPR 8

    Steps for CPR 8

    Two-Rescuer Adult BLS/CPR 9

    Adult Mouth-to-Mask Ventilation 9

    Adult Bag-Mask Ventilation in Two-Rescuer CPR 9

    Adult BLS Algorithm 9

    Self Assessment Questions 10

    Use of the Automated External Defibrillator (AED) 11

    Self Assessment Questions 13

    BLS for Children (Age 1 to Puberty) 15

    One-Rescuer BLS for Children 17

    Two-Rescuer BLS for Children 17

    Child Ventilation 18

    BLS for Infants (0 to 12 months old) 19

    One-Rescuer BLS for Infants 19

    Two-Rescuer BLS for Infants 20

    Automated External Defibrillator Infants & Children 21

    Self Assessment Questions 23

    Airway Management 25

    Mouth-to-Mouth Rescue Breathing 26

    Adult and Older Children Mouth-to-Mouth 26

    Infant Mouth-to-Mouth/Nose 26

    Rescue Breathing 27

    Relief of Choking 28

    Choking in an Adult or Child Older than One Year 28

    Abdominal Thrusts (Heimlich Maneuver) 29

    Successful Relief of Choking 29

    Choking in Infants (Less than One Year Old) 29

    Back Blows and Chest Thrusts in Infants 30

    Self Assessment Questions 31

    Additional NHCPS Tools 32

    Review Questions 33

    3

  • GENERAL CONCEPTS OF BASIC LIFE SUPPORTThe American Heart Association (AHA) has updated the Basic Life Support (BLS) course over the years as new research in cardiac care

    has become available. Cardiac arrest continues to be a leading cause of death in the United States. Life Support guidelines have changed

    dramatically, and the elements of BLS continue to be some of the most important steps in initial treatment. Basic Life Support includes:

    QuicklystartingtheChainofSurvival

    Deliveringhighqualitychestcompressionsforadults,childrenandinfants

    KnowingwheretolocateandunderstandinghowtouseanAutomaticExternalDefibrillator(AED)

    Providingrescuebreathingwhenappropriate

    Understandinghowtoperformasateam

    Knowinghowtotreatchoking

    INITIATING THE CHAIN OF SURVIVALEarly initiation of BLS has been shown to increase the probability of survival for a victim of cardiac arrest. To increase the odds of

    surviving a cardiac event, the rescuer should follow the steps in the Adult Chain of Survival.

    POST-CARDIAC ARREST CARE

    POST-CARDIAC ARREST CARE

    ADVANCED LIFE SUPPORT

    ADVANCED LIFE SUPPORT

    DEFIBRILLATE WITH AED

    ACTIVATE EMS

    PERFORM EARLY CPR

    PERFORM EARLY CPR

    RECOGNIZE SYMPTOMS & ACTIVATE EMS

    PREVENT ARREST

    Infants and children do not usually have primary cardiac events. Pediatric patients will most often suffer from respiratory events or

    dehydrationthatleadtocardiacarrest.ThemostimportantpartofthePediatricChainofSurvivalisthefirstlinkPrevention.

    figure 1: adult Chain of Survival

    figure 2: pediatriC Chain of Survival

    4

  • 2010 BLS GUIDELINES CHANGES

    In2010,theAmericanHeartAssociation(AHA)releasedarevisionoftheBLSGuidelines.ApproximatelyeveryfiveyearstheAHAupdatesthe

    guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). The content contained herein is based on the

    most recent AHA publications on BLS and will periodically compare old versus new recommendations for a comprehensive review. 1

    These changes include:

    Previously,theinitialstepswereA-B-C(Airway,Breathing,Compressions).Theliteratureindicatesthatstartingcompressionsearly

    in the process will increase survival rates. Therefore, the steps have been changed to C-A-B (Compressions, Airway, Breathing). This

    is intended to encourage early CPR and avoid bystanders interpreting agonal breathing as signs of life and withholding CPR.

    Look,listenandfeelforbreathingisnolongerrecommended.Insteadofassessingthevictimsbreathing,beginCPRifthevictim

    isnotbreathing(orisonlygaspingforbreath),hasnopulse(orifyouareunsure),orifthevictimisunresponsive.Donotperforman

    initial assessment of respirations. The goal is early delivery of chest compressions to cardiac arrest victims.

    High-qualityCPRiskeyandisdefinedas:

    - Compression rate of AT LEAST 100 per minute for all victims

    - Compression depth of AT LEAST 2 inches for adults/children and about 1.5 inches for infants

    - Allow complete chest recoil after each compression

    -MinimizeinterruptionsinCPRexcepttouseanAEDorchangerescuerpositions

    -DoNOTover-ventilate

    - Provide CPR as a team when possible

    CricoidpressureisNOlongerroutinelyperformed.

    Pulsechecksareshorterfeelforapulsefor10secondsthenbegincompressionsifapulseisabsentorifyouarenotsureyou

    feel a pulse. Even trained clinicians cannot always reliably tell if they can feel a pulse.

    Forinfants,useamanualdefibrillatorifoneisavailable.IfoneisNOTavailable,anAEDwithpediatricdoseattenuatorshouldbe

    usedforaninfant.IfanAEDwithdoseattenuatorisnotavailable,youmayuseanadultAEDevenforaninfant.

    1ameriCan heart aSSoCiation. advanCed CardiovaSCular life Support provider manual. aha: 2011; p 183.

    5

  • BLSFORADULTSThe Basic Life Support (BLS) course for adults focuses on doing several tasks simultaneously. In previous versions of BLS, the focus was

    primarily on one-rescuer CPR. With the 2010 guideline update, it is recognized that more than one person is typically available to do CPR.

    However, all rescuers should know how to do both one and two-person resuscitation. This includes chest compressions, establishing an

    airway,breathingforthevictim,anddefibrillationwhenanAEDmachineisavailable.ItiscriticaltoknowthestepsinAdultBLS.

    MONITOR RHYTHM/ SHOCK IF NEEDED

    REPEAT AFTER 2 MIN

    GET AED & START CPR

    PUSH HARD AND FAST

    ACTIVATEEMERGENCYRESPONSE

    UNRESPONSIVE:NO BREATHING OR

    ONLY GASPING

    SIMPLE ADULT BLS ALGORITHM

    6

  • ONE-RESCUER ADULT BLS/CPR

    1. Check for the carotid pulse on the side of the neck. Remember not to waste time trying to feel for a pulse; feel for NO MORE THAN 10 seconds. If you are not sure you feel a pulse, begin CPR with a cycle of 30 chest compressions and two breaths. (fig. 1)

    2. Use the heel of one hand on the lower half of the sternum in the middle of the chest. (fig. 2)

    3.Putyourotherhandontopofthefirsthand.(fig. 3)

    4. Straighten your arms and press straight down. Compressions shouldbeATLEASTtwoinchesintothevictimschestandata

    rate of AT LEAST 100 per minute. (fig. 4)

    5.Stoppressingandletthechestexpandaftereachcompression thiswillallowbloodtoreturnbackintotheheart.

    6. After 30 compressions, stop compressions and open the airway by tilting the head and lifting the chin. (fig. 5a & b)

    a.Putyourhandonthevictimsforeheadandtiltthehead

    back.

    b.Liftthevictimsjawbyplacingyourindexandmiddle

    fingersonthelowerjaw;liftup.

    c.Donotperformheadtilt/chinliftifyoususpectthe

    victimmayhaveaneckinjury.

    7. Give a breath while watching the chest rise. Repeat while giving a second breath. Breaths should be delivered over 1 second.

    8. Resume chest compressions.

    BE SAFE

    ASSESS THE VICTIM

    CALL EMS

    CPR

    DEFIBRILLATE

    Move the victim out of traffic. Move the victim out of water. Be sure you do not become a victim.

    Shake the victim and shout at the victim. Check to see if the victim is breathing.

    Send someone for help and an AED. If alone, first call for help.

    Check pulse. Begin compressions and breathing.

    Attach the AED when available. Listen and perform the steps as directed.

    STEPS FOR CPR

    fig. 1

    fig. 4

    fig. 5b

    fig. 5a

    fig. 2

    fig. 3

    7

  • TWO-RESCUER ADULT BLS/CPRMany times there will be a second person available that can act as a second team member.

    SendthispersontocallEMSandfindanAEDwhileyoubeginCPR.Whenthesecondrescuer

    returns, the CPR tasks can be shared:

    1.Havethesecondres