Download pdf - CPR - Fixed

8/12/2019 CPR - Fixed

1/26

Cardio Pulmonary Cerebral

Rescucitation and ManagementAdvisor: dr. Nicolaas P.S, Sp. An

8/12/2019 CPR - Fixed

2/26

Goal

Support & restore effective oxygenation,

ventilation and circulation

with return of intact neurological function.

Intermediate Goal:

Return of spontaneous circulation (ROSC)

8/12/2019 CPR - Fixed

3/26

OVERVIEW

CARDIOPULMONARY RESUSCITATION

Is a first aid practiceunconscius person w/

abnormal breathing & no pulse

Successfull resuscitation following cardiac

arrest requires several key actions

8/12/2019 CPR - Fixed

4/26

CARDIAC ARREST

4

8/12/2019 CPR - Fixed

5/26

Caused of Cardiac

Arrest

8/12/2019 CPR - Fixed

6/26

Cardiopulmonary Resuscitation

6

BLS

ALS

Perform at the scene

Perform at hospital

8/12/2019 CPR - Fixed

7/26

BASIC LIFE SUPPORT

Basic life support (BLS) is the foundation forsaving lives following cardiac arrest.

Fundamental aspects of BLS include:

immediate recognitionof sudden cardiac arrest(SCA)

activationof the emergency response system

early cardiopulmonary resuscitation(CPR)

rapid defibrillationwith an automated external

defibrillator (AED).

7

8/12/2019 CPR - Fixed

8/26

CHAIN OF SURVIVAL

NEW AHA ADULT CHAIN OF SURVIVAL

Immediate recognition and activation of emergency

response system

Early CPR, w/emphasis on chest compressionsRapid defibrillation

Effective advanced life support

Integrated post-cardiac arrest care

8/12/2019 CPR - Fixed

9/26

Universal

Algorithm forAdult CPR

8/12/2019 CPR - Fixed

10/26

CHANGE IN SEQUENCE

10

8/12/2019 CPR - Fixed

11/26

8/12/2019 CPR - Fixed

12/26

CHEST COMPRESSIONS

8/12/2019 CPR - Fixed

13/26

Without effective chest compressions

Oxygen flow to brain stops.

Oxygen flow to heart stops.

Drugs go nowhere.

Chest Compressions Critical

8/12/2019 CPR - Fixed

14/26

Triple Airway Maneuver

Head tilt

Chin lift

Jaw trust

AIRWAY

8/12/2019 CPR - Fixed

15/26

Rescue Breath

8/12/2019 CPR - Fixed

16/26

8/12/2019 CPR - Fixed

17/26

1. High-quality chest compressions with minimal

iterruptions

2. Airway management and ventilation

3. Intravenous acces and drugs

4. The identification and correction of reversible

factors

Advanced Life Support

8/12/2019 CPR - Fixed

18/26

Airway management and ventilation

1. Endo Tracheal Tube

2. Laringeal Mask Airway


8/12/2019 CPR - Fixed

19/26

Intravenous acces and drugs

1. Peripheral versus central venous drug delivery

2. Intraosseous route3. Tracheal route

4. Adrenaline

5. Anti-arrhythmic drugs


8/12/2019 CPR - Fixed

20/26

Non-shockable rhythms (PEA and asystole)

1. Start cpr 30:2 and give adrenaline 1 mg i.v

2. Give adrenaline 1 mg i.v every 3-5 min3. If there is doubt about wether the rhythm is

asystole or fine VF, do not attempt

defibrilation; instead, continue chest

compressions and ventilation.


8/12/2019 CPR - Fixed

21/26

The identification and correction

of reversible factors

1. Hypovolemia

2. Hypoxia

3. Hydrogen ions (Acidosis)

4. Hyperkalemia or hypokalemia

5. Hypoglycemia

6. Hypothermia


8/12/2019 CPR - Fixed

22/26

The identification and correction

of reversible factors

7. Toxin (drug overdose)

8. Cardiac Tamponade

9. Tension pneumothorax

10.Thrombosis (myocardial infarction, pulmonary

embolism)11.Tachycardia

12.Trauma (hypovolemia from blood loss)


8/12/2019 CPR - Fixed

23/26

1. Patient back to healthy condition

2. No progress

3. No electrical cardiac activity

4. No spontaneous breathing

5. No carotid pulse

6. Unresponsive

7. Dilated pupil and no light reflex

8 . Rescuer too tired

9 Patient definitely death already

10. After 30 min1 hour without improvement

When we stop resuscitation?

8/12/2019 CPR - Fixed

24/26

1. RIB FRACTURES2. FRACTURE STERNUM

3. RIB SEPARATION

4. PNEUMOTHORAX

5. HEMOTHORAX6. LUNG CONTUSIONS

7. LIVER LACERATIONS

8. FAT EMBOLI

9. HIV, HEPATITIS10.INFECTIONS

PROBLEMS AND COMPLICATIONS OF

CHEST COMPRESSIONS

8/12/2019 CPR - Fixed

25/26

8/12/2019 CPR - Fixed

26/26