ACLS 2010 Presentation

7/18/2019 ACLS 2010 Presentation

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ACLS 2010

dr. Rainhard Octovianto

Puskesmas Kecamatan PasarRebo



v



Misconception

ACLS 200 vs ACLS 2010

1. A!"!C C!A!"

2. #denti$cation o% A&ona' (asp

). Activation o% *mer&enc+ S+stem,. *mphasis on hi&h -ua'it+ CPR

. Compression 100/ min Min100/ min

. Pu'se check a%ter CPR

. 3ands on'+ CPR su&&estion

4. One he'per vs 5eam Resuscitation



A!"!C C!A!"

• 200 Air6a+ 7 "reathin& 7 Circu'ation

• 2010 Circu'ation 7 Air6a+ 7 "reathin&

• 8h+ 9 – Most patient o% cardiac arrest :; < Pu'se'ess

:5 A!"!C a'&orithm de'a+s ear'+ compression< de$bri'ation

– Research resuscitation startin& 6ith )0compression instead o% venti'ation comes 6ithbetter output

– Research de'a+ in chest compression in

cardiac arrest reduced surviva' rate



#denti$cation o% A&ona'(asp



#denti$cation o% A&ona'(asp

• 200 CPR on'+ be &iven to patient 6ithapneu respirator+ arrest

• 2010 CPR be &iven to patient 6ith

apneu or &aspin& on'+

• 8h+ 9

–:arious cardiac arrest cases start 6ith a&ona'&asp instead o% respirator+ arrest apneu

– Research ear'+ compression on &aspin&patient increase surviva' rate



Activation o% *mer&enc+S+stem



Activation o% *mer&enc+S+stem

• 200 Activated as soon as $ndin& anunconscious patient

• 2010 Activated as respirator+ arrest or

&aspin& is con$rmed on an unconsciouspatient.

• 8h+ 9 – Most patient o% cardiac arrest comes 6ith

unconsciousness and respirator+ arrest or&aspin& 2 pieces o% ke+ in%ormation is re-uired



*mphasis o% 3i&h =ua'it+CPR

• 200 >ot mentioned

• 2010 ?

– Minimum 100 /min

– Minimum depth o% cm – Per%ect chest recoi'

– Minimum interruption

– Prevent 3+perventi'ation

• 8h+ 9

– 3i&h -ua'it+ CPR increase surviva' rate



Minimum compression o% 100/min

• 200 Chest compression o% appro/imate'+100/min

• 2010 Chest compression o% min 100 /min

• 8h+ 9 – Research More %re-uenc+ o% compression

associated 6 better surviva' rate

– Minimum compression o% 100/min is one o%man+ aspects o% hi&h -ua'it+ CPR a'' must beper%ormed to achieve best resu't



Pu'se Check a%ter CPR

• 200 due to an+ circumstances per%ormpu'se check a%ter c+c'e o% CPR

• 2010 carotid pu'se check on'+ to be

per%ormed i% the monitor doesn@t sho6 :; :5or As+sto'e

• 8h+ 9

– Most o% :; :5 and As+sto'e cases comes 6ithoutpu'se

– A'6a+s per%orm minimum interruption %or chestcompression ru'es



One 3e'per vs 5eamResuscitation

• 200 no diBerence bet6een onehe'per and team resuscitation

• 2010 a ne6 venti'ation techni-ue%or one he'per < no c+c'e app'ied onpatient 6ith patent air6a+ support

• 8h+ 9 – A'6a+s per%orm minimum interruption %or

chest compression ru'es



Cardiac Arrest Algorithm

Cases ?1.:entricu'ar ;ibri''ation2.Pu'se'ess :entricu'ar 5ach+cardia

).As+sto'e,.Pu'se'ess *'ectrica' Activit+



Shockab'e

>on ! Shockab'e

:; :5

As+sto'e P*A



What if ROSC occurs ?



Air6a+<

"reathin&

Circu'atio

n3 < 5



3 < 5

3 ?

1.3+pothermia 5hermometer

2.3+po/ia O2 Saturation

). 3+povo'emia 3b vs 35

,. 3+po3+perka'emia

*'ectro'it

. 3+dro&en Acidit+ "(A

>on!#nvasive

#nvasive



3 < 5

5

1. 5ension Pneumothora/

2. 5amponade Cardiac). 5hrombosis Pu'monar

,. 5hrombosis Cardiac

. 5o/in

Ph+sica' */am

< Ront&enPh+sica' */am "'ood Ana'+sis <

*K("'ood Ana'+sis



Acute Coronary SyndromeAlgorithm

Cases ?1.nstab'e An&ina DAPE2.>on ! S5 *'evation Miocard #n%ark

D>S5*M#E).S5 *'evation Miocard #n%arkDS5*M#E

. nse > m ni li



#OL

"'oodAna'+sis

*K( < Fra+

MO>A

2. Pain uality 10!10". #eels li$e chest

%eing com&ressed! %urned

'. Pain refers tonec$ ( shoulder (

mandi%le ore&igastric

). Occurs duringresting

*. Accom&anied +ithnausea ( ,omiting

( headache -s+eating



;ibrino'+tic Check'ist1. aemoragicStro$e

2. /schemicStro$e > "

hr ( "onths3

". /ntracranial4umor

'. A5

#acial4rauma " onths

Aorta

6issection

1. assi,eA%dominal7leeding

2. ClottingPro%lem



5hank Gou

ACLS 2010 Presentation

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