RJP New Guideline
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Transcript of RJP New Guideline
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BANTUAN HIDUP DASAR (BHD)
(AHA 2010)
BANTUAN HIDUP DASAR (BHD)
(AHA 2010)
S u t o n o
PUSBANKES 118 PERSI DIY
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Rehabilitation
DISASTER/TRAUMA /CRITICAL DISEASE
I.C.URuang rawat
Unit Emergensi
(Pertolongan medis)
Kondisi Pelayanan Gawat Darurat di Indonesia saat ini ??Kondisi Pelayanan Gawat Darurat di Indonesia saat ini ??
Fase Pra-RS Fase RS
(Dokter Umum)
Pusat Kesehatan Umum / Klinik /
Puskesmas
Penolong awam
P3K?/pertolongan
awam
BHLBHD BHJP
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Bantuan Hidup Dasar Bantuan Hidup Dasar (BHD) (BHD)
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•Early recognition & EMS activation •Early CPR•Early defibrilation•Early ALS •Integrated Post cardiac arrest care
RANTAI KESELAMATAN RANTAI KESELAMATAN (CHAIN OF SURVIVAL)(CHAIN OF SURVIVAL)
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How to improve the outcome of sudden cardiac arrest?
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Indikasi BHDIndikasi BHD
Henti nafasHenti nafas
Henti jantungHenti jantung
(= mati klinis)(= mati klinis)
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Adult BLS Adult BLS AlgorithmeAlgorithme
AMERIKA
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Adult BLS Adult BLS AlgorithmeAlgorithme
EROPA
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International Liaison Committee on Resuscitation
ILCOR
Konsensus 2005
Universal Cardiac Arrest Algorithm
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International Liaison Committee on Resuscitation
ILCOR
Konsensus 2005
Universal Cardiac Arrest Algorithm
Unresponsive|
Open airwayLook for signs of life
|Give 2-5 initial breaths
if no regular breathing|
Give 30 chest compressionsfollowed by 2 breaths
|Continue until
defibrillator arrives
AA
BB
CC
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AHA NEW GUIDELINES FOR CPR 2010
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Beberapa perubahan yang prinsip dlm CPR (AHA 2010)
• Look - Listen – feel, dikeluarkan dari algoritmaLook - Listen – feel, dikeluarkan dari algoritma• Peningkatan kualitas kompresi :Peningkatan kualitas kompresi :
– Rate dan kedalamanRate dan kedalaman– Minimalisir interupsi kompresiMinimalisir interupsi kompresi– Menghindari napas berlebihMenghindari napas berlebih
• Cricoid pressure selama ventilasi tdk Cricoid pressure selama ventilasi tdk direkomendasikan lagidirekomendasikan lagi
• A – B – C >> C – A – B A – B – C >> C – A – B • Mempersingkat waktu dari kompresi ke AEDMempersingkat waktu dari kompresi ke AED• Meningkatan pendekatan tim dalam CPRMeningkatan pendekatan tim dalam CPR
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LANGKAH-LANGKAH BANTUAN HIDUP DASAR (AHA 2010)
LANGKAH-LANGKAH BANTUAN HIDUP DASAR (AHA 2010)
Open the Airway : Head tilt chin lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek Nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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JANGAN MENJADI KORBANBERIKUTNYA !
Lingkungan
Penolong
Korban
Orang2 disekitarOpen the Airway : Head tilt chin
lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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PASTIKAN KORBAN TIDAK SADAR
Open the Airway : Head tilt chin lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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Guncangkan bahu dengan lembut
Tanya: ”apakah anda baik-baik saja?”
Jika ada respons:
• Jangan ubah posisi korban.
• Cari hal yang tidak beres.
• Ulangi pemeriksaan berkala
Jika tidak ada respon, segera nilai pernapasan (quick look).
PERIKSA KESADARAN
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• Pada > 40% kasus henti jantung, terjadi segera
• Nafas Agonal : gasping / megap-megap
>>>> tanda henti jantung !!
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MENILAI PERNAFASAN
Quick look
Open the Airway : Head tilt chin lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek Nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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jika korban tidak respon
Panggil BANTUAN
Open the Airway : Head tilt chin lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek Nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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aktifkan sistem pelayanan emergensi
✓ telp. 118 (atau no. lokal lain)✓ sebutkan: ‣ ID penelpon, lokasi, apa yg terjadi, jumlah korban,
keadaan korban, apa yg sudah dilakukan, informasi penting lain
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30x KOMPRESI JANTUNG
Open the Airway : Head tilt chin lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek Nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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• Letakkan pangkal telapak tangan di pertengahan bawah tulang dada
• Letakkan tangan yang lain diatas punggung tangan yang satunya
• Jari-jari saling mengunci• Kompresi dada– Laju kompresi 100x per menit– Kedalaman 5 cm– push hard and fast
• Jika mungkin, bergantian kompresi setiap 2 menit
KOMPRESI DADA
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BUKA JALAN NAFAS
Open the Airway : Head tilt chin lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek Nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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2X NAFAS BUATAN
Open the Airway : Head tilt chin lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek Nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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NAFAS BUATAN
• Bibir penolong menutupi mulut korban dgn rapat
• Tiupkan udara nafas sampai dada korban bergerak terangkat (tidal volume)
• 1 tiupan = 1 detik• Biarkan dada korban
mengempis spontan• Ulangi
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LANJUTKAN BHD
30 2
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Periksa apakah ada tanda-tanda
sirkulasi:
Bergerak
Bernafas
Batuk
dll
Open the Airway : Head tilt chin lift/ jaw thrust
Periksa kesadaran
Lihat napas, tdk ada atau gasping
Panggil bantuan / telpon ambulans
Cek Nadi, Kompresi dada 30 X
Berikan 2 x napas buatan
Lanjutkan RJP 30:2, 5 siklus atau 2 menit
Pastikan keamanan
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Kembalinya sirkulasi dan ventilasi spontan Pasien dialihrawatkan kpd yg lebih
berwenang Baru diketahui telah ada tanda-tanda
kematian yang irreversibel Penolong lelah atau keselamatannya
terancam Adanya perintah DNAR Jika 30’ setelah ACLS yang adekuat tidak
didapatkan tanda-tanda kembalinya sirkulasi spontan (asistole yang menetap), bukan intoksikasi obat atau hipotermia.
STOP BHD JIKA .....
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tanda-tanda kematian yang irreversibel :
Kaku mayat
Lebam mayat
Dekapitasi
Pembusukan
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JIKA KORBAN MULAI BERNAFAS NORMAL LAGI,
TEMPATKAN DALAM POSISI “RECOVERY”
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