cardio pulmonal skill
TRANSCRIPT
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Not SICK
SICK
Stablepotential unstable.
UnStable Level 1 Resuscitative Level 2 Emergent
Level 3 Urgent
Level 4 Less urgent
Level 5 Non-urgent
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3
MENENTUKAN
ANAK SAKIT GAWAT
PAT
MELIHAT KEADAAN ANAK
GENERAL ASSESSMENT
PENILAIAN ABCDE
INITIAL ASSESSMENT
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For the purpose of resuscitation,children are divided into 3 age
groups:
Infants: under one year of age
Small children: 1 to 8 years of age
Older children/adults: 9 years and over
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Circulation, Circulation,Circulation
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If you see someone down in theparking lot, ask them if they areok, if they don't respond, juststart chest compressions.
NO mouth to mouth.
No more "look, listen, and feel" for
breathing. Just start compressions.
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This doesn't apply to hospitalizedpatients or ER patients.
In the hospital, you can havesomeone bag them right away andintubate them.
You don't have to ignore airway
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Advanced airways, central lines, anddrug delivery
should not interupt chestcompressions
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Atropine is gone.
Atropine is no longer part of ACLS
protocols at all. If they are slow or bradycardic,
epinephrine will work just fine.
Use an epinephrine drip or dopaminedrip if needed.
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Determine Responsiveness
Gently tap on shoulder and speakloudly.
If responsive, place in position ofcomfort
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Basic Life Support Check forDANGER, stop and look
Check RESPONSE, verbal and tactile but do notshake and shoutIf conscious, assess carefully, patient may still need
urgent medical review
Continue to assess and manage
Airway
Breathing
CirculationSlide 12
D
R
AB
C
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Slide 13
Basic Life Support Flowchart
Check forDANGER Check forRESPONSECONSCIOUSMake comfortable
Observe ABC
UNCONSCIOUSAlert assistance
Clear airway
Apply head tilt and jaw supportCheck for breathing
NOT BREATHING2 rescue breaths
Check for pulseLook for signs of life
BREATHINGLateral position
Observe ABC
INADEQUATE PULSENo signs of life
Commence CPR
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Slide 18
Airway Opening ManoeuvresChin lift/head tilt
Infants
Neutral head position
with chin lift
Smaller children
Sniffing position
with chin lift
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Slide 19
Airway Opening ManoeuvresChin lift/head tilt
Older children/adultsBackward head tilt
with pistol grip
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Nasopharyngeal Airway
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Slide 29
Breathing
If breathing is absent or inadequate:
n Give 2 rescue breaths allowing about 1
second per inspiration
n Sufficient breath to achieve gentle riseand fall of chest, this means
puffs for an infant
breaths for a child
full breaths for an older child/adult
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Slide 30
Bag and Mask
Correct mask size: cover mouth and nose only
Holding the mask: C-grip
C
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Monitor the Effectiveness of
Ventilation
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Child CPR
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Place child on firm surface andmaintain airway with one hand
Place heel of other hand over lower
half of the sternum. Avoid the xiphoid process.
Compress chest about 1" to 1 1/2"at a rate of 100/min.
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PULSE Check
Take no more than 10secondsCardiac output in infancy and childhood largelydepends on heart rate.
No scientific data has identified an absolute heart
rate at which chest compressions should be
initiated;
the recommendation to provide cardiac compression
for a heart rate
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Locating and palpating carotid artery
pulse ( > 1 year)
Locating and palpating brachial pulse
( < 1 year)
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C tid l h k i hild
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Copyright 2000 American Heart Association
Circulation 2000;102:253I--290I-
Carotid pulse check in child
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PIJAT JANTUNG LUAR
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If no pulse palpated,begin
chest compression
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Slide 61
Patient should be on a hardsurface eg. cardiac board
Rhythmic action, equal time for
compression and relaxation
Aim for a rate of 100
compressions per minute
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Slide 62
CPR Ratio
CIRCULATION
Hand Position
Depth ofCompression
INFANT
1/3 depth of chest
OLDER
CHILD
30 compressions: 2 breaths
5 cycles / 2 min
SMALL
CHILD
Lower half of sternum
Ratio and Rate
1 rescuer
The ratio describes the number of
compressions in relation to breaths, the
rate is the number of
compressions/breaths given per minute.
Ratio and Rate
2 rescuers
15: 2
5 cycles/min
30: 2
5 cycles/2 min
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CPR Infant
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Slide 64
CPR Infant
Finger/Thumb
position:lower 1/2 of the sternum
Compression depth:
1/3 of the depth of the chest
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CPR R ti
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Slide 69
CPR Ratio
CIRCULATION
Hand Position
Depth of
Compression
INFANT
1/3 depth of chest
OLDER
CHILD
30 compressions: 2 breaths
5 cycles / 2 min
SMALL
CHILD
Lower half of sternum
Ratio and Rate
1 rescuerRatio and Rate
2 rescuers
15: 2
5 cycles/min
30: 2
5 cycles/2 min
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Slide 70
CPR Small Child
Child: Up to 8 yearsUse the heel of one hand
Locate lower half of sternumRatio
Lone health care provider/ lay rescuer
30 compressions : 2 breaths (5 cycles per 2 minute)
Two health care providers 15 compressions : 2 breaths (5 cycles per 1 minute)
Aim for a rate of 100 compressions per minute
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Locating hand position for chest
compressions in child (> 1 year)Use 2-3 fingers to locate lower margin of
rib cage. Follow rib margin to base of
sternum (xiphoid process)Over 8 yr
Place other hand on top of hand on sternum
Depress 1 - 2 in at least 100 per min
2 breaths to every 15 compressions
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1 ~ 8 yr
Use heel of one hand
Depress 1 1 in
100 per min
One-rescuer
1 breath to every 5 compressions
Two-rescuer
2 breaths to every 15 compressions
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One hand chest compression
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Circulation 2000;102:253I--290I-
One-hand chest compressiontechnique in child
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