Basic Life Support
Consensu
s
Guidelines
The major contributor for ILCOR
Resuscitation Council of
Southern Africa
(RCSA)
Inter American Heart Foundation
Resuscitation Council of ASIA
(IAHF) (RCA)
NEWGuidelines
2015
CARDIO PULMONARY
RESUSCITATION
Since 2000, researchers from the ILCOR member councils have evaluated
resuscitation science in 5-yearly cycles.
The most recent International Consensus Conference was held in Dallas in
February 2015 and the published conclusions and recommendations from
this process form the basis of these ERC Guidelines 2015.
New Guidelines 2015 ~
Guidelines 2010
Key Points
Adult basic life support (BLS):
1. By standers should initiate compression-only CPR.
2. Compression rate should be 100–120 per minute (updated
from “at least” 100 per minute).
3. Compression depth should be 2–2.4 inches (upper limit added).
4. Compression time should be maximized.
5. Social media may be used to summon rescuers to perform
CPR.
Chest Compression-
Only CPR
The AHA recommends that anyone who sees an adult suddenly
collapse should call 911 and push hard and fast on the center of the
chest,
a technique known as Hands-Only CPR. 2015 AHA
Treatment Recommendation
• Chest compressions alone are recommended for untrained
laypersons
• Professional rescuers should provide chest compressions
with ventilations for cardiac arrest victims
• Performing chest compressions alone is reasonable for
trained laypersons if they are incapable of delivering
airway and breathing maneuvers 2010 ILCOR
ERC – AHA -
ILCOR
ERC Guidelines 2015
AHA Guidelines 2015
Since 2010 The 2010 Guidelines
were most notable for the
re-orientation of the universal
sequence from
A-B-C (Airway, Breathing,
Compressions) to C-A-B
(Compressions, Airway,
Breathing) to minimize time
to initiation of chest compressions.
HEAD TILT – CHIN LIFT "Look, Listen, and Feel" is no
longer recommended
ERC 2015 = ILCOR 2015
"Look, Listen, and Feel"
is recommended
ERC Guidelines
2015
HEAD TILT – CHIN LIFT
LOOK – LISTEN – FEEL
ILCOR 2010
3 – 5 seconds
Kapan pijat jantung harus segera dilakukan??
Bila mendadak tidak sadar dan
tidak bernafas atau
Mendadak tidak sadar, nafas ter-
sengal2 (gasping)
Treatment Recommendation
It is reasonable that lay rescuers and healthcare professionals use the combination
of unresponsiveness and absent or abnormal breathing to identify cardiac arrest.
Palpation of the pulse as the sole indicator of the presence or absence of cardiac
arrest is unreliable.
Agonal gasps are common during cardiac arrest and should not be considered
normal breathing.
2010 ILCOR
April_Surabaya
Sel otak : normal reversible irreversible
injury injury
4-6
menit
19
Push hard and fast — but not too hard or too fast!
Pijat dibagian tengah dada
(setengah bagian bawah tulang dada)
Dengan berat badan penolong,
agar tulang dada tertekan 5-6
cm
BLS - awam 100-120x per menit
Mendadak tidak sadar ...??
Tidak bernapas ...??
Pijat jantung saja ....
sampai bantuan datang atau 5-6 cm
korban sudah mulai
bergerak2 sebagai tanda
adanya kehidupan
Korban mendadak
roboh
Code Blue
Kepala di-tengadahkan
Bila ternyata tidak sadar & tidak
bernafas
segera lakukan pijat jatung
dan berteriak minta tolong
....Code Blue
Pijat jantung dan
teruskan ....... sampai
bantuan tim medis
datang
Pijat ditulang dada bagian
bawah Kecepatan pijatan
100-120 x/ menit
Perhatikan
Korban mendadak tidak sadar
Berteriak-
lah minta
bantuan
Kepala
ditengadahkan
Check Nafas
Bila anda tidak
mau atau tidak
mampumemberika korban tidak
n bernafas
tiupan atau nafas tersengal-
nafas sengal
Lakukan pijat Pijat jantung
jantung saja sd 30 X
bantuan medis disusul dengan
datang 2 x tiupan
nafas
Korban mendadak tidak sadar
Berteriak-
lah minta Kepala
bantuan ditengadahk
an Check
Nafas
korban tidak
bernafas
atau nafas tersengal-
sengal
tidak PijatRaba
jantung
nadi 30 X tera
teraba karotis ba
Pijat jantung Stop
30 X 2 x Pijatan
tiupan nafas
Cardiac Arrest, jantung berhenti berfungsi sbg pompa
• Penelitian: 70% ECG arrest awalnya adalah
VT/VF, ketika akhirnya ATP di miokard habis
ECG menjadi asystole
• Jika ECGnya VT/VF, 50-70% bisa ROSC jika
ditolong dalam waktu < 5 menit, dgn melibatkan
defibrilator biphasic
• Jika ECG-nya asystole hanya 7-10% yang bisa
ROSC
AED
berperan
Ventrikel Fibrilasi kasar Ventrikel Fibrilasi halus Asystole
Key Points
New Guidelines 2015
Advanced Cardiovascular Life Support (ACLS):
Advanced Life Support (ALS):
1. Vasopressin is out; stick with epinephrine.
2. Extracorporeal CPR is an alternative to CPR in patients for whom
the suspected etiology is reversible.
3. Maximize oxygenation during CPR, but titrate down after return
of spontaneous circulation (ROSC).
4. After 20 minutes of CPR, a low end-tidal CO2 level may be used to
help determine whether to terminate resuscitation in intubated
patients.
5. Ultrasound may be used to confirm endotracheal tube placement.
Capnography
Waveforms
Key Points
New Guidelines 2015
•Post Cardiac Arrest Care
• After ROSC:
• In comatose patients, target temperature to 32–36°C for at
least 24 hours, and prevent fever.
Sel cortex otak, normotermia Sel cortex otak, teknik hipotermi
Banyak sel apoptosis (mati) Banyak sel normal (hidup)
GOALS of
CPR
The goals of resuscitation are not only to
preserve cardiac and neurologic function but
also to improve quality of life for survivors
Return of cardiac function does not automatically
restore normal cerebral circulation. Depending on
the duration of the ischemic period, cerebral vessel
dysfunction develops which likely contribute to
neuronal damage. Reperfusion Injury
2010
Pembagian Peran Saat BLS
• Setidaknya ada 4 peran dalam BLS :
1. PJ Airway dan Breathing
- bertanggungjawab untuk membebaskan jalan nafas dan memberi nafas
- Posisi ada diatas kepala pasien
2. PJ Pijat Jantung
- bertanggungjawab untuk pijat jantung
- Ada di kanan kiri tubuh pasien
3. PJ Sirkulasi dan Obat
- Bertanggungjawab menyiapkan akses vena untuk infus dan memberikan
obat2an.
4. PJ Timer pemberian obat dan DC Shock
- Bertanggungjawab untuk meberitaukan waktu pemberian obat dan obat apa yg
diberikan
- Brtanggungjawab untuk menyiapkan DC Shock bila diperlukan
Kapan giliran anda
berkesempatan “menghidupkan”
seseorang kembali ...............???
• Berlatihlah
agar
senantiasa siap
• Kesempatan “indah”
itu bisa tiba-tiba
muncul
dimuka Anda
Tidak ada waktu untuk berfikir dua kali,
kerjakan .....atau kesempatan itu
hilang
ED_2013
?