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PEMBIMBING :Dr. Purwito Nugroho, Sp.An, MMOleh :Elvina Elizabeth406138163

KEPANITERAAN KLINIK ANESTESIOLOGI DAN RAWAT INTENSIFRUMAH SAKIT UMUM DAERAH KOTA SEMARANGFAKULTAS KEDOKTERAN UNIVERSITAS TARUMANAGARAPERIODE 24 NOVEMBER 2014 13 DESEMBER 2014

CPR CARDIAC ARREST DAN NON CARDIAC ARRESTCardio pulmonary resuscitation is an emergency measure as an attempt to reverse the situation stop breathing and cardiac arrest (clinical death) to function optimally, in order to prevent biological death. Resuscitation from cardiac arrest and stopped breathing is a critical business that absolutely must be mastered by medical personnel to obtain optimum results.DEFINITIONINDICATIONS1. Respiratory Arrest2. Cardiac Arrest

a. Respiratory Arresta. Drowningb. Stroke Attackc. Airway Obstructiond. Overdosise. Electric Shockf. Infark Miokard

b. Cardiac Arrest1. Asystole 2. PEA (Pulseless Electrical Activity) 3. VF (Ventricular Fibrillation) 4. Pulseless VT (Ventricular Tachycardia ) Cardiac arrest ( > 5 minute)Terminal phase of the diseaseThe inside of the chest trauma , such as sharp cutsAir embolismTension pneumothorak Cardiac tamponade Normal death Patients with criteria do not resuscitate ( DNR )KONTRAINDIKASISpontaneous circulation and ventilation has been improved Sign of irreversible death, as rigormortis, decapitation, decomposition, or paleHelper has been unable to continue the action because of tired or the circumstances endanger environmentWhen a patient is found to be in the terminal stages of the disease

WHEN STOPPED CPR ????

CPR PHASEI. Basic Life SupportII. Advanced Life Supporta. Airway controlb. Breathing supportc. Circulation supporta. Drug and fluid b. Electrocardiographyc. Fibrillation treatment

III. Prolonged Life Supporta. Gaugingb. Human Mentationc. Intensive Care

BASIC LIFE SUPPORT

AIRWAY CONTROLCross finger technique Finger sweep technique

Heimlich ManeuverChest Thrust

BREATHING SUPPORTLook, listen and feel

CIRCULATION SUPPORT

ADVANCED LIFE SUPPORT)Installation of infusion IV drug delivery / in the etiology of cardiac arrest with VT / VF : a. 1 mg of adrenaline after 3 times of shock and then every 3-5 minutes ( during CPR cycle in progress ) b. Amiodarone 300 mg is also given after 3 times of shock c. Atropine is no longer recommended in asystole and PEA Hypotension ---dopamine 200mg in 500 ml physiological saline Metabolic acidosis --- Sodium bicarbonate , 1mEq dose / kg ivDrug and fluid

ElectrocardiographyFibrilasi VentrikelAsystoleTo treat ventricular fibrillation do DC - shock . The first defibrillation given 3 joules / kg . The highest repeat dose is 5 joules / kg with a maximum of 400 joules .Fibrillation treatment

PROLONGED LIFE SUPPORT)Evaluate and treat the cause as well as to assess whether the patient can be saved and whether the relief efforts need to be continued .

GaugingFurther resuscitation of the brain and nervous system to prevent permanent neurologic abnormalities . Some use the term hypothermia for human mentation . Hypothermia is one way to resuscitate the brain after hypoxia , by lowering the patient 's body temperature to 32 - 330C .

Human mentation

Long-term care in the form of efforts to maintain homeostasis extracranial and intracranial homeostasis , among others, by maintaining the function of the respiratory , cardiovascular , metabolic , renal and liver function .

Intensive careCPR DIFFERENCE ILCOR 2005 & 2010Not ABC again but CAB No more look , listen and feel Chest Compression deeper Chest Compression faster again Hands -only CPR Recognize sudden cardiac arrest Do not stop pressing

Recommendations CPR 2010

CONCLUSIONCPR is an emergency action performed on certain conditions that can lead to a stop breathing or cardiac arrest . Indications CPR was stopped breathing and cardiac arrest are not expected death . CPR is contraindicated patients with terminal stage of disease . CPR consists of basic life support , advanced life support and long-term assistance . At each stage there is action - action that were prepared alphabetically .In basic life support , the guidelines in 2005 , the first to be examined is the airway and breathing and circulation last . However , in 2010 there were guidelines that change , which was first examined is the consideration that the circulation because oxygen can still be fulfilled his needs and the sooner performed CPR will increase its success

1. Safar P, Resusitasi Jantung Paru Pada Kegawatan Kardiovaskuler. Juni 2009. Dikutip dari : http://medlinux.blogspot.com/2009/02/resusitasi-jantung-paru-pada-kegawatan. Diunduh pada tanggal 23 Januari 2015. 2. Pedoman RJP update 2010 (revisi) dikutip dari :http://www.medicalzone.org/2010/index.php?option=comcontent&task=view&id=553&Itemid=4. Diunduh pada tanggal 23 Januari 2015. 3. Mansjoer, Arif. Resusitasi Jantung Paru, dalam Buku Ajar Ilmu Penyakit Dalam, Editor Soeparman, Jilid I, ed. Ke-5. Jakarta : Balai Penerbit FKUI; 2010 : 227Andrey, Resusitasi Jantung Paru Pada Kegawatan Kardiovaskuler. Diakses dari http://yumizone.wordpress.com/2008/11/27/resusitasi-jantung-paru-pada-Kegawatan -Kardiovaskuler,2008. Diunduh pada tanggal 23 Januari 2015. 4. Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia. Buku Ajar Ilmu Penyakit Dalam. Jakarta : EGC; 2005 : 176-80. 5. Latief, S. A. Petunjuk Praktis Anestesiologi. Edisi kedua. Jakarta: FKUI; 2010 : 151-60.

BIBLIOGRAPHY 6. American Heart Association. International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. 2010.dikutip dari : http://www.circ-ahajournals.org Diunduh pada tanggal 23 Januari 2015. 7. UK Resiscitation Council. Resuscitation Guidelines. 2010. Dikutip dari : http://www.Resus.org.uk. Diunduh pada tanggal 23 Januari 2015. 8.Resusitasi Jantung Paru, dikutip dari http://www.arismaduta.org/index.php? option=com_content&view=article&id=102:resusitasi-jaResuscitation and Emntung paru&catid=63:artikel-lain&Itemid=86. Diunduh pada tanggal 23 Januari 2015.