BASIC LIFE SUPPORT

Essa Loyallita Lestari

Handayani Puspa Sari
Muhammad Rizka Yahya
 BLS ???
Usaha yang dilakukan untuk mempertahankan
kehidupan pada saat pasien atau korban
mengalami keadaan yang mengancam jiwa.
Rata-rata orang yang tidak terlatih masih bisa
menyelamatkan nyawa orang lain dengan
fokus utama pada penekanan dada, hal ini
merupakan pedoman terbaru dari American
Heart Association 2010.
 CPR / RJP ???
• Re = Kembali
• Resusitasi = mengembalikan fungsi jantung
paru pada :
– Henti jantung
– Henti nafas
• Tindakan pertolongan pertama pada orang
yang mengalami henti napas karena sebab-
sebab tertentu.
 What’s new ?
• 1958 : “mouth to mouth” ventilation
• 1959 : defibrilator
• 1960 : chest compression
• 2000 : ABC 15:2 with 3 shock 60 sec CPR
pause
• 2005 : ABC 30:2 with 1 shock 120 sec CPR
pause
• 2010 : C-A-B
2005  2010 ???
 From A – B – C to C – A - B
• AHA 2010 (new)
“A change in the 2010 AHA Guidelines for CPR
and ECC is to reccomend the initiation of chest
compression before ventilation.”

• AHA 2005 (old)

“The sequence of adult CPR began with opening
of the airway, checking for normal breathing,
and then delivering 2 rescue breaths followed by
cycles of 30 chest compressions and 2 breaths.”
 Look, Listen, Feel ?
• AHA 2010 (new)
“Look, listen, and feel for breathing was
removed from the sequence for assessment
of breathing after opening the airway. The
healthcare provider briefly checks for
breathing when checking responsiveness to
detect signs of cardiac arrest. After delivery
of 30 compressions, the home rescuer opens
the victim’s airway and delivers 2 breaths.”

• AHA 2005 (old)

“Look, listen, and feel for breathing was used
to assess breathing after the airway was
 ≠ Rescue Breath
• AHA 2010 (new)
“Beginning CPR with 30 compressions rather
than 2 ventilations leads to a shorter delay
to first compression”
 Kompresi dada lebih dalam lagi
• AHA 2010 (new)
“The adult sternum should be depressed at
least 2 inches (5 cm)”

• AHA 2005 (old)

“The adult sternum should be depressed 11/2
to 2 inches (approximately 4 to 5 cm).”
 Kompresi dada lebih cepat lagi
• AHA 2010 (new)
“It is reasonable for lay rescuers and
healthcare providers to perform chest
compressions at a rate of at least 100x/min.”

• AHA 2005 (old)

“Compress at a rate of about 100x/min.”
 Hands only CPR
• AHA 2010 (new)
“Hands-Only (compression-only) bystander
CPR substantially improves survival following
adult out-of-hospital cardiac arrests
compared with no bystander CPR.”
Pengaktivasian Emergency Response
System (ERS)
• AHA 2010 (new)
“Check for response while looking at the
patient to determine if breathing is absent or
not normal. Suspect cardiac arrest if victim is
not breathing or only gasping.”

• AHA 2005 (old)

“Activated the emergency response system
after finding an unresponsive victim, then
returned to the victim and opened the airway
and checked for breathing or abnormal
breathing.”
 Jangan berhenti kompresi dada !!!
• AHA 2010 (new)
“The preponderance of efficacy data suggests
that limiting the frequency and duration of
interruptions in chest compressions may
improve clinically meaningful outcomes in
cardiac arrest patients.”
Tidak dianjurkan lagi Cricoid Pressure

• AHA 2010 (new)

“The routine use of cicoid pressure in
cardiac arrest is not recommended.”

• AHA 2005 (old)

“Cricoid pressure should be used only if the
victim is deeply unconscious, and it usually
requires a third rescuer not involved in
rescue breaths or compressions.”
 Pemberian Precordial Thump
• AHA 2010 (new)
“The precordial thump should not be used for
unwitnessed out-of-hospital cardiac arrest.
The precordial thump may be considered for
patients with witnessed, monitored, unstable
VT (including pulseless VT) if a defibrillator is
not immediately ready for use, but it should
not delay CPR and shock delivery.”

• AHA 2005 (old)

“No recommendation was provided
previously.”
2005 2010
 Langkah – langkah
CPR Pada orang dewasa
 Approach safely
Check response
Shout for help
30 chest compressions
Open airway
2 rescue breaths
30 chest compressions
 Call 112
APPROACH SAFELY!

Approach safely
Scene Check response
Shout for help
Rescuer
30 chest compressions
Victim Open airway
2 rescue breaths
Bystanders 30 chest compressions
 Call 112
CHECK RESPONSE

Approach safely
Check response
Shout for help
30 chest compressions
Open airway
2 rescue breaths
30 chest compressions
SHOUT FOR HELP

Approach safely
Check response
Shout for help
30 chest compressions
Open airway
2 rescue breaths
30 chest compressions
 Approach safely
Check response
Shout for help
30 chest compressions
Open airway
2 rescue breaths
30 chest compressions
OPEN AIRWAY

Approach safely
Check response
Shout for help
30 chest compressions
Open airway
2 rescue breaths
30 chest compressions
RESCUE BREATHS

Approach safely
Check response
Shout for help
30 chest compressions
Open airway
2 rescue breaths
30 chest compressions
 Approach safely
Check response
Shout for help
30 chest compressions
Open airway
2 rescue breaths
30 chest compressions
Recovery Position
STOP CPR??
Perbedaan CPR pada dewasa,
anak2, dan neonatus
 Adult Child Infant
When to call Call 911 before you call 911 after you call 911 after you have tried
for help begin adult CPR have tried resuscitation for at least one
resuscitation for at to two minutes
least one to two
minutes

Circulation/pul Check the carotid Check the carotid Look for the brachial artery
se artery (located in the artery (located in the (located on the inside of the
neck) neck) upper arm)
Head position be very careful not to tilt the head into the ‘sniffer’s
when tilt a child’s head back position,’ which is just far
attempting too far enough back for the baby to
rescue breaths look like he or she is sniffing
the air.

Compression Two hands in the One or two hands in Two fingers in the center of
hand position center of the chest the center of the the chest
chest
Depth of Two inches One and a half inches One inch
compressions