CARDIO PULMONARY

RESUSCITATION

Prof.Dr. Ruswan Dachlan, Sp An KIC

Dept.of Anaesthesiology & Intensive
Care FKUI
CPR:

Consists of Giving Rescue breathing & Chest

Compressions.

Combination :
EAR : Expired Air Resuscitation
ECC : External Cardiac Compression
Definition:

CPR is an emergency first aid procedure to support &

maintain breathing & circulation for a person who has
stopped breathing (Respiratory Arrest) and/or whose heart
has stopped beating (Cardiac Arrest)

CPR : - is an emergency life support

- is a life saving methode
DEVELOPMENT OF CPR:

Before & after 1960

As a transtition periode from old to
modern methode of CPR
SUDDENT CARDIAC ARREST
The main cause of death in
Europe,USA,Canada.
USA 330,000 a year
Europe 700,000 a year
About 80% of SCA happen in
peoples homes/ out of hospital
(OHCA).
1530
 CPR
AFTER 1960 :
by PETER SAFAR
(ANAESTHESIOLOGIST )

inventor of ABC system of CPR.

BLS (Basic Life Support)-- most effective
than old methode.
MODERN CPR
MODERN CPR
MODERN CPR
CPR :

CAN DOUBLE OR TRIPLE THE

VICTIMS CHANCES OF SURVIVAL

WHEN COMMENCE IMMEDIATELLY

!!!!!!!!!!!!!!!!
DAILY ACCIDENTS:

HEART ATTACK
DROWNING
ELECTRIC SHOCK
INJURY (TRAUMA)
AIRWAY OBSTRUCTION/CHOKING
SMOKE INHALATION
DRUG INTOXICATION/OVER DOSIS
etc.
DAILY ACCIDENT OF INFANTS
&CHILDREN
ASPHYXIA :
TRAUMA/INJURY
NEAR DROWNING
CHOKING : - COIN
- PARTS OF TOY
SUDDENLY INFANT DEATH
SYNDROME (SIDS)
ETC
Signs of RESPIRATORY
ARREST:

Look = No movement of the chest

Listen = Air flow of breathing
Feel = Air flow on your cheek
The skin will be pale or slightly bluish color
Signs of CARDIAC ARREST:

Loss of Consciousness
Loss of Circulation
Loss of Breathing / Gasping
SIGN OF LOSS OF CIRCULATION

ABCENT OF :
- MOVING
- BREATHING
- COUGHING
What to do in an
EMERGENCY ?

Stay calm and remember, you can only do your best

Assess the situation, make sure the area is free of

hazards
Call for skilled / medical help (Activation of EMS)
Check the casualtys responsiveness / consciousness
shake their shoulders gently & shout Are you OK?
Check their Breathing :

Open the Airway by tilting the head & lifting the

chin.

Look, Listen & Feel.

**
X CHIN LIFT

X
NECK LIFT X HEAD TILT

JAW THRUST
Triple Airway Manauvre :
- Chin lift - Head Tilt - Jaw Thrust
If the person is breathing but unconscious:

RECOVERY POSITION :
Continue Reassessed

(to keep the airway clear & allow fluid/secret

to drain from the mouth)
If the casualty is not breathing and unconscious:

Start CPR immediately

CPR must be performed within 4-6 minutes
after cessation of breathing so as to
prevent brain damage or death.
The types of death
Clinical death
Social death/vegetatif state :
-Persistent veg.state
-Permanent Veg.state
Brain Death
Biological Death
Clinical Death
The signs of Clin.Death :
No breathing, the heart stop
beating and brain function temporary
stop but still irreversible.
The brain cells are not damaged yet.
It lasts 4-6 minutes
Clinical death

4 6 minutes is a golden periode to

perform CPR, to prevent irreversible
brain damage due to no oxygenation
of the blood in the brain.
CPR

IS ALMOST NEVER EFFECTIVE IF

STARTED MORE THAN 15 MINUTES
AFTER COLLAPSE BECAUSE
PERMANENT BRAIN DAMAGE HAS
ALREADY OCCURED
CPR : ABC of First AID

A : Airway (Control)
B : Breathing (Support)
C : Circulation (Support)
 A - AIRWAY

Place victim flat on his/her back on a hard surface.

Shake victim at the shoulders and shout
are you okay?
If no response, call emergency medical help.
Head-tilt/chin-lift open victims airway by tilting
their head back with one hand while lifting up their
chin with your other hand.
Airway control
 B - BREATHING

Position your cheek close to victims nose and mouth, look

toward victims chest, and
Look, listen, and feel for breathing (5-10 seconds)
If not breathing, pinch victims nose closed and give 2 full
breaths into victims mouth (use microshield).
If breaths wont go in, reposition head and try again to give
breath. If still blocked, perform abdominal thrusts
(Heimlich maneuver)
EXPIRED AIR

IT HAS BEEN PROVED THAT EXPIRED

AIR WAS SUFFICIENT TO MAINTAIN
ADEQUATE OXYGENATION
 C - CIRCULATION

Check for carotid pulse by feeling for 5-10 seconds at side of victims
neck.
If there is a pulse but victim is not breathing, give Rescue breathing
at rate of 1 breath every 5 seconds or 12 breaths per minute.
If there is no pulse, begin chest compressions as follows:
Place heel of one hand on lower part of victims sternum. With your
other hand directly on top of first hand, Depress sternum 1.5 to 2
inches.
Perform 30 compressions to every 2 breaths. (rate: 80-100 per
minute)
Check for return of pulse every minute.
CONTINUE UNINTERRUPTED UNTIL ADVANCED LIFE SUPPORT IS
AVAILABLE
CPR on Adult and child 8 years
or older

Ratio 30 : 2

One or two Rescuers

Chest Compression effectiveness :

Provide 25%-35% of the bodys

normal blood flow(cardiac output)
C - CIRCULATION
Check Carotid Artery on the neck
Sometime not representative
CPR INFANT :
Heimliech maneuver :

A. Back Blows B. Abd.Thrust

BACK BLOWS
 CPR on a Child Under Age 8 :
Basic CPR on a child is five chest compressions and one breath. You
may have to repeat the five compressions and one breath multiple times.
You will push down on the chest 100 to 120 times per minute. Continue
until breathing begins or help arrives.

Kneel next to the child.

With the fingers of the hand that is closest to the childs feet, find the
bottom of the breastbone.
Place the heel of one hand below the nipples and above the bottom of
the breastbone and push down forcefully, 1 inches with each
compression; then let the chest rise. Count out loud: 1 and 2 and 3
and 4 and 5.
Then tilt the childs head back slightly and form a seal with your mouth
over the childs mouth and nose (see Mouth-to-Mouth-and-Nose
Resuscitation on a Child Under Age 8 or on an Infant, p. 1197). Blow
one breath so that the chest rises.
Continue, alternating five compressions and one breath, until help
arrives.
CPR on a Child under 8 :

CPR = 30 : 2
( one rescuer )

1: 2
(two rescuers)
TOTAL OBSTRUCTION OF THE
AIRWAY because of solid/
foreign materials
HEIMLICH MANAUVRE :
- Abdominal Thrust
- Chest thrust : = Fat people
= pregnant

BACK BLOWS
Basic Life Support

SSSSSSSS 30 : 2 ratio
Neck collar / Collar brace

The Fracture of the cervical/neck bone

Fixation head & neck with sand pillow

Hati-hati, jalan nafas bisa tersumbat,

bila muntah = langsung aspirasi
CPR:

With both of your hand you can do

anything to save LIVES & GIVE some
one second chance of life.