Dr.

Muhammad Fadil SpJP (K)

Langsa, 31 Mei 1980
Jl. Andalas Raya no 1, Padang

PENDIDIKAN
•Dokter Umum FK-UNAND tahun 1998
•Dokter Spesialis Penyakit Jantung & Pembuluh Darah FKUI, 2007
•Acute & Intensive Cardiac Care, Intervensional Cardiology Fellowship RS Jan
tung Harapan Kita Jakarta 2013
•Invasive Cardiology Fellowship, Santakunta Hospital Pori, Finland 2016

PEKERJAAN
•Staf Pengajar Bagian Kardiologi FK UNAND, 2008 – Sekarang
•Kepala Subbagian Emergency, Acute & Intensive Cardiac Care RS dr. M Djamil
Padang 2013-sekarang

ORGANISASI
•Ketua Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI) Cabang
Padang 2015-sekarang
Cardiac arrest step by step
Save the heart, Save the life

Dr. Muhammad Fadil, SpJP(K)

ALLPPT.com _ Free PowerPoint Templates, Diagrams and Charts

 Why is this so important?
• Ischemic Heart Disease is the leading cause of
death in the world
• 1 in 3 deaths in the U.S. is due to cardiovascular
• 326,200 Out Of Hosital Cardiac Arrests treated
by EMS
• 209,000 In Hospital Cardiac Arrests
• Most victims will die without immediate and
appropriate intervention
Highlights of the 2015 AHA Guidelines Update for CPR and ECC
 • Survival rates are improving (all rhythms)
• Survival increase attributed (in part) to:
– Increased emphasis and focus on CPR quality
– Systems of Care – Post cardiac arrest care

Highlights of the 2015 AHA Guidelines Update for CPR and ECC
Highlights of the 2015 AHA Guidelines Update for CPR and ECC
Highlights of the 2015 AHA Guidelines Update for CPR and ECC
BLS Healthcare Provider Adult Cardiac Arrest Algorithm—2015 Update
Scenario
You are strolling around in a mall an
d looking out onto the parking lot.
You see a man lying unresponsive o
n the ground. There are no signs of
trauma, and no one witness him fall.

What should
you do?
Check response
Shake shoulders
gently
“Hello can you hear me?”
If he responds
• Leave as you find him.
• Find out what is wrong.
• Reassess regularly.
• If no response.....
Shout for help
• Activate emergency
response system
• Get AED and emergency
equipment (or send
someone to do so)
Open Airway
• Head tilt
• Chin lift
Check breathing and pulse
simultaneously
• No breathing?
• Gasping?

• Pulse definitely felt

within 10 seconds?

No breathing
No pulse
Do CPR, use AED as soon as it’s
available
• High quality CPR
AED arrives :
shockable?
• Shock indicated :
– Stand clear
– Deliver shock
– Continue CPR
immediately

– Patients start moving

– ALS team is coming
– Send to EMG
immediately
 Victim was arrived at EMG
• You are reporting patient’s condition to EMG
doctor, when he suddenly collapse again
• Monitor is already attached, and it shows..

What should you do?

Adult Advanced Cardiovascular Life Support 2015 AHA Guidelines Update for Cardiopulmonary Resuscitation
and Emergency Cardiovascular Care
• Patient was succesfully rescucitated, while givi
ng the oxygen and check the blood pressure,
a 12 leads ECG was taken
• Here is the ECG

What should you do next?

Initial management of ACS

“MONACO”
• Morphine
• O2
• Nitrates
• Aspilet
• clopidogrel
Coronary reperfusion
PCI procedure
 Hypothermic therapy

Core Temperature Measurement If Comatose

Rationale:
Minimize brain injury and improve outcome
• Prevent hyperpyrexia >37.7°C
• Induce therapeutic hypothermia if no contraindicatio
ns
• Cold IV fluid bolus 30 mL/kg if no contraindication
• Surface or endovascular cooling for 32°C–34°C×24 h
ours
• After 24 hours, slow rewarming 0.25°C/hr

Post-Cardiac Arrest Care 2015 American Heart Association Guidelines for Cardiopu
lmonary Resuscitation and Emergency Cardiovascular Care