cardio pulmonal skill

7/30/2019 cardio pulmonal skill

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Not SICK

SICK

Stablepotential unstable.

UnStable Level 1 Resuscitative Level 2 Emergent

Level 3 Urgent

Level 4 Less urgent

Level 5 Non-urgent


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MENENTUKAN

ANAK SAKIT GAWAT

PAT

MELIHAT KEADAAN ANAK

GENERAL ASSESSMENT

PENILAIAN ABCDE

INITIAL ASSESSMENT


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For the purpose of resuscitation,children are divided into 3 age

groups:

Infants: under one year of age

Small children: 1 to 8 years of age

Older children/adults: 9 years and over


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Circulation, Circulation,Circulation


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If you see someone down in theparking lot, ask them if they areok, if they don't respond, juststart chest compressions.

NO mouth to mouth.

No more "look, listen, and feel" for

breathing. Just start compressions.


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This doesn't apply to hospitalizedpatients or ER patients.

In the hospital, you can havesomeone bag them right away andintubate them.

You don't have to ignore airway


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Advanced airways, central lines, anddrug delivery

should not interupt chestcompressions


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Atropine is gone.

Atropine is no longer part of ACLS

protocols at all. If they are slow or bradycardic,

epinephrine will work just fine.

Use an epinephrine drip or dopaminedrip if needed.


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Determine Responsiveness

Gently tap on shoulder and speakloudly.

If responsive, place in position ofcomfort

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Basic Life Support Check forDANGER, stop and look

Check RESPONSE, verbal and tactile but do notshake and shoutIf conscious, assess carefully, patient may still need

urgent medical review

Continue to assess and manage

Airway

Breathing

CirculationSlide 12

D

R

AB

C


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Slide 13

Basic Life Support Flowchart

Check forDANGER Check forRESPONSECONSCIOUSMake comfortable

Observe ABC

UNCONSCIOUSAlert assistance

Clear airway

Apply head tilt and jaw supportCheck for breathing

NOT BREATHING2 rescue breaths

Check for pulseLook for signs of life

BREATHINGLateral position

Observe ABC

INADEQUATE PULSENo signs of life

Commence CPR


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Slide 18

Airway Opening ManoeuvresChin lift/head tilt

Infants

Neutral head position

with chin lift

Smaller children

Sniffing position

with chin lift


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Slide 19

Airway Opening ManoeuvresChin lift/head tilt

Older children/adultsBackward head tilt

with pistol grip


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Nasopharyngeal Airway


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Slide 29

Breathing

If breathing is absent or inadequate:

n Give 2 rescue breaths allowing about 1

second per inspiration

n Sufficient breath to achieve gentle riseand fall of chest, this means

puffs for an infant

breaths for a child

full breaths for an older child/adult


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Slide 30

Bag and Mask

Correct mask size: cover mouth and nose only

Holding the mask: C-grip

C


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Monitor the Effectiveness of

Ventilation


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Child CPR

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Place child on firm surface andmaintain airway with one hand

Place heel of other hand over lower

half of the sternum. Avoid the xiphoid process.

Compress chest about 1" to 1 1/2"at a rate of 100/min.


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PULSE Check

Take no more than 10secondsCardiac output in infancy and childhood largelydepends on heart rate.

No scientific data has identified an absolute heart

rate at which chest compressions should be

initiated;

the recommendation to provide cardiac compression

for a heart rate


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Locating and palpating carotid artery

pulse ( > 1 year)

Locating and palpating brachial pulse

( < 1 year)

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C tid l h k i hild


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Copyright 2000 American Heart Association

Circulation 2000;102:253I--290I-

Carotid pulse check in child


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PIJAT JANTUNG LUAR


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If no pulse palpated,begin

chest compression

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Slide 61

Patient should be on a hardsurface eg. cardiac board

Rhythmic action, equal time for

compression and relaxation

Aim for a rate of 100

compressions per minute


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Slide 62

CPR Ratio

CIRCULATION

Hand Position

Depth ofCompression

INFANT

1/3 depth of chest

OLDER

CHILD

30 compressions: 2 breaths

5 cycles / 2 min

SMALL

CHILD

Lower half of sternum

Ratio and Rate

1 rescuer

The ratio describes the number of

compressions in relation to breaths, the

rate is the number of

compressions/breaths given per minute.

Ratio and Rate

2 rescuers

15: 2

5 cycles/min

30: 2

5 cycles/2 min


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CPR Infant


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Slide 64

CPR Infant

Finger/Thumb

position:lower 1/2 of the sternum

Compression depth:

1/3 of the depth of the chest


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CPR R ti


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Slide 69

CPR Ratio

CIRCULATION

Hand Position

Depth of

Compression

INFANT

1/3 depth of chest

OLDER

CHILD

30 compressions: 2 breaths

5 cycles / 2 min

SMALL

CHILD

Lower half of sternum

Ratio and Rate

1 rescuerRatio and Rate

2 rescuers

15: 2

5 cycles/min

30: 2

5 cycles/2 min


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Slide 70

CPR Small Child

Child: Up to 8 yearsUse the heel of one hand

Locate lower half of sternumRatio

Lone health care provider/ lay rescuer

30 compressions : 2 breaths (5 cycles per 2 minute)

Two health care providers 15 compressions : 2 breaths (5 cycles per 1 minute)

Aim for a rate of 100 compressions per minute


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Locating hand position for chest

compressions in child (> 1 year)Use 2-3 fingers to locate lower margin of

rib cage. Follow rib margin to base of

sternum (xiphoid process)Over 8 yr

Place other hand on top of hand on sternum

Depress 1 - 2 in at least 100 per min

2 breaths to every 15 compressions

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1 ~ 8 yr

Use heel of one hand

Depress 1 1 in

100 per min

One-rescuer

1 breath to every 5 compressions

Two-rescuer

2 breaths to every 15 compressions

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One hand chest compression


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Circulation 2000;102:253I--290I-

One-hand chest compressiontechnique in child


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cardio pulmonal skill

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