pemakaian aed
DESCRIPTION
Emergency First Aid with AED in Bahasa Indonesia ProcedureTRANSCRIPT
SafeSafe SimpleSimple UseUse
HighHigh SuccessSuccess RateRate
Dr. Hardi Cahyanta
Belida 1 September 2012
Kenyataan Hidup …Kenyataan Hidup …
……Suatu saat setiap orang akan mati!Suatu saat setiap orang akan mati!
Kematian dini
Peter Safar, MDPeter Safar, MD
Walaupun ilmu kedokteran telah maju …Walaupun ilmu kedokteran telah maju …
Kematian mendadak tetap meningkatKematian mendadak tetap meningkat
350,000
300,000
250,000
200,000
150,000
100,000
50,000
Kem
a tia
n /ta
hun
(U. S
.)
SuddenCardiacArrest
Lung Breast Traffic AIDS/ Cancer Cancer Accidents HIV
PENYEBAB2 KEMATIAN
Stroke
Penyakit atau kecelakaan
Murder
menimbulkanmenimbulkan
MenghasilkanMenghasilkan
sehinggasehingga
OO2 2
BlockedBlockedCoronaryCoronaryArteryArtery
Damaged Damaged HeartHeartMuscleMuscle
The “S-A” NodeThe “S-A” NodeThe heart’s ownThe heart’s own
““pacemaker”pacemaker”
HeartbeatHeartbeatContinuesContinuesto Beatto Beat
Serangan Jantung
Tanda & Gejala(Patient may have one or more…)
• Nyeri dada/ tak nyaman• Merambat ke lengan, leher, rahang• Banyak keringat• Susah bernafas• Ketakutan, bingung, marah• Membantah gejala
tetap bernafas dan nadinya berdenyut …
Serangan Jantung
VentricularVentricularFibrillationFibrillation
ChaoticChaoticQuiveringQuivering
butbut
NO NO HeartbeatHeartbeatNO NO BreathingBreathing
V-fibV-fib
Kematian Mendadak
Gejala Pasien yang mengalami Ventricular Fibrillation
Tidak SadarTidak Sadar Tidak ada denyut jantungTidak ada denyut jantung Tidak bernafasTidak bernafas Tampak sakit parah dan pucatTampak sakit parah dan pucat
Sehingga …Sehingga …
Hidup dan mati -> masalah WAKTU
Tak ada oksigen ke otak dan tubuhTak ada oksigen ke otak dan tubuh
Sedikitoksigen
0 Minutes0 Minutes0 Minutes0 Minutes
Kematian MendadakKematian Mendadak
NoNo OxygenOxygen
10-12 Minutes10-12 Minutes
Kematian OtakKematian Otak
80-90%80-90%Kematian mendadakKematian mendadak
Disebabkan oleh:Disebabkan oleh:
V-fibV-fib
Satu-satunya koreksi untukSatu-satunya koreksi untuk
V-fibV-fib
De-fibDe-fib
Chain of SurvivalChain of Survival
EarlyEarly Early Early Early Early Early Early Access Access CPR Defibrillation Advanced CPR Defibrillation Advanced Care Care
EarlyEarly DefibrillationDefibrillation
© © American Heart AssociationAmerican Heart Association
Surv
ival
Rat
e (p
erce
nt)
Time to Defibrillation (minutes)
00
2020
4040
6060
8080
100100
55 1010 1515 2020 2525 3030
Untuk setiap menit penundaan defibrillasiUntuk setiap menit penundaan defibrillasiPeluang hidup berkurang 10% Peluang hidup berkurang 10%
• CPR (saja) ……………………… 0-2%
• EMS/ER …………………… 5-15%
• CPR+AED…….. 30-75%
Bagaimana jikaSeseorang tiba-tibaMengalami gejalaSerangan jantung?
Berikan bantuan awal
ASA
1 Adult 1 Adult OrOr
4 Baby4 Baby
Hubungi bantuan medis
Jika anda melihat seseorang tak sadarkan diri …
… … anda tidak tahu apakah ituanda tidak tahu apakah itu
Kematian MendadakKematian MendadakAtau sebuahAtau sebuah
Serangan JantungSerangan Jantung
• Audible Audible
• VisualVisual (Graphical Operator Interface)(Graphical Operator Interface)
ANDA MEMERLUKAN AED
• Kenali bahwa seseorang Kenali bahwa seseorang memerlukan bantuan medismemerlukan bantuan medis
• CCheckheck TThehe AArea rea for personal dangersfor personal dangers
Apakah perlu pertolongan?
• Apakah orangnya tak sadar?Apakah orangnya tak sadar?
Are you Are you okay?okay?
• ““Log-roll” patient onto his backLog-roll” patient onto his back on a firm surfaceon a firm surface
……if not already there,if not already there,
minta bantuanminta bantuan
Ambil nafas dalam2, Ambil nafas dalam2, dan pusatkan dan pusatkan
perhatian kepada perhatian kepada energi emosional energi emosional
andaanda
Tetap tenang
Someone should IMMEDIATELYIMMEDIATELY
Call forCall for EMS/Medical Help
Make the Right Call
• Send someone forSend someone for the AED…the AED…
……or if alone, go yourself!or if alone, go yourself!
Compressions
3030
Sementara ada yg mengambilkan AED, Sementara ada yg mengambilkan AED, bila tidak ada nafas dan denyut nadi …bila tidak ada nafas dan denyut nadi …
22 Breaths
Mulailah CPRMulailah CPR
JIKA AED SUDAH ADAJIKA AED SUDAH ADA
Push thePush the““ ON” ON”
ButtonButton
Tetap tenangTetap tenang Are you Are you
okay?okay?
Periksa daya tanggap pasienPeriksa daya tanggap pasien
• Pastikan lagi Pastikan lagi bahwa bahwa
pasiennya tak pasiennya tak sadarsadar
• Be sure someone Be sure someone has called forhas called for
EMS/Medical HelpEMS/Medical Help
Apakah bantuan sudah Apakah bantuan sudah menuju lokasi?menuju lokasi?
• Head Tilt/Chin LiftHead Tilt/Chin Lift• Empty the mouth? Empty the mouth?
Buka Jalan Nafas
• LookLook• ListenListen• FeelFeel
Check Breathing
• Give 2 Slow Give 2 Slow BreathsBreaths (Take a Fresh Breath In (Take a Fresh Breath In Between)Between)
...if none is found ...if none is found
Provide BreathingProvide Breathing
• Check for Neck PulseCheck for Neck Pulse (If skilled to do so) (If skilled to do so)
• Normal Skin Color ??? Normal Skin Color ??? • Coughing Coughing or or
Obvious BreathingObvious Breathing
Examine for
Signs of Circulation
• Don’t Touch Patient During AnalysisDon’t Touch Patient During Analysis
• Stay Clear of Patient During ShocksStay Clear of Patient During Shocks Verbal Command to ClearVerbal Command to Clear Visually Confirm All Are ClearVisually Confirm All Are Clear
AEDAED ONLYONLY Advises TreatmentAdvises Treatment
Deliver one shock If there is aDeliver one shock If there is a
Shockable RhythmShockable Rhythm Push Shock Button No Shock Needed
OpenOpen
Airway
Check forCheck for
Breathing
Signs of Circulation
Whether shocks are delivered or not advised…Whether shocks are delivered or not advised…
If No Signs of Circulation …If No Signs of Circulation …
• Kneel next to patientKneel next to patient• Locate hand positionLocate hand position(on compression depth sensor) (on compression depth sensor)
• Position your body Position your body • Give CPR at rate of 30:2Give CPR at rate of 30:2
22 3030
Resume CPR 2 Mins
You will hear: You will hear: “Good compressions” “Good compressions” or or “Push harder”“Push harder” A Adaptive metronome will help pace you daptive metronome will help pace you
• Maintain AirwayMaintain Airway CChin Lift hin Lift Empty Mouth? Empty Mouth? “ “RecoveryRecovery Position” ?Position” ? Place PASS ??Place PASS ??
• Assist BreathingAssist Breathing• Give Emotional SupportGive Emotional Support
If CPR or Shocks aren’t needed…If CPR or Shocks aren’t needed…
When Breathing & PulseWhen Breathing & PulseDo Not ReturnDo Not Return
• Continue CPRContinue CPR• Follow Voice PromptsFollow Voice Prompts
Rhythm Re-analysisRhythm Re-analysis Repeat Shock(s)Repeat Shock(s)
When Breathing When Breathing && Pulse Return Pulse Return
• AirwayAirway• BreathingBreathing• Circulation Circulation
Be as Be as Efficient & EffectiveEfficient & Effective as Possible as Possible
Support LifeSupport Life
……Until EMS ArrivesUntil EMS Arrives
• Verbal ReportVerbal Report Initial ConditionInitial Condition Care Delivered Care Delivered (including # of shocks) (including # of shocks) Estimated “Down Time”Estimated “Down Time” Any Changes in Patient’s ConditionAny Changes in Patient’s Condition Any available Medical HistoryAny available Medical History
Transfer of Care
• Cooperate Cooperate and and AssistAssist (as necessary & requested) (as necessary & requested)
Additional FactorsAdditional FactorsWhen using an AEDWhen using an AED
Sensitivity to FamilySensitivity to Family Crowd ControlCrowd Control Periods of “Inactivity”Periods of “Inactivity” Talk to the PatientTalk to the Patient
When Not to Use an AEDWhen Not to Use an AED Patient is less than 8 yrs of agePatient is less than 8 yrs of age Patient is under 80 poundsPatient is under 80 pounds Explosive environmentExplosive environment Patient is Patient is immersedimmersed in water in water Following serious traumaFollowing serious trauma
Returning to AED ReadinessReturning to AED Readiness
Clean AreaClean Area Clean AED PlusClean AED Plus Replace Batteries Replace Batteries (if necessary)(if necessary)
Replace CPR-D PadzReplace CPR-D Padz Repack & Restore Unit Repack & Restore Unit
LogisticsLogistics