Perhimpunan Dokter Emergensi Indonesia

IDI Cabang Jakarta Pusat

RS YARSI
IMANI CARE
BLS-ACLS Instructor (American Heart Association)

1
 Describe critical actions of the BLS Survey &
ACLS Survey
 Describe assessment & management that
occur with each step of the systematic
approach
 Describe how assessment & management
approach is applicable to most
cardiopulmonary emergencies.
Tentukan kesadaran pasien
 Jika tidak sadar : BLS Survey, kemudian lanjutkan dg ACLS Survey
 Jika sadar : ACLS Survey

Critical Concept :
 Memulai kompresi dada kurang dari 10 detik
 Kompresi dada dengan kecepatan 100-120 kali per menit
 Kompresi dada dengan kedalaman :
▪ Dewasa 5-6 Cm
▪ Anak : Sepertiga kedalaman dinding dada (Sekitar 2 Inci / 5 Cm)
▪ Bayi : Sepertiga kedalaman dinding dada (Sekitar 1.5 Inci / 4 Cm)
 Complete Chest Recoil
 Minimalkan interupsi pada saat CPR (Max : 10 Detik)
 Hindari pemberian bantuan napas yang berlebihan
1. Ensure scene safety
2. Check for response.
3. Shout for nearby help/activate the resuscitation team.
4. Check for no breathing or only gasping and check pulse
(ideally simultaneously). Activation and retrieval of the
AED/emergency equipment by either the lone healthcare
provider or by the second person sent by the rescuer must
occur no later than immediately after the check for no
normal breathing and no pulse identifies cardiac arrest.
5. Immediately begin CPR, and use the AED/defibrillator
when available.
6. When the second rescuer arrives, provide 2-person CPR
and use AED/defibrillator.
When the BLS survey is complete or if the patient is conscious and
responsive, the responder should conduct the ACLS survey with a
focus on identifying and treating the underlying cause(s) of the
patient’s problem.

1. Assess
2. perform appropriate action

The ACLS Survey :

A : Airway
B : Breathing
C : Circulation
D: Differential Diagnosis.
BLS ALS ROSC
• SIMPLE • AIRWAY • AIRWAY
AIRWAY ADJUNCT ADVANCED
MANUVER • AIRWAY
ADVANCED
Assess :
- is the airway patent?
- is an advanced airway indicated?
- is proper placement of airway device confirmed?
- is tube secured and placement reconfirmed frequently?

Action as appropriate
1. maintain airway patency with unconscious patients
2. use advanced airways if needed
3. confirm placement of airway
- chest rise
- quantitative waveform capnography
4. secure device to prevent dislodgement
5. monitor capnography
Assess :
- Are ventilation and oxygenation adequate?
- are quantitative waveform capnography and is oxyhemoglobin
saturation monitored?
Action as appropriate
1. Give oxygen when needed
- cardiac patients administer 100% 02
- other, 02 is given to achieve saturation of >94% by pulse oximetry
2. monitor adequacy of ventilation and oxygenation
- chest rise and cyanosis
- quantitative waveform capnography
- oxygen saturation
3. Avoid excessive ventilation
Assess :
- are chest compressions effective?
- What is the cardiac rhythm?
- is defibrillation or cardioverison indicated?
- Has IV/IO access been established?
- is ROSC present?
- is the patient with a pulse unstable?
- are any medications needed for rhythm or blood pressure?
- does the patient need volume (fluid) for resuscitation?
Action as appropriate
1. Monitor CPR quality
- Quantitative waveform capnography - Petco2 is < 10 mm Hg, improve CPR
- Diastolic pressure < 20, improve CPR
2. Attach monitor / defibrillator for arrhythmias or cardiac arrest rhythms
3. Provide defibrillation / cardioversion
4. Obtain IV/IO access
5. Give appropriate drugs
- managing rhythm and blood pressure
6. Give IV/IO fluids if needed
Assess :
- Why ?
- Any reversible cause(s) that can be treated ?

Action as appropriate
Find and treat reversible causes
 AIRWAY:
OPA/NPA
ETT+Laryngoskopi,LMA, Laryngeal Tube
 Breathing:
Pulse Oxymetri
Nasal Canul/ Face Mask/MRM
BVM
 CIRCULATION:
IV / IO Cathteter
Infus Set
Cairan
 Drug:
OBAT (Amiodaron, Epinephrin, Adenosin,
Atropin, Dopamin)
Spuit 10 cc / 20 cc
 CPR BOARD

 FOOT STEP

 RECORDING:
 Lembar Recording
 Algoritma
 Stop Watch

BAG vs TROLLEY
 Describe critical actions of the BLS Survey &
ACLS Survey
 Describe assessment & management that
occur with each step of the systematic
approach
 Describe how assessment & management
approach is applicable to most
cardiopulmonary emergencies.