Ceramah bls choking

3,717 views

Published on

0 Comments
7 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
3,717
On SlideShare
0
From Embeds
0
Number of Embeds
9
Actions
Shares
0
Downloads
429
Comments
0
Likes
7
Embeds 0
No embeds

No notes for slide

Ceramah bls choking

  1. 1. KURSUS BLS Disediakan Oleh : Miharil Ruminggun Hospital Pitas. CHOKING ( TERSEKAT SALURAN PERNAFASAN)
  2. 2. SALURAN PERNAFASAN SALURAN MAKANAN Bahan yang masuk melalui mulut tersekat pada saluran pernafasan, dan seterusnya menyekat pernafasan mangsa akan menyebabkan tercekik PROSES TERCEKIK PERTOLONGAN CEMAS
  3. 3. CLASSIFICATION OF OBSTRUCTION <ul><li>In Mild FBAO, the victim can </li></ul><ul><li> 1. speak </li></ul><ul><li> 2. breath </li></ul><ul><li> 3. cough effectively </li></ul>
  4. 4. TANDA – TANDA TERCEKIK Sukar untuk bernafas Susah atau tidak boleh bercakap Batuk Muka dan leher menjadi merah Mangsa mengeluarkan bunyi aneh atau menjadi senyap PERTOLONGAN CEMAS
  5. 5. 2. SEVERE <ul><li>unable to speak, breathe, or cough and may clutch the neck with the thumb and fingers. Movement of air is absent. </li></ul>
  6. 6. Tersekat saluran pernafasan(choking) : -Dewasa -Kanak-kanak berumur 1 tahun ke atas.
  7. 7. Dewasa sedar <ul><li>Tanya / pastikan mangsa boleh bercakap atau Batuk. </li></ul>
  8. 8. Mangsa tidak boleh bercakap <ul><li>1: GIVE 5 BACK BLOWS </li></ul><ul><li>BERDIRI DI BELAKANG / SISI MANGSA </li></ul><ul><li>TUNDUKKAN MANGSA SEDIKIT KE HADAPAN </li></ul><ul><li>BERIKAN 5 PUKULAN DI BELAKANG MANGSA (DIANTARA KEDUA TULANG SKAPULA) </li></ul>
  9. 9. <ul><li>To give back blows, position yourself slightly behind the child.  </li></ul><ul><li>Provide support by placing one arm diagonally across the chest and bend the child forward at the waist until the upper airway is at least parallel to the ground.  </li></ul><ul><li>Firmly strike the child between the shoulder blades with the heel of your other hand. </li></ul>
  10. 10. <ul><li>2: GIVE 5 ABDOMINAL THRUSTS </li></ul><ul><li>Place a fist with the thumb side against the middle of the person’s abdomen, just above the navel. </li></ul><ul><li>Cover your fist with your other hand.  </li></ul><ul><li>Give 5 quick, upward abdominal thrusts.  </li></ul><ul><li>: CONTINUE CARE </li></ul><ul><li>Continue sets of 5 back blows and 5 abdominal thrusts until the: </li></ul><ul><li>Object is forced out.  </li></ul><ul><li>Person can cough forcefully or breathe.  </li></ul><ul><li>Person becomes unconscious. </li></ul><ul><li>4: WHAT TO DO NEXT IF PERSON BECOMES UNCONSCIOUS—CALL 9-1-1, if not already done.  </li></ul><ul><li>Carefully lower the person to the ground and give CARE for an unconscious choking adult, beginning with looking for an object. </li></ul>
  11. 11. Lean the victim forward and give 5 back blows with the heel of your hand Position yourself slightly behind the victim Provide support by placing one arm diagonally across the chest and lean the victim forward Firmly strike the victim between the shoulder blades with the heel of your hand Each blow is a distinct attempt to dislodge the object
  12. 12. Beri 5 abdominal thrusts <ul><li>Dewasa-berdiri dibelakang mangsa </li></ul><ul><li>Kanak-kanak-berdiri/berlutut dibelakang mangsa </li></ul>Give 5 abdominal thrusts Adult:  stand behind the victim Child:  stand or kneel behind the victim; use less force on a child Use on hand to find the navel Make a fist with your other hand and place the thumb side of your fist against the middle of the victims abdomen, just about the navel Grab the fist with your other hand
  13. 13. Abdominal thrust
  14. 14. KAEDAH ABDOMINAL THRUST Berdiri di belakang mangsa Genggam tangan kanan atau kiri anda Tempatkan ditengah-tengah abdomen (2 inci di atas pusat) Kunci kedua-dua tangan Tarik genggaman tangan anda “ KE DALAM DAN KE ATAS” Lakukan sehingga benda asing tersebut keluar
  15. 16. <ul><li>These include:  Coughing, either forcefully or weakly </li></ul><ul><li>Clutching the throat with one or both hands  </li></ul><ul><li>An inability to cough, speak, cry or breathe  </li></ul><ul><li>Making high-pitched noises while inhaling, or noisy breathing </li></ul><ul><li>Panic  </li></ul><ul><li>Bluish skin color  </li></ul><ul><li>Losing consciousness </li></ul>
  16. 17. Kaedah chest thrust – mangsa mengandung dan obese <ul><li>Berdiri dibelakang mangsa </li></ul><ul><li>Genggam tangan kiri atau kanan anda </li></ul><ul><li>Tempatkan ditengah-tengah dada berhampiran tulang sternum mangsa </li></ul><ul><li>Kunci kedua-dua tangan </li></ul><ul><li>Tarik genggaman tangan anda </li></ul><ul><li>“ KE DALAM DAN KE ATAS” </li></ul><ul><li>Lakukan sehingga benda asing tersebut keluar </li></ul>
  17. 18. unconscious <ul><li>  GIVE A RESCUE BREATH Retilt the head and give another rescue breath. </li></ul><ul><li>2: GIVE 30 CHEST COMPRESSIONS If the chest still does not rise, give 30 chest compressions. </li></ul>
  18. 19. <ul><li>  LOOK FOR AND REMOVE OBJECT IF SEEN </li></ul><ul><li>: GIVE 2 RESCUE BREATHS 5: WHAT TO DO NEXT IF BREATHS DO NOT MAKE THE CHEST RISE—Repeat steps 2 through 4.  </li></ul><ul><li>IF CHEST CLEARLY RISES—CHECK for breathing. Give CARE based on the conditions found.  </li></ul><ul><li>Do not stop except in one of these situations:  The object is removed and the chest clearly rises with rescue breaths. </li></ul><ul><li>The person starts to breathe on his or her own. </li></ul><ul><li>Another trained responder or EMS personnel take over. </li></ul><ul><li>You are too exhausted to continue. </li></ul><ul><li>The scene becomes unsafe. </li></ul>
  19. 20. <ul><li>Locate the correct hand position for chest compressions. Use the same technique that is used for CPR. Give chest compressions. Compress an adult’s chest 30 times to a depth of at least 2 inches.  </li></ul><ul><li>Compress at a rate of at least 100 chest compressions per minute; the 30 chest compressions should take about 18 seconds to complete. </li></ul>
  20. 22. Kanak2 unc <ul><li>Give 2 rescue breaths. Tilt the head back, pinch the nose shut and seal your mouth over the child's mouth.  </li></ul><ul><li>If the chest does not clearly rise, repeat cycles of chest compressions, foreign object check/removal and 2 rescue breaths.  </li></ul><ul><li>If a conscious choking child becomes unconscious, carefully lower the child to the ground, open the mouth and look for an object.  </li></ul><ul><li>If an object is seen, remove it with your finger.  </li></ul><ul><li>Open the person’s airway by tilting the head and try to give 2 rescue breaths. </li></ul><ul><li>If the chest does not clearly rise, begin the modified CPR technique used for an unconscious choking child. </li></ul>
  21. 23. <ul><li>Initial assessment steps: </li></ul><ul><ul><li>Assess responsiveness </li></ul></ul><ul><ul><li>Activate EMS </li></ul></ul><ul><ul><li>Assess breathing </li></ul></ul><ul><ul><li>Perform CPR </li></ul></ul><ul><li>CAB – begin CPR cycles with compressions, followed by airway and breathing. </li></ul><ul><li>Guideline applies to adults, children, and infants. </li></ul>
  22. 24. If No Breathing <ul><li>Step 1: Attempt to breathe into </li></ul><ul><li>their mouth </li></ul><ul><li>-if the chest doesn’t rise, </li></ul><ul><li>Step 2- REPOSITION and RE- </li></ul><ul><li>attempt ventilation </li></ul><ul><li>-if still no air going in, </li></ul>
  23. 25. If No Breathing <ul><li>Step 3: BEGIN CHEST COMPRESSION </li></ul><ul><li>-Give 30 chest Compression s then 2 breaths </li></ul><ul><li>“ The only difference here from normal CPR is the you must check for the obstruction at the back of the throat as you open airway after every 30 compressions and before giving 2 rescue breaths.” </li></ul><ul><li>Step 4 : If the obstruction is visible, REMOVE it with a finger sweep </li></ul>
  24. 26. Infant choking
  25. 27. Check the Scene   - make sure it is safe for you to help the choking victim.   Don't become another victim yourself.    Check the Victim    - If the parent is there, identify yourself and ask if you can help.   If the infant cannot cough, cry, or breathe, then they need help.    Call for Help    - Tell someone to call 9-1-1. If you are alone with an infant, skip this step until later - it's more important to fix the choking.      <ul><li>      Blows and Thrusts </li></ul><ul><li>Carefully hold the infant face down on your forearm, your hand supporting its head and neck </li></ul><ul><li>Strike the infant directly between the shoulder blades with the heel of your other hand 5 times </li></ul><ul><li>Turn the infant over and position two fingers in the center of the chest </li></ul><ul><li>Give 5 1/2 to 1 inch deep chest thrusts </li></ul><ul><li>    Repeat Blows and Thrusts </li></ul><ul><li>   until the object is forced out, the infant starts breathing, or the infant becomes unconscious. </li></ul>
  26. 28. f the infant cannot cough, cry or breathe, carefully position the infant face-down along your forearm Support the infant's head and neck with your hand Lower the infant onto your thigh, keeping the infant's head lower than his or her chest. 
  27. 29. <ul><li>Position the infant face-up along your forearm Position the infant between both of your forearms, supporting the infant's head and neck </li></ul><ul><li>Turn the infant face-up </li></ul><ul><li>Lower the infant onto your thight with the infant's head lower than his/her chest </li></ul>Give 5 back blows Use the heel of your hand Give back blows between the infant's shoulder blades Each back blow should be a distinct attempt to dislodge the object
  28. 30. <ul><li>Give 5 chest thrusts Put 2-3 fingers on the center of the chest just below the nipple line </li></ul><ul><li>Compress the chest 5 times about 1/2- 1 inch </li></ul>Continue giving 5 back blows and 5 abdominal thrusts until... <ul><li>The object is forced out </li></ul><ul><li>The victim begins to breathe or cough forcefully on his/her own </li></ul><ul><li>The victim becomes unconscious </li></ul>
  29. 31. <ul><li>mmmm </li></ul>
  30. 32. KAEDAH BACK BLOW & <ul><li>Pegang bayi dengan stabil dan kukuh </li></ul><ul><li>Berikan 5 tepukkan ditengah-tengah tulang belikat (shoulder blade) </li></ul><ul><li>Pusing bayi, periksa mulutnya sekiranya benda asing tersebut dapat dikeluarkan, jika tidak: </li></ul>PERTOLONGAN CEMAS
  31. 34. <ul><li>To give back blows:  Position the infant face-down on your forearm, holding the infant's jaw with your thumb and fingers. </li></ul><ul><li>Lower your arm onto your thigh so that the infant’s head is lower than his or her chest.  </li></ul><ul><li>Then give 5 firm back blows with the heel of your hand between the shoulder blades.  </li></ul><ul><li>Each back blow should be a separate and distinct attempt to dislodge the object.  </li></ul>
  32. 35. 5 back blow <ul><li>Back blow </li></ul>
  33. 37. KAEDAH CHEST THRUST <ul><li>Tempatkan 2 jari anda ditengah-tengah dada bayi </li></ul><ul><li>Kedudukan jari telunjuk hendaklah sebaris dengan puting susu </li></ul><ul><li>Berikan 5 tekanan dada ( ½ - 1 inci) </li></ul>PERTOLONGAN CEMAS
  34. 38. Actions for Relieve of FBAO for unconscious infant
  35. 39. Unc inf <ul><li>Give 2 rescue breaths. -Tilt the head to a neutral position and seal your mouth over the infant's mouth and nose. If the breaths do not make the chest clearly rise, repeat cycles of chest compressions, foreign object check/removal and rescue breaths.  </li></ul>
  36. 40. <ul><li>Locate the correct hand and finger position for chest compressions. Use the pads of two or three fingers of your other hand to give chest compressions on the center of the chest, just below the nipple line (toward the infant’s feet). If you feel the notch at the end of the infant’s sternum, move your fingers slightly toward the infant’s head. </li></ul><ul><li>Give 30 chest compressions at a rate of at least 100 chest compressions per minute. Each compression should be about 1½ inches deep. </li></ul>
  37. 41. <ul><li>f the infant cannot cough, cry or breathe, carefully position the infant face-down along your forearm Support the infant's head and neck with your hand </li></ul><ul><li>Lower the infant onto your thigh, keeping the infant's head lower than his or her chest.  </li></ul><ul><li>Give 5 back blows Use the heel of your hand </li></ul><ul><li>Give back blows between the infant's shoulder blades </li></ul><ul><li>Each back blow should be a distinct attempt to dislodge the object </li></ul><ul><li>Position the infant face-up along your forearm Position the infant between both of your forearms, supporting the infant's head and neck </li></ul><ul><li>Turn the infant face-up </li></ul><ul><li>Lower the infant onto your thight with the infant's head lower than his/her chest </li></ul><ul><li>Give 5 chest thrusts Put 2-3 fingers on the center of the chest just below the nipple line </li></ul><ul><li>Compress the chest 5 times about 1/2- 1 inch </li></ul>Continue giving 5 back blows and 5 abdominal thrusts until... <ul><li>The object is forced out </li></ul><ul><li>The victim begins to breathe or cough forcefully on his/her own </li></ul><ul><li>The victim becomes unconscious </li></ul>
  38. 42. Unconscious Choking <ul><li>If rescue breaths do not make the chest clearly rise, reposition the airway by retilting the infant's head and try 2 rescue breaths again </li></ul><ul><li>If rescue breaths still do not make the chest clearly rise, remove the resuscitation mask and give 5 chest thrusts Keep 1 hand on the infant's forehead to maintain an open airway </li></ul><ul><li>Put 2-3 fingers on the center of the chest just below the nipple line </li></ul><ul><li>Compress the chest about 1/2 to 1 inch </li></ul><ul><li>Each chest thrust should be a distinct attempt to dislodge the object </li></ul><ul><li>Compress at a rate of about 100 compressions per minute </li></ul><ul><li>Look for an object Grasp the tongue and lower jaw between your thumb and fingers and lift the jaw </li></ul><ul><li>If you see the object, take it out Remove it with your little finger by sliding it along the inside of the cheek, using a hooking motion to sweep the object out. </li></ul><ul><li>Replace the resuscitation mask and give 2 rescue breaths </li></ul>Continue 2 rescue breaths and 5 chest thursts until... <ul><li>Object is removed and the victim begins breathing </li></ul><ul><li>Victim becomes conscious </li></ul><ul><li>Victim loses pulse, begin CPR </li></ul>
  39. 46. Unconscious Choking <ul><li>if rescue breaths do not make the chest clearly rise, reposition the airway by tiliting the head farther back and try 2 rescue breaths again </li></ul>
  40. 47. <ul><li>If resc ue breaths still DO NOT make the chest clearly rise, give 5 chest thrusts Place the heel of one hand on the center of the chest </li></ul><ul><li>Place the other hand on top of the first hand and compress the chest 5 times </li></ul><ul><li>Adult:  compress the chest about 1 1/2 to 2 inches </li></ul><ul><li>Child:  compress the chest about 1 to 1 1/2 inches </li></ul><ul><li>Each chest thrust should be a distinct attempt to dislodge the object </li></ul><ul><li>Compress at a rate of about 100 compressions per minute </li></ul><ul><li>Look inside the victim's mouth Grasp the tongue and lower jaw between your thumb and fingers and lift the jaw </li></ul>
  41. 48. <ul><li>f you see the object, take it out Adult:  remove the object with your index finger by sliding the finger along the inside of the cheek, using a hooking motion to sweep the object out </li></ul><ul><li>Child:  remove the object with your little finger by sliding along the inside of the cheek, using a hooking motion to sweep the object out </li></ul>
  42. 50. Replace the resuscitation mask and give 2 rescue breaths Continue 2 rescue breaths and 5 chest thursts until... <ul><li>Object is removed and the victim begins breathing </li></ul><ul><li>Victim becomes conscious </li></ul><ul><li>Victim loses pulse, begin CPR </li></ul>
  43. 51. Relief of Foreign Body Obstruction • If the foreign body obstruction is mild, do not interfere. Allow the victim to clear airway by coughing while you observe for signs of severe foreign body obstruction. • If the foreign body obstruction is severe you must act to relieve the obstruction. • For adults and children, perform abdominal thrusts until the object is expelled or the victim becomes unresponsive. • For infant, deliver repeated cycles of 5 back blows followed by 5 chest compressions until the object is expelled or the victim becomes unresponsive.
  44. 52. Foreign Body Airway Obstruction (Choking) • Greater than 90% of childhood deaths from foreign body aspiration occur in children under 5 years old. • Foreign body obstruction can be either mild or severe. • When it is mild, the adult and children can cough and make some sounds. • When it is severe, the adult or child cannot cough or make any sound
  45. 53. Relief of Foreign Body Obstruction (Unresponsive) If the victim becomes unresponsive: • Start CPR with chest compressions – do not perform a pulse check. • After 30 chest compressions open the airway. • If you see a foreign body, remove it but do not perform blind finger sweeps because they may push the objects further into the pharynx. • Attempt to give 2 breaths and continue with cycles of chest compressions and ventilations until the object is expelled. Look for the object after each round of compressions and sweep if seen. • After 2 minutes, if no one has done so, activate the emergency response system
  46. 55. Terima Kasih Thank you

×