Cardiac arrest is a leading cause of death, with low survival rates for out-of-hospital cardiac arrest. High quality CPR can increase survival rates from cardiac arrest. The document discusses guidelines for adult basic life support, including checking responsiveness and calling for help, checking breathing and pulse, performing chest compressions and rescue breathing, using an AED, and treating tachycardia and bradycardia. It provides steps for managing unstable and stable tachycardia and bradycardia through medications, cardioversion, pacing, or consulting specialists. The guidelines aim to optimize emergency cardiovascular care.

1. DISKUSI TOPIK
Basic & Advance Cardiac Life Support
dr. Achyar Sp.JP, FIHA
Oleh :
Muhammad Alwan
Raden Tasya Shafira
Izzatunnisa Istiqomah
KEPANITERAAN KLINIK ILMU KARDIOLOGI DAN KEDOKTERAN VASKULAR
RSUP FATMAWATI – FK UIN JAKARTA

2. Background
 Cardiac arrest → main leading cause of death
 2015 → 350.000 OHCA cases in US → 10% survive in initial hospitalization, 8.2% with good
functional status
 1.2% of hospitalized patients had IHCA → 25.8% discharged & alive, 82% of survivors have a
good functional status
 High quality CPR → increases rate of survival in cardiac arrest
Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020

4. Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020

5. Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020
Menemukan pasien curiga henti jantung
Cek respons pasien, amankan diri, pasien & lingkungan
A: Alert-fully awake, but may still Confused
V: Verbal-responds to verbal stimuli
P: Painful-responds to painful stimuli
U: Unresponsive-does not respond
Aktifkan system respons emergensi
(Panggil ambulans & ambil AED)
Memeriksa Nadi + nafas Bersamaan
Raba arteri karotis (<10 detik)
Perhatikan pergerakan dinding dada
Nadi teraba dan nafas tidak ada
• Berikan nafas bantuan tiap 5 – 6 detik
• Cek nadi tiap 2 menit
Denyut nadi tidak teraba
• Tentukan landmark untuk kompresi
dada
• Lakukan teknik kompresi dada

6. Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020
Teknik kompresi dada
● Tekan kuat dan cepat
● Kecepatan 100 – 120x/menit
● Kedalaman 5 – 6 cm
● Complete chest recoil
● Minimalkan interupsi terhadap kompresi dada
Periksa denyut nadi dan pernapasan setelah 5 siklus/per 2
menit
Jika nadi & nafas belum ada kompresi langsung di
lanjutkan
Kompresi dada dan bantuan nafas tetap dilakukan hingga alat AED
datang

7. Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020
Setelah 30 kompresi dada
Jika trauma/cedera spinal jaw thrust
tanpa mengekstensikan kepala
buka jalan napas dengan
manuver head tilt - chin lift

8. Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020
BAG-MASK
VENTILATION
MOUTH TO MASK
• Volume cukup untuk membuat dada mengembang,
• Hindari pemberian bantuan napas yg cepat dan berlebih

9. THE ACLS
SURVEY
ABCD

13. BRADIKARDIA
Bradikardia
simtomatik = <50
denyut per menit +
gejala ➔
identifikasi dan
obati langsung
penyebab yang
mendasari.
Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020

14. BRADIKARDIA
Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020
Jalan Napas
Pertahankan
patensi jalan napas
→ bantuan
pernapasan bila
perlu.
Berikan oksigen
tambahan jika
hipoksia
Pemantauan
Tempatkan pasien
untuk pantau
jantung terus
menerus untuk
mengidentifikasi
ritme + pemantauan
tekanan darah dan
saturasi oksigen.
Dapatkan akses IV
dan EKG 12 sadapan.

15. BRADIKARDIA
Pasien datang dengan hipotensi / perubahan status mental akut / tanda syok /
ketidaknyamanan dada iskemik / tanda gagal jantung akut, maka:
Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020
Atropin
Atropin IV dosis 1 mg setiap
3 sampai 5 menit. (Jangan
> 3 mg total).
Pacu Jantung Transkutan
Jika Atropin tidak efektif
pertimbangkan pacu
jantung transkutan
dan/atau infus Dopamin IV
5 sampai 20 mcg/kg per
menit atau Epinefrin 2-10
mcg per menit.
Pertimbangkan
- Konsultasi ahli
- Pacu jantung
transvena
⇨ ⇨ ⇨

16. TACHYCARDIA
WITH A PULSE

17. Takikardia
Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020

18. Adult Basic Life Support. American Association Guidelines for Cardiopulmonary Resusitaion and Emergency Cardiovascular Care. 2020
Takikardia
Jalan Napas
Pertahankan patensi jalan
napas → bantuan pernapasan
bila perlu.
Berikan oksigen tambahan jika
hipoksia
Monitor Jantung
Tempatkan pasien = monitor jantung
terus menerus untuk identifikasi ritme +
pemantauan sering tekanan darah dan
saturasi oksigen. (oksimetri) Dapatkan
akses IV dan EKG 12 sadapan.

19. Takikardia (Unstable)
Pasien datang dengan hipotensi / perubahan status mental aku / tanda syok /
ketidaknyamanan dada iskemik / tanda gagal jantung akut, maka:
Kardioversi
Kardioversi emergensi →
sedasi sebelum kardioversi,
jangan tunda pengobatan.
Adenosin
Pertimbangkan adenosin
jika kompleks regular
narrow
Refrakter
Pertimbangkan:
- Pikirkan penyebab
- ↑ energi kardioversi
selanjutnya
- Penambahan obat
anti-aritmia
- Konsultasi ahli
⇨ ⇨ ⇨

20. Takikardia Stable
(Narrow QRS <0,12 S)
Vagal
Maneuver
Jika regular
Adenosin
Jika regular
ß- blocker /
CCB
Konsultasi
ahli

21. Takikardia Stable
(Wide QRS <0,12 S)
Pertimbangkan
- Adenosin. (regular,
monomorfik)
- infus anti-aritmia
- konsultasi ahli
Refrakter
Pertimbangkan:
- Pikirkan penyebab
- ↑ energi kardioversi
selanjutnya
- Penambahan obat
anti-aritmia
- Konsultasi ahli
⇨ ⇨

22. Daftar Pustaka
Adult Basic Life Support. American Association Guidelines for Cardiopulmonary
Resusitaion and Emergency Cardiovascular Care. 2020
Algorithms for Advanced Cardiac Life Support. 2021

23. TERIMA KASIH