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RJP Ni Luh Widani
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2010 - AHA ECC Adult Chain of Survival
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Sumbatan Jalan Nafas • Benda asing : makanan, mainan , gigi palsu Harus dikeluarkan • Korban tidak sadar lidah kebelakang
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Mengeluarkan Benda Asing • Pada klien sadar yang tersedak heamlik manuver letakkan tangan diantara PX dan umbilikus
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Mengeluarkan sumbatan benda asing korban tidak sadar
Abdominat trust PPKC
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Mengeluarkan benda asing • Klien hamil / obesitas • Letakkan tangan di sternum
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Mengeluarkan benda asing •
Bila benda asingnya tampak
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finger sweep
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Choking: Conscious Infants • Position with head downward • 5 chest thrusts • Repeat PPKC
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Open the Airway • Head-tilt/chin lift (no trauma) – The most common cause of obstruction is the tongue!
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Open the Airway • Jaw thrust (trauma)
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Oropharyngeal Airway • Keeps tongue from blocking the airway • Cannot be used in patients with gag reflex
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Oropharyngeal Airway • Insertion – Upside down until resistance – Rotate and advance until flange is in contact with teeth or gums
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Oropharyngeal Airway •
Other methods of insertion 1. Insert right side up, and use a tongue depressor. 2. Insert at corner of mouth and rotate 90º while advancing. •
Preferred for infants
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Oropharyngeal Airway • Must use correct size – Measure from corner of mouth to tip of ear • Too big could push, tongue into airway • Too small, won’t reach back of throat
• Have a selection of sizes available PPKC
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Oropharyngeal Airway • Wrong!
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Nasopharyngeal Airway • Keeps the tongue from blocking the airway • Better tolerated by patients with gag reflex • with locked jaws
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Nasopharyngeal Airway • Must use correct size – Measure from tip of nose to tip of ear
• Lubricate with water soluble gel • Try right nostril first
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Assess for Breathing • Is the patient breathing? – Look, listen, & feel for 10 seconds
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• If the victim is not breathing, give two breaths (1 an d½ - 2 sec.) – Pinch the nose –
• If the first two don’t go in, re-tilt and give two more breaths (if breaths still do not go in, suspect choking)
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Ventilate the Patient • Mouth to mask
Bag--Valve Bag Valve--Mask Ventilations
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Bila KU penderita tdk baik OKSIGEN • Kanul hidung ( 2 – 4 l )
Bag--ValveBag Valve-Mask Ventilations • Making a good mask to face seal – Use two hands • For mouth to mask ventilation • For two person bag-valve-masking
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Bag--ValveBag Valve-Mask Ventilations • Two person BVM (preferred) – Good seal
• No air leak around mask
– Two hands on bag • Good volume delivered • Good control of breath
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Bag--ValveBag Valve-Mask Ventilations • One person BVM – Prone to inadequate tidal volumes • Air leaks around mask • Less air delivered by bag • Fatigue
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Oxygen • For all patients with inadequate or absent breathing • For all patients with • For all patients in shock • For all patients with decreased responsiveness
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Circulation • Assess circulation – 10 seconds – Carotid pulse in adults and children – Observe: Breathing, coughing, movement, normal skin
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temp. and color, improved level of responsiveness, pulse Check pulse at carotid artery NEAREST YOU
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Rescue Breathing • If victim shows signs of circulation but is not breathing: • Give one rescue breath every 5 seconds • Reassess after 1 minute and ever few minutes thereafter – Loosen restrictive clothing around the neck • No chest compressions when there are signs of circulation
Recovery Position • Used in unresponsive, uninjured patients, breathing adequately • Gravity helps the airway to drain
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Menghentikan RJP • Teraba arteri karotis, pernafasan spontan • Petugas kelelahan & tidak ada petugas yg mengantikan dan RJP sudah dilakukan tanda kehidupan • Klien dinyatakan meninggal
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Komplikasi RJP • Fraktur iga posisi tangan salah • Perdarahan intraabdominal posisi tangan salah • stens am ung vent as ere an