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Agus Harsoyo, MDCardiovascular Intervensionist and Electrophysiology Intervensionist

Department of Cardiology

Gatot Soebroto Army Center Hopital

a!arta"#$$

%he "#$# American Heart AssociationGuidelines for Cardiopulmonary

&esuscitation 'C(&)

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Chain of Survival

Immediate recognition of cardiac arrestand activation of the emergency response

system Early C(& that emphasi*es chest

compressions &apid de+brillation if indicated

Eective advanced life support Integrated post- cardiac arrest care (Travers, et al. Circulation. 2010;122;S676-S684),

2010 Guidelines) Chain of Survival./ 0or adultsthey include1

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Activation of Emergency ResponseSystem

2010 Guidelines (New) %he

healthcare provider should chec! forresponse 2hile loo!ing at the patient todetermine if breathing is absent or notnormal. %he provider should suspectcardiac arrest if the victim is notbreathing or only gasping,

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Change in C! Se"uence# C-$-%!ather Than $-%-C

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In CAB chest compression will initiatedsooner and ventilation only minimally

delayed until completion of the rstcycle of chest compression! ("0compression should #e accomplish inappro$imately1% seconds)!

&ewer than '0 of person in CardiacArrest receive #ystander C*! Startin+with Compressions mi+ht ensure that

more victim receive C* and that recuerswho are unwillin+ to provide ventilationswill at least perform cheast compressions

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,he vast ma-ority of cardiac arrest occur inadults with winessed arrest are patients

with .& (ventricular #rillation) or pulsessventricular tachycardia (.,)!

In these patients the critical initial

elements of C* are chest compression andearly de#rilation/

In the ABC seuence chest compression are

often delayed when the responder +ivemouth to mouth #reaths or retrieves a#arrier device or other ventilationeuipment/

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CricoidPressure 2010 Guidelines New:%he routine

use of cricoid pressure in cardiac arrestis notrecommended

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Emphasis on High-ua!ityCPR

2010 Guidelines (New)

%o provide eective chest compressions, push hard and push fast. compress the adult chest at a rate of at least $##

compressions per minute 2ith a compression depth of atleast " inches34 cm.

allo2 complete recoil 5ot trained in C(&, the bystander should provide Hands6

7nly 'compression6only) 0or %he HC(, chest compressions and rescue breaths

for cardiac arrest victims(%erg, et al. Circulation. 2010;122;S68&-S70&).

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Compression HandPosition

Compression Hand Position (2010Guidelines New)%he rescuer shouldplace the heel of one hand on the center'middle) of the victim/s chest '2hich is the

lo2er half of the sternum) and the heel ofthe other hand on top of the +rst so thatthe hands are verlapped and parallel(Circulation. 200&; 112# '1-'*4)

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Compression *ate

Compression *ate (Guidelines 2010) compress theadult chest at a rate of at least $## compressions 3mnt

compression depth of at least " inches '4 cm.), *ationale &or Chan+e higher survival rates 2ith an increase in the number of

compressions provided per minute. (%erg, et al. Circulation.2010;122;S68&-S70&)

ChildInfant Compression *ate (2010 Guidelines3ew) (ush fast8 push at a rate of at least $##compressions per minute,

for Compression Depth (ush hard/1 push 2ith su9cientforce to depress at least one third the anterior6posterior'A() diameter of the chest or appro:imately $ ; inches '