perform CPR in emergency

CPR performed in case of stopping breathing and / or cardiac arrest. Stop breathing occurs when the victim is not breathing, characterized by the absence of chest movement and breathing air flow. Cardiac arrest occurs when the heart stops beating and pumping blood, marked by no pulse terabanya on major arteries, such as carotid artery, the brachial artery and the femoral artery.

Preparation CPR

Before doing CPR helpers need to make preparations to ensure CPR and other assistance needed by victims can be done well. It is first and foremost thing to do is ensure the security of the scene. Ensure security of self-helpers and use personal protective equipment (APD). After ensuring the security then do these steps:
1. Perform general impression judgments.
Shake the victim's shoulder. Encourage the victim to talk and fishing verbal answers to determine the awareness and victim's airway condition. When the victim turned out not to respond to the call for help immediately, by shouting "please", and immediately activate SPGDT.
When the victim gave a positive response, position the victim in the recovery position or as when found. The help of medical personnel is necessary because of the victim could have been worse in a matter of minutes.
Conduct periodic evaluations of the victim until the victim is handled by the more expert.
2. For help. Activate SPGDT.
3. Improve the position of victims and clothing that covers the open chest (chest exposure victims). Resuscitation would be more effective if the victim's position sleep on their backs, with a flat base and hard. Place the victim in supine position with both arms on the right side and left the victim (anatomical position). When I did notice a change in position is always unity / kesegarisan between the head, neck, and body, including shoulders and spine. Remember to always protect the victim's neck, especially if the suspected neck injury. Exempt from the victim's chest covering clothing to facilitate the victim's actions and judgments.
4. Set the auxiliary position.
Immediately knelt beside the victim in line with his shoulder, so as to aid rescue breathing and circulation do not need a lot of moves, thus saving time.

CPR Steps

After doing the basic procedures in preparation for doing CPR, go to:

1. Airway control and cervical control, control of the airway.
a. Open the airway. How to open the airway are described in detail in the discussion of the basic life support.
b. Value of degree and type of blockage.
Guidelines do with look, feel, listen. To facilitate kneel beside the victim in the head. Tilt the head helper near the victim's mouth and nose with his eyes looked toward the victim's chest, while her airway open. In this way the helper can do airway and breathing assessment. Ear helpers listen (listen), cheek helper can be used to feel (feel), and the eye relief to see (look) movement of the chest and the use of respiratory muscles extra.
c. Free action of airway obstruction. Steps in to free the airway will also be explained in the discussion of the basic life support.

2. Breathing support; artificial ventilation and emergency pulmonary oxygenation.
a. While maintaining a free airway, ensure breathing victim. Check breathing victim with a look, feel, listen.
b. If breathing adequately, and no and no suspicion of neck injury in the position of the victim position to recover. Evaluate A and B periodically.
c. If the victim is not breathing, give artificial breathing 2 times. Then check the signs of circulation. If the victim only needs to do resuscitate resuscitate it with a frequency 12-15 times / minute. Continue with re-evaluation of A and B on a regular basis.

3. Circulation support; introduction of the absence of pulse and provision of artificial circulation by cardiac compression.
a. Make sure there is at least the heart rate to touch the victim with the carotid artery.
b. If palpable carotid artery, then continue with the management of victims by re-evaluation of A and B periodically.
c. If no palpable carotid artery, do the compression / external cardiac massage. the steps outside the heart compress will dterangkan below.

4. Make a reevaluation / reassessment A-B-C.
a. If still no palpable pulse compression of the heart go out and do the re-evaluation every 4 cycles.
b. When palpable pulse, but not breathing, give assistance only to the speed of breath 12-15 times / minute.
c. If the victim breathing spontaneously and palpable pulse, put in a position to recover, with no records or suspected neck injury.


The steps outside the cardiac compression

1) Determine the end of the bone xifoid. Use your index finger and middle finger traced curved ribs right or left until they meet the breastbone or sternum, is known as xifoid, resembling the tip of the sword.
2) From the end of xifoid, place your index finger and middle finger on the sternum, one finger above and another xifoid beside him, to the head. Right next to the finger closer to the head is the point of compression.
3) Place the heel of one hand in the position had been determined. The other hand placed above the first hand. Recommended fingers interlocking hands. The pressure is given through the heel of the hand, keep your fingers touch the helper does not even pressing intercostal victims.
4) When performing chest wall pressure, the position of auxiliary bodies perpendicular plane, with both arms straight. Helper hit victim's chest wall with the force of his weight. Do it 15 times compression periodically, with a depth of 3.8 to 5 cm. Compression performed at 100 times / min.
5) Each time after compression allow the victim's chest puffed out, back into position. Do not remove the helper's hand from the victim's chest or change position of the hand.
6) The time to squeeze and release is the same, namely 1: 1.
One cycle of artificial respiration and external cardiac compression consists of 15 compression and artificial breathing 2 (15:2). The comparison is valid both for 1 or 2 helpers helpers. Perform 4 complete cycles. After a full 4 cycles, re-evaluation done starting from A, B, and C.

How signs CPR performed successfully?

The success of CPR can not be separated from the success of each step performed CPR. If successful CPR is performed on the victim found signs of re-functioning of the respiratory system and sirkulas system. Victims can breathe spontaneously, the victim's chest was moving up and down and the breath of air flow. Again palpable pulse and heartbeat heard through the stethoscope again. The original skin pale victims to normal. Victims can perform directional movement and the victim tried to swallow. The pupils will shrink when exposed to light which indicates a positive pupil reaction.

Whenever CPR is stopped?

Helper is exhausted and unable to continue the action may terminate resuscitation efforts was doing CPR. If the other officers for help and more experts are coming, the helper may terminate the action on resuscitation and transfer those officers. Sometimes the victim was found unconscious without a helper to know whether the victim had long since died or had just happened stop breathing and cardiac arrest. If then obtained information that the victim had died so long should CPR be stopped. CPR was stopped when the act of circulation (pulse) and breathing is restored, the victim was able to breathe spontaneously and pulse back beating spontaneously. In victims with electric shock or drowning, the heart is usually longer respond to the actions of CPR.

When is CPR may be stopped for a while?

Heart lung resuscitation be suspended if the victim has to be moved. Removal of victims can occur in various circumstances, such as the victim was transferred to a stretcher, out of or into the ambulance, through the stairs, through a narrow hallway, when the victim raised or lowered from the plane. On life support measures are sometimes further action defibrilasi (to surprise the heart with a special tool), when doing this defibrilasi CPR should be stopped temporarily.