When is CPR not be done and done


In a broad sense, all forms of resuscitation is a medical business, which is committed against those who are in serious or critical condition, to prevent death. Death in the clinic is defined as loss of consciousness and all the reflexes, accompanied by cessation of breathing and blood circulation irreversible. Therefore, resuscitation is any effort to restore the function of respiratory system, circulatory and nervous, which interrupted or disturbed so that the functions can be stopped at any time, in order to return to normal as before.1

Success or failure of the heart lung resuscitation depends on fast action and precise implementation techniques. In some circumstances, resuscitation measures are not recommended (not effective), among others if the cardiac arrest (arrest) has berlangung more than 5 minutes since it is usually permanent brain damage has occurred, in late-stage malignancy, refractory heart failure, refractory pulmonary edema, which precedes "arrest", severe neurologic disorders, kidney disease, advance liver and lung failure.2

Resuscitation performed on:

1. Cardiac infarction "small" resulting in "electric death"
death of heart muscle disease due to blocked coronary arteries that supply blood to the heart muscle. In laymen, marked by a heart attack that destroyed large heart muscle known as heart failure, and the result can cause the death.3

2. Adams-Stokes attack
Not aware of a sudden heart rhythm disturbance due to a slowdown or even elimination of the heartbeat stun with or without seizures.4

3. Trauma

4. Inhalation of smoke (toxic)

5.Acute Hypoxia

Hypoxia is a reduction in oxygen intake to the network to below the physiological level of tissue perfusion despite adequate blood. 5.6

6. poisoning and overdosing on drugs

7. Electric Stings

8. Vagal reflex

9. Drowning and other accidents that still gives the opportunity to live.

2. Resuscitation was not done at:

1. normal deaths, as is common in acute illness or severe chronic.
2. terminal stage of a disease that can not be cured anymore.
3. When almost certain that the cerebral function will not recover, that is, after ½ - 1 hour proven there is no pulse on the normotermia without RJP.7
Resuscitation efforts performed on the state of clinical death when a large pulse (circulation) and breathing stopped, but it is doubtful whether the two functions of the heart and breathing spontaneously have stopped for sure or irreversible.8

When do we start CPR
The decision to perform CPR was taken after we got the results of primary examination, namely: no conscious, no breath, no heartbeat. The incident that led to doing CPR:
1. Ensure Victim Response
We have to monitor the response of patients with shoulder shake and asked him how, for example, "Are you OK?"
2. Repositioning Victim
Repositioning of the victim if necessary, for example, you find the victim in the tummy.
3. Make sure the Open Airway
Perform maneuvers head-tilt, chin lift or modified jaw thrust, as needed.
4. Check Breathing
See, Hear and Feel the breath. Ensure the presence or absence of breath within 3 - 5 seconds. At the victim is not breathing do not directly do CPR, but you have to do ....
5. 2 Provision of artificial breathing
Perform rescue breathing techniques. If you notice any blockage of the airway, apply the technique to clean the airway. If the victim's airway clear and he was still in a state of continuous breath after you give 2 breaths made it ...
6. Check Absent carotid
Maintain head tilt with one hand on the victim's forehead and use other hand to feel the carotid pulse. If no palpable pulse when you check in 5 to 10 seconds, this means that the victim in a state of cardiac arrest and you have to. ...
7. Begin CPR
With cardiac arrest victims to lie down on a hard surface, such as the floor, ground or spinal board. Injuries that occur on the victim is not a reason for delaying CPR. CPR should be done as soon as possible.

In CPR procedures always include the principles of ABC. A CPR would not be effective if the airway is not open. CPR is also ineffective if the circulation stopped. Circulating blood will not be effective, unless the blood is oxygenated. Always remember that if the bleeding can interfere with circulation. Therefore, if a victim loses too much blood does the CPR ineffective. When bleeding occurs so great, as in the case of arterial bleeding in large (for example: A. Femoral) so that we do CPR may actually accelerate the bleeding, and causing biological death. Although such cases are rare, but we must take action to reduce the amount of blood lost prior to CPR. In CPR, we aim to force the blood of victims who had stopped the circulation to re-circulate by external chest compression, which is known as the artifisial circulation .9

When are resuscitation is terminated?
 Have resurgent spontaneous circulation and ventilation are effective.
 resuscitation efforts have been taken over by a more competent and responsible to continue resuscitation (if there is no doctor).
 A doctor takes charge.
 Helper too tired and could not continue the resuscitation.
 Patients declared dead.
 Given then that after resuscitation, the patient was in terminal stages of a disease that can not be healed again: or the patient almost certainly not going to get back serebralnya function, that is, after 0,5-1 hours, proved there was no pulse in the no resuscitation in normotermia condition, at heart-lung.10

Bibliography

1. Safar P. Resusitasi Jantung Paru Otak. Jakarta : Departemen Kesehatan Republik Indonesia. hal : 4, 1984.
2. Alkatri J, dkk. Resusitasi Jantung Paru, dalam Buku Ajar Ilmu Penyakit Dalam, Editor Soeparman, Jilid I, ed. Ke-2, Balai Penerbit FKUI, Jakarta, hal : 281, 1987.
3. Terapi Sel Induk Obati Infark Jantung. http://www.kompas.com/read/xml /2008/04/06/1654448/terapi.sel.induk.obati.infark.jantung. (1 Des. 2009)
4. Definition of Stokes Adam Attacks. http://www.medterms.com/script/main/art.asp? articlekey=19423. (1 Des 2009)
5. Rima dkk., 1996, “Hipoksia”, Kamus Kedokteran Dorlan, hal: 898, cet.II, EGC, Jakarta.
6. Sylvia A.P., Lorraine M.W., 1995, Tanda dan Gejala Penyakit Pernapasan, “Hiperkapnea dan Hipokapnea”, hal: 685, Fisiologis Proses-proses Penyakit, ed. 4, Buku II, EGC, Jakarta
7. Sunatrio DR, Resusitasi Jantung Paru, Editor Muchtaruddin Mansyur, IDI, Jakarta, hal : 193.
8. Sunatrio, S. Penentuan Mati, Penghentian Resusitasi Darurat dan Jangka Panjang. http://repository.ui.ac.id/contents/koleksi/11/be94c925ae70fb1c58a298c2586d8ca7249e5541.pdf. (1 Des. 2009)
9. Teknik:Resusitasi Jantung Paru. http://groups.yahoo.com/group/jejakpetualang/messa ge/216. (1 Des 2009)
10. Sunatrio, S. Penentuan Mati, Penghentian Resusitasi Darurat dan Jangka Panjang. http://repository.ui.ac.id/contents/koleksi/11/be94c925ae70fb1c58a298c2586d8ca7249e5541.pdf. (1 Des. 2009)


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