AMERICAN HEART ASSOCIATION

GUIDELINES for
CARDIOPULMONARY
RESUSCITATION
2005

Dr. Prabowo Wicaksono SpAn

BAGIAN/SMF ANESTESI FAKULTAS KEDOKTERAN
UNISSULA/RSISA
2007

Types of cardiac arrest:

1. SUDDEN CARDIAC ARREST (SCA)
Etiology: Ventricular fibrillation (VF)
Pulseless vetricular tachycardia (VT)
2. HYPOXIC ARREST
Etiology: drowning, drug overdose, trauma, most
infant and children

MAJOR CHANGES AFFECTING ALL RESCUERS

The 5 major changes in the 2005 guidelines are:
1.Emphasis on and recommendation to improve, delivery of
effective chest compression
2.A single compressionto-ventilation ratio for all single rescuers
for all victims (except newborn)
3.Recommendation that each rescue breath be given over 1
second and should produce visible chest rise
4.A new recommendation that single shocks, followed by
immediate CPR, be used to attempt defibrillation for VF cardiac
arrest. Rhythm checks should be performed every 2 minutes.
5.Endorsement of the 2003 ILCOR recommendation for use of
AEDs in children 1 to 8 years old.; use a child dose reduction
system if available.

EMPHASIS ON EFFECTIVE CHEST COMPRESSIONS

To give chest compression, all rescuers should push hard and push
fast. Compress the chest at rate of about 100 compressions per
minute for all victims .
Allow the chest to recoil (return to normal position) completely after
each compression .
Try to limit interruptions in chest compressions. Every time you stop
chest compressions, blood flow stops.

ONE UNIVERSAL COMPRESSION-to-VENTILATION RATIO

FOR ALL LONE RESCUERS
The AHA recommends a compression-to-ventilation ratio of 30:2 for
all lone (single) rescuers to use for all victims from infants through
adults. This recommendation applies to all lay rescuers and to all
heatlhcare providers who perform 1 rescuers.

RECOMMENDATIONS for 1-SECOND BREATHS DURING

ALL CPR
Each rescue breath should be given over 1 seconds. Each rescue
breath should make the chest rise (rescuers should be able to see the
chest rise). All rescuers should give the recommended number of
rescue breath. All rescuers should avoid delivering too many breaths

Rescue breaths can safely be given in 1 second. During CPR, it is

important to limit the time used to deliver rescue breaths to reduce
interruptions in chest compressions. Rescue breaths given during CPR
increase pressure in the chest which reduces the amount of blood that
refills the heart and in turn reduces the blood flow generated by the
next group of chest compressions. Hyperventilation may also cause
gastric inflation and its complications.

ATTEMPTED DEFIBRILLATION: 1 SHOCK, THEN IMMEDIATE

CPR
When attempting defibrillations, all rescuers should deliver 1 shock
followed by immediate CPR, beginning with chest compressions. All
rescuers should check the victims rhythm after giving about 5 cycles
(about 2 minutes) of CPR

DEFIBRILLATION
Objective: to reset electrical conduction in the heart.
Indication : Shockable rhytme: - Ventricular Fibrillation (VF)
- Pulseless Ventricular Tachycardia
(pulseless VT)

Ventricular Fibrillation
Pulseless Ventricular Tachycardia

Ventricular Fibrillation

Ventricular Tachycardia

Non-Shockable Rhythm
Asystole
PEA ( Pulseless Electrical Activity ) / EMD
( Electro Mechanical Dissociation )

Asystole

Pulseless Electrical
Activity

AUTOMATED EXTERNAL DEFIBRILLATORS

Detect shockable waves then automatically gives shock. Can be
operated by trained personel (lay rescuers or healthcare provider)

Thank you......