CHAPTER I

INTRODUCTION
A. Issue Background
Cardiac pulmonary resuscitation is a relief action performed on a victim who has
stopped breathing and cardiac arrest. This situation can be caused by the victim suffered a
heart attack (heart attack),drowning, electric shock, poisoning, accidents, and others. In the
condition of breathing and the heart beat stopped, blood circulation and oxygen transport
also stopped so that in a short time the organs of the body, especially vital organs will
experience oxygen deficiency that is fatal for the victim and damaged.
The organ that is most rapidly damaged is the brain, because the brain will only survive
if there is intake of glucose and oxygen. If in more than 10 minutes the brain is not getting
oxygen and glucose intake, then the brain will experience death permanently. Brain death
also means the death of the victim. Therefore, the golden period (time gold) to the victims
who suffered respiratory arrest and cardiac arrest is under 10 minutes. That is, in watu less
than 10 minutes patients who have stopped breathing and cardiac arrest should have started
to get help. If not, then the victim's life expectancy is very small. As for the help that must
be done in patients who have stopped breathing and cardiac arrest is by doing heart/ CPR
resuscitation.
BLS actions carried out by step CAB (Circulation, Airway, Breathing). The main
purpose of BLS is to protect the brain from irreversible damage caused by hypoxia, because
blood circulation will stop for 3-4 minutes.
B. Problem Formulation
Base on the issue background the problem discussed can be formulated as follow How
to do a primary survey of the victims?
C. Purpose
As the purpose of writing this paper is to know how to do a primary survey of the
victims.

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 CHAPTER II
DISCUSSION
A. Definition of The Primary Survey
The primary survey (initial or rapid assessment) is a methodical process used to quickly
identity immediate life threatening injuries and conditions that require intervention without
delay. The primary survey should be completed promptly upon initial patient contract if no
immediate life threatening injuries and conditions requiring intervention arefound during the
survey.
The primary survey is a process carried out to detect and treat life threatening condition.
The primary survey is a treat-as-you-goprocess. In the primary survey focused on the
circulation aand defibrillation
The purpose of a primary survey is to check the life treaatning aand give urgentfirt aid
care.
B. Indicatio
1. Stop breathing
Breathing is characterized by the absence of chest movement and respiratory airflow
from the victim / patient.Respiratory arrest may occur in drowning, stroke, airway
obstruction, epiglottitis, drug overdose, electric shock, myocardial infarction, lightning
or coma from multiple cases.In the early stops the breath of oxygen can still enter into
the blood for several minutes and the hearts can still circulate blood to the brain and vital
organs.
2. Cardiac arrest
In the event of cardiac arrest, there will be a direct stop circulation.These circulatory
stops will quickly cause the brain and vital organs to be deprived of oxygen.Irritated
breathing (wheezing) is an early sign of cardiac arrest.
Basic life support is part of medical emergency management that aims:
a. Blood Activation
b. Maximize Oxygen
c. Return of Spontanious Circulation
d. Minimize Neurological Damage

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C. Help On Basic Principles
1. Safety
Ensure safe conditions for rescuers and victims. Pulmonary Heart Resuscitation
(CPR) is performed on a hard and flat surface.
2. Responsiveness
To make sure the victim is conscious or not helper should make efforts in order to
ensure awareness of victim / patient, can by touching or shaking the shoulders victim /
patient gently and steadily to prevent excessive movement, while calling her name or sir
!!!/ Mom!/ Mas !!!/Miss !!!
Response may be a groan or movement.An abnormal breath is not considered a
response.To recognize the patient who experienced the attack is if the patient does not
respond or not breathing normally.
3. Ask For Help
If the victim / patient does not respond to the call, immediately ask for help by:
a. 1 helper and download immediately phone 118 AED (automated external
defibrillator) (if available)
b. Inform:
1) What happened (eg heart attack / unconsciousness)
2) The number of victims
3) Location of the victim
4) Phone number to call
5) An ambulance is needed immediately.
c. Hang up after being instructed by the clerk
4. Shout For Help
a. Check in carotid communis artery
b. Remember no more than 10 seconds (just make sure whether there is a pulse)

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5. Circulation
This chest compressions create blood flow by increasing intra-thoracic pressure and
directly compressing the heart.This results in the delivery of oxygen and blood flow to
the myocardium and brain. Effective chest compressions are essential for providing
flow.
Blood during CPR.For this reason all patients with cardiac arrest should receive chest
compressions.The massage position below the patient's breastboneBy positioning the
heel of the helper hand in the massage area and the other hand above it.

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 Effective chest compression
a. Minimum 100 presses per minute and a maximum of 120 presses per minute
b. With a minimum compression depth of 2 inches / 5 cm and a maximum of 2.4 inches
/ 6 cm
c. Minimizes interruptions and duration to maximize the number of compressions that
do per minute.
d. Perfect namely chest wall recoil back to its normal position in full before
compressionSubsequent chest by means of a helper's hand is not impinged on the
victim's chest between two presses.
e. Avoid breathing assistance too often (avoid hiperventilation)30 chest compressions
and 2 breaths assistance is called one cycle of CPR / CPR (cardiopulmonary
resuscitation / cardiopulmonary resuscitation).5 CPR cycles performed for 2
minutes.After 5 CPR cycles, carotid pulse assessment is performed, if no pulse is
continued then 5 next cycle of CPR, and so on.

6. Airway
After completion of the basic procedure, then proceed with the action:
a. Examination of the airway.
This action aims to determine the presence or absence of airway obstruction by
foreign objects.If there is a blockage to be cleaned first, if a blockage of liquid can be
cleaned with the index finger or middle finger coated with a piece of cloth, while the
blockage by hard objects can be scraped by using a bent index finger.The mouth can

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 be opened with Cross Finger technique, in which the thumb is placed opposite to the
index finger At the mouth of the victim.
b. Open the airway.
Once the airway is confirmed to be free from the obstruction of a foreign body, it is
common for the victim not aware of muscle tone to disappear, then the tongue and
epiglottis will close the pharynx and larynx, this is one cause of airway
obstruction.Liberation of the airway by the tongue can be done by the chin looked up
the prop head (Head tild - chin lift) and maneuver the furtherance of the mandible
(jawthrust).The recommended airway opening technique for laymen and
officers,Health is looking at the head of the chin, but health workers should be able
to perform other maneuvers.

7. Breathing
Consists of 2 stages
a. Ensure the victim / patient is not breathing.
By looking at the movement up and down the chest, hear the breath and feel the
breath of the victim / patient.For that helper should be closer to the mouth and nose
of the victim / patient, while maintaining the airway remains open.This procedure
should not exceed 10 seconds.
b. Providing breath help
If the victim / patient is not breathing, breathing can be done through mouth to
mouth, mouth to nose or mouth to stoma (a hole made in the throat) by giving 2

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breaths of breath, the time required for each blow is 1, 5-2 seconds and the volume of
exhaled air is 700-1000 ml (10 ml / kg) or until the victim's chest / patient is visibly
expanding.The helper should take a deep breath when it will exhale to achieve
sufficient air volume.The concentration of oxygen that canGiven only 16 - 17%.The
helper should also pay attention to the response of the victim / patient after being
given a breath.Conduct vent 2 times each time 30 chest massage
How to provide breathing assistance:
a. Mouth to mouth
Respiratory aids using this method is an appropriate and effective way of giving
the victim / patient's lung air.When breathing from mouth to mouth, the helper
should take a deep breath first and the helper's mouth should be able to
completely cover the mouth of the victim in order to avoid leaks while exhaling
and also the helper should close the victim / patient nostrils with the thumb and
finger Forefinger to prevent air from coming back out of the nose.The volume of
air given to most adults is 700-1000 ml (10 ml / kg).Excessive air volume and
excessive inpiration rate can cause air to enter the stomach, resulting in gastric
distension.

b. Mouth to nose
This technique is recommended if the ventilation effort from the mouth of the
victim is not possible, for example on Trismus or where the victim's mouth is
severely injured, and vice versa if by mouth to nose the helper should cover the
victim's mouth.
c. Mouth to stoma

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Patients with laryngotomy have a hole (stoma) that connects the trachea directly
to the skin.If the patient has difficulty breathing, ventilation must be done from
mouth to stoma.

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 CHAPTER III

CLOSING

A. Conclusion
The primary survey (initial or rapid assessment) is a methodical process used to quickly
identity immediate life threatening injuries and conditions that require intervention without
delay.
The principle of primary survey are safety, Responsiveness, ask for help, shout for help,
circulation, airway, and breathing.