V-fib after Asystole

Specialties CCU

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In a code situation a paient is found in asystole. CPR is performed and resucue meds are given. Approximately 5 minutes have elapsed and you see V-fib on the monitor is that then a shockable rhythym?

If they are in a fine vfib I would recommend epi and a few rounds of cpr and then see if they have a coorificer vfib to shock. I think if it is coorificer then you will have better sucess. Just an idea

Specializes in Advanced Practice, surgery.
If they are in a fine vfib I would recommend epi and a few rounds of cpr and then see if they have a coorificer vfib to shock. I think if it is coorificer then you will have better sucess. Just an idea

Personally I think any deviation from the official resuscitation guidence is just asking for trouble. If V fib shows on the monitor then this is a shockable rhythm and should be shocked. Give one shock energy will be dependent on the type and make of defibrillator, the ones we use are 200 j biphasic, once the shock has been delivered then continue CPR with epinepharine every 3 - 5minutes.

I just took ACLS and if pulseless, yes it is a shockable rhythm. Of course CPR and meds must be given before and after til a pulse is felt. Epinephrine 1mg every 5 minutes time 3 doses. Hope this helps

Specializes in Tele, M/S, Psych.

Though not NEAR as experienced as most people that have posted on this thread I work on Tele and am on the code team almost every night I work (Adrenaline Junkie), I definitely agree with Gilf. Max out your meds with asystole and if you have pulseless VF and not PEA, shock it! Always go with the Holy Bible of Cardiac...ACLS...:up:

Specializes in ER/ICU/Flight.
I just took ACLS and if pulseless, yes it is a shockable rhythm. Of course CPR and meds must be given before and after til a pulse is felt. Epinephrine 1mg every 5 minutes time 3 doses. Hope this helps

i don't believe there is a max dose on epinephrine according to acls guidelines. of course there is the "point of diminishing returns" where you have to ask yourself if it's pointless or not.

you may have been referring to atropine 1mg q5m x 3 doses (or until .04mg/kg) but atropine isn't indicated in any shockable algorithm.

the most important thing by far is good compressions. without that everything else is basically useless. we worked a code recently and the pressure by a-line was 87/53, ekg-asystole. for the few seconds cpr was interuppted you could really see the precipitous drop in pressure.

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