V-fib after Asystole

Specialties CCU

Published

  • by Shell5
    Specializes in Med Surg/Tele/Ortho/Psych.

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?

jmgrn65, RN

1,344 Posts

Specializes in cardiac/critical care/ informatics.

Yes the only unshockable rhthym is no rhthym such as asystole and PEA but some will agrue to shock aststole because it might be fine VF.

Shell5

200 Posts

Specializes in Med Surg/Tele/Ortho/Psych.

I don't think there was a pulse, so I take it we were still not to shock even if it showed V-fib on the monitor?

Specializes in ER/ICU/Flight.

If it was v-fib on the monitor, then shock it. one of the purposes in giving epinephrine during a code is to alter the fibrillation threshold, in order to produce a more shockable rhythm. remember coorifice v-fib is typically more responsive to electrical therapy than fine v-fib. the flatter the line...the longer they have been fibrillating.

MassED, BSN, RN

2,636 Posts

Specializes in ER.
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?

yes, then the algorithm has changed as well.

allnurses Guide

ghillbert, MSN, NP

3,796 Posts

Specializes in CTICU.

Yes of course, if you ever see VF, shock it.

Special31

30 Posts

Yes, definitely a shockable rhythm

Specializes in Cardiothoracic Transplant Telemetry.
I don't think there was a pulse, so I take it we were still not to shock even if it showed V-fib on the monitor?

You won't generally have a pulse with V-tach either, and you still shock that. If you get v-fib back after asystole consider yourself lucky and add electricity ASAP. If you are really lucky you will continue the progress

joeyzstj, LPN

163 Posts

Specializes in CVICU, ICU, RRT, CVPACU.
I don't think there was a pulse, so I take it we were still not to shock even if it showed V-fib on the monitor?

What would you do if you saw V-tach with no pulse, which commonly happens? V-fib is a shockable rhythm even with no pulse. The patient is dead, and without intervention he or she is going to remain that way.

allnurses Guide

ghillbert, MSN, NP

3,796 Posts

Specializes in CTICU.

I don't really understand your question. VF (or rapid VT) most commonly does not have a pulse, because the heart is beating/filbrillating too fast to fill and empty properly and create a pulse.

The purpose of defibrillating is to disrupt that rhythm and restore the electrical (and hence mechanical) firing.

anurseuk

140 Posts

Specializes in Paediatric Cardic critical care.

Yes definatly. Was this an actual situation you had? What did you do?

Spatialized

1 Article; 301 Posts

Specializes in Cardiac Telemetry/PCU, SNF.

...in best "Waterboy" accent, "they need some high-quality ee-leck-tri-city!"

It doesn't really matter when you get V-fib, it's always a shockable rhythm, the heart needs a good 200 joule jolt to reset.

Cheers,

Tom

+ Add a Comment