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V-fib after Asystole



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Jul 10, 2008 09:02 AM

V-fib after Asystole

by Shell5

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?


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16 Comments
No. 1
from jmgrn65
Old Jul 10, 2008, 09:11 AM

Default Re: V-fib after Asystole
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.
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No. 2
from Shell5
Old Jul 10, 2008, 09:16 AM

Default Re: V-fib after Asystole
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?
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No. 3
from getoverit
Old Jul 10, 2008, 01:29 PM

Default Re: V-fib after Asystole
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 coarse v-fib is typically more responsive to electrical therapy than fine v-fib. the flatter the line...the longer they have been fibrillating.
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No. 4
from MassED
Old Jul 10, 2008, 04:49 PM

Default Re: V-fib after Asystole
Originally Posted by Shell5 View Post
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.
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No. 5
from ghillbert
Old Jul 10, 2008, 09:43 PM

Default Re: V-fib after Asystole
Yes of course, if you ever see VF, shock it.
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No. 6
from Special31
Old Jul 10, 2008, 09:45 PM

Default Re: V-fib after Asystole
Yes, definitely a shockable rhythm
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No. 7
Old Jul 10, 2008, 10:35 PM

Default Re: V-fib after Asystole
Originally Posted by Shell5 View Post
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
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No. 8
from joeyzstj
Old Jul 11, 2008, 12:17 PM

Default Re: V-fib after Asystole
Originally Posted by Shell5 View Post
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.
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No. 9
from ghillbert
Old Jul 12, 2008, 09:34 AM

Default Re: V-fib after Asystole
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.
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