Pulseless patients: shock or drugs

  1. When coding a pulseless patient in VT or VF do you generally shock them first or use drugs in your practice?
    •  
  2. 63 Comments

  3. by   tiredfeetED
    Quote from EricTAMUCC-BSN
    When coding a pulseless patient in VT or VF do you generally shock them first or use drugs in your practice?
    Shock!!!!!!!!!!!!!!!!!
  4. by   ernurse728
    Shock times three...then drug-shock-drug-shock! Always use electricity first!
  5. by   gwenith
    Shock!!!! Always shock first. The evidence is unassailable and is the main reason for autmatic defibrillators.
  6. by   tridil2000
    Quote from EricTAMUCC-BSN
    When coding a pulseless patient in VT or VF do you generally shock them first or use drugs in your practice?
    no pulse with vf or vt?
    shock 200

    why do you ask?
  7. by   lovelee
    vt or vt "shock, shock, shock, every body shock shock shock and lets make patients better"...............!
    Quote from erictamucc-bsn
    when coding a pulseless patient in vt or vf do you generally shock them first or use drugs in your practice?
  8. by   EricTAMUCC-BSN
    The reason I ask is because I saw a relatively healthy person suffering acute illness shocked after going into pulseless VT at around 160 bpm. The initial shock converted him into VF than asystole. He died after continued resusitation attemps.
  9. by   PA-C in Texas
    Quote from EricTAMUCC-BSN
    When coding a pulseless patient in VT or VF do you generally shock them first or use drugs in your practice?
    LOL. Aren't you the one who thought you should be able to step onto an ambulance right after nursing school? Good luck with that.
  10. by   EricTAMUCC-BSN
    I am sorry that you misunderstood the subject matter discussed in this post. I am also sorry that you misunderstood an earlier post of mine. Maybe you can try to interperet again,

    "I agree with Biffs25, there is no reason that an RN shouldn't be allowed to gain prehospital certification quickly and economically especially after taking ACLS."

    Hope that helps.

    Quote from PA-C in Texas
    LOL. Aren't you the one who thought you should be able to step onto an ambulance right after nursing school? Good luck with that.
    Last edit by gwenith on Feb 3, '05 : Reason: personal attack
  11. by   Dixielee
    Eric, I think all the literature supports the shock, shock, shock theory. The person you saw may have just been circling the drain anyway, and nothing was going to help. There are exceptions to every rule, you just have to go with the odds. I have rarely seen anyone come "back" after CPR, but have seen quite a few after potentially fatal arrhythmias.
  12. by   EricTAMUCC-BSN
    Yes, you're right that it was more than likely inevitable and this was only one case. Having only witnessed a handful of codes with only one turnaround I see where you are coming from. I still find myself questioning whether or not this is an appropriate first line intervention.

    Eric, I think all the literature supports the shock, shock, shock theory. The person you saw may have just been circling the drain anyway, and nothing was going to help. There are exceptions to every rule, you just have to go with the odds. I have rarely seen anyone come "back" after CPR, but have seen quite a few after potentially fatal arrhythmias.
  13. by   JessicRN
    I have seen many unsuccessful rescitations with healthy persons who have suffered a lethal arrythmia. The studies have showed that without shock there is little to no chance of survival.
    Quote from EricTAMUCC-BSN
    The reason I ask is because I saw a relatively healthy person suffering acute illness shocked after going into pulseless VT at around 160 bpm. The initial shock converted him into VF than asystole. He died after continued resusitation attemps.
  14. by   candyndel
    Not only would you shock them three times, but if the rhythm is still the same and meds arent readily avail (say, in the field), you could shock them a 4th. (Dont forget, only 10% of all arrests survive....) You're relatively healthy person probably had a blockage of his Widow Maker, and little or no collateral development.

close