Sudden VTACH to VFIB

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by Rise Against
Mar 23, '10   Views: 3,831   Comments: 13

  1. Is sudden Vtach and then to pulseless vfib randomly in the night of day common? No pvc's during the day, electrolytes within range. Bilat chest tubes d/t bilat pneumo's. s/p cabg several weeks. vitals within normal limits all shift. Probably from some type of resp failure caused vtach/vfib. Has this happened to anyone? no warnings and just bam!
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    About Rise Against

    Joined: Aug '09; Posts: 17; Likes: 6
    CVICU; from US
    Specialty: 1 year(s) of experience

    13 Comments

    Comment
  3. by PAERRN20
    Mar 23, '10
    Well I wouldn't say its normal, but I wouldn't say it is totally abnormal though. Many people that code do so with sudden V-Tach. I don't work on a floor though so I haven't seen the rhythms over a period of days...rather I see tele of the course of a few hours. Maybe someone with more experience will come and give you a better answer.
  4. by April, RN
    Mar 23, '10
    Is it possible that one of his grafts from the CABG ruptured?
  5. by Rise Against
    Mar 23, '10
    pressures were great
  6. by resumecpr
    Mar 23, '10
    Reperfusion? Does the patient move him/herself? Perhaps the left chest tube is up against the PA???
  7. by questionsforall
    Mar 23, '10
    What is his RV function like? Was it distended. Was he fluid overloaded?
    Most respiratory arrests I have seen were either bradycardic arrests or asystolic arrests.
    Last edit by questionsforall on Mar 23, '10 : Reason: addition
  8. by larrsma
    Mar 23, '10
    so he coded ....i think it had something to do with the CABG....what happened???
  9. by larrsma
    Mar 23, '10
  10. by nurse0409
    Mar 23, '10
    I had a patient who had been totally fine, but the graft failed. The pt. was rushed directly to the OR during the code, because this had happened to her once before. Her rhythm had been great and I was talking to her and then all of sudden she went into vtach then vfib. So I'm guessing the graft failed.
  11. by Rise Against
    Mar 23, '10
    I ran to him within seconds of the vtach. shocked so many times. not a good outcome
  12. by traumalover
    Mar 24, '10
    it could have been any number of things, tension pneumothorax, PE (PE's can be a PEA, or brady arrest, but also can be v tach)collapsed or ruptured graft, a clot in any of the grafts or coronary arteries, etc.....are they doing an autopsy? Sudden change in K level due to lasix? Calcium and mag both okay? No new meds or withdrawal of antiarryhmics?
  13. by OMGWhatIsThatSmell
    Mar 24, '10
    agree with trauma lover on possible causes

    Was the QT interval long? Was the VT preceded by an R-on-T PVC? Hypoxia or sleep apnea? Were isoenzymes okay following the code?
  14. by April, RN
    Mar 24, '10
    I'm also interested in whether they are doing an autopsy? To answer your question about whether or not it's common to have someone suddenly go into VT/VF arrest... I wouldn't say it's common, but your patient did have a strong cardiac history and post-op complications.

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