Published Nov 13, 2001
We had an exam question in class that everyone was upset about .....It basically was about Ventricular Fib.
The patient was in a hospital bed and his arrythmias set off the tele monitor and the ECG was showing Ventricular Fib so what intervention needs to be taken?
a. Call the Doctor
c. Defib the patient with the bedside defibrillator
d. Give a PRN medication
The answer was Defib the patient with the bedside Defibrillator
Please give me your reaction to this question because I have never seen a nurse in a hospital Defib a patient I have only seen Doctors do it.
I've been an RN for 17 years. I've worked mostly ER and ICU's. I personally have defibbed several patients over the years. I have assisted other RN's to defib. I cannot remember a time when a DR has done the defib. The answer is correct. Gary
I agree that defib is the right answer for that question. At my school, the CPR certification for nursing students includes instruction on using the defib. For v fib, the pt needs to be shocked, and immediately. CPR will not correct this dysrhythmia as I understand it. I believe that is the reason that many large stores, malls, churches, etc. are now housing automatic defibrillators, because you're not going to save a person with a ventricular dysrhythmia in any other way. Somebody please correct me if I'm wrong....
I have to agree with everybody else. As an EMT, that is what we do if the pt is in V Fib. Machine even tells you what and when to do.....
canoehead, BSN, RN
Well the correct answer was defib, but I must say that in nursing school they did not teach us ACLS at all, that came after I got my first job. So if that is the case with you, I cannot imagine a student being asked to perform a procedure that they have not been taught, or shown. So if you want to argue the answer from that angle I think you have a case.
Last week we had a 12 hour ACLS workshop. Then on friday we were tested over all of the flow charts and protocols so that we are able to recieve ACLS certification as soon as we are licensed. It was a very long class, and on a saturday evening, it was BORING! :) The material was interesting, but the lecture was dry.
I agree that the answer is d- fib the patient in the hospital i work at even the cna's are expected to do this if they are the first ones in the room in fact our hosp does not initiate cpr first they have some one run for the d- fib machine
zacarias, ASN, RN
If you think about the situation it will make sense. Nurses can and do defib and you know how serious VF is. That heart needs to get going NOW and FAST..do call a doctor and wait for him/her to come and do it? No, the rhythm needs immediate attention!
Just redid my ALS last week - don't know where they got the stats from, or even if I have them exactly right, but something like - after the first 90 seconds of v-fib, the outcome goes down by 50%, then a further 10% for every minute. So, someone in VF for 5 mins would have a 90% chance of not surviving it. Early defib is the only way to go. In the ED where I work, the techs and reception staff are trained in it as well (not that they ever use it, there are always plenty of RN's hanging around waiting for the chance to refresh their skills. The docs are usually doing drugs or airway management, they never manage a code.
Defib was the right answer given your choices however let me stress in a real life situation please check the patient first. Just because the monitor says V-fib doesn't necessarily make it so.
That said...Yes nurses defib all the time, much more often than physicians because most often the nurses are at the bedside and the physicians are not.
EXOTIC NURSE, RN
I understand the rationale for Defibbing the patient and I appreciate all the comments.....Thanks again everyoneeeeee!!!!
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