Sudden VTACH to VFIB

Published

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!

Up Vote Up Vote ×
Specializes in ER.

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.

Up Vote Up Vote ×

Is it possible that one of his grafts from the CABG ruptured?

Up Vote Up Vote ×

pressures were great

Up Vote Up Vote ×
Specializes in ED, ICU, Education.

Reperfusion? Does the patient move him/herself? Perhaps the left chest tube is up against the PA???

Up Vote Up Vote ×

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.

Up Vote Up Vote ×

so he coded ....i think it had something to do with the CABG....what happened???

Up Vote Up Vote ×
:nurse::yeah:
Up Vote Up Vote ×

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.

Up Vote Up Vote ×

I ran to him within seconds of the vtach. shocked so many times. not a good outcome

Up Vote Up Vote ×
Specializes in ICU/ER.

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?

Up Vote Up Vote ×

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?

Up Vote Up Vote ×
+ Join the Discussion