Asystole
Asystole or “flatline”
Asystole is not actually a true rhythm but rather is a state of no cardiac electrical activity. The main treatment of choice in the pulseless arrest algorithm is the use of epinephrine and CPR.
During asystole, there is no blood flow to the brain and other vital organs. This results in very poor outcomes if resuscitation is successful.
If asystole is visualized on the monitor, you should ensure that all leads are connected properly. If all leads are properly connected, you should rapidly assess for any underlying causes for the asystole.
As with pulseless electrical activity (PEA), asystole can have possible underlying causes which can be remembered using the H’s and T’s mnemonic.
In the following video, asystole is depicted on the defibrillator monitor and suggestions for treatment are given. Please allow several seconds for the video to load.
Pop-Quiz
Question: What can sometimes be mistaken for asystole during a code?
click here for answer»
Why can’t asystole be shocked?
Defibrillation or “shock” actually stuns the heart and cause temporary asystole and resets the pacemaker of the heart. Shocking asystole does nothing because the pacemaker is not firing in the first place and therefore cannot be reset. For defibrillation to work, you first need a heart that has a working electrical impulse.—Kind regards, Jeff
What Teresa may be getting at is the “fine VF” issue. If you’re not sure whether it’s fine VF or asystole, what would be the downside of shocking?
If you think that what you see is find VF go ahead and shock. There really is not a downside to shocking. If in doubt and you think you are dealing with fine VF, Shock.—Regards, Jeff
will let you know how it turns out, but this is fantastic stuff!
Great learning tool. Thanks a lot. You are doing a fantastic job here.
Great videos. Commentary on the defibrillator screen is a great learning tool. And I did have sound (music) with the videos.
Can the AED be overridden to administer a shock for fine VF if it mistakenly reads asysstole?
Some AED’s have this feature.
May I assume that fine VF will call for VF/VT algorithm? FIne VF is therefore shockable. Correct?
Yes, Shock fine VF. Jeff
This is very helpful to get ready for my
ACLS test.
Is there suppose to be sound?
Hi jodi. No these short videos do not have any sound. Jeff
I can’t seem to get the sound from the ACLS Rhythm series.
The EKG Rhythm videos do not have sound. Thanks, Jeff