Ventricular Fibrillation
Ventricular Fibrillation
Ventricular fibrillation or VF occurs when there are uncoordinated contractions within the ventricles of the heart. The primary cause of VF is hypoxia (lack of oxygen) to the heart muscle which causes hyperirritability in the cardiac muscle tissue.
As a result, multiple muscles cells within the ventricles simultaneously fire as pacemakers causing a quivering or fibrillation that is ineffective for adequate cardiac output.
The two images above show what ventricular fibrillation will look like on a EKG rhythm strip.
VF can rapidly lead to heart muscle ischemia and there is a high likelihood that it will deteriorate into asystole.
Ventricular fibrillation is treated using the left branch of the puslesless arrest arrest algorithm. Click below to view the pulseless arrest algorithm diagram. When done click again to close the diagram.
Pulseless Arrest Algorithm Diagram.»
Ventricular fibrillation is always pulseless and must be confirmed by EKG or defibrillator monitor. Defibrillation is the treatment of choice and should occur as soon as possible.
The video below shows an example of what ventricular fibrillation will look like when you see it on the defibrillator monitor. Please allow several seconds for the video to load.
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So much emphasis is placed on: Epi, Vasopressin and Amiodarone. How do you know when/if to give Lidocaine during Cardiac Arrest?
Thanks!
The overall benefits of lidocaine for the treatment arrhythmias in cardiac arrest has come under scrutiny. It has been shown to have no short term or long term efficacy in cardiac arrest.
During a code if you have already use the 2 doses of amiodarone and the code continues then you could at this point initiate the use of lidocaine. I have seen lidocaine used only once in a code over the last 5 years.
It does seem to be falling out of use. On the other hand, I have seen amiodarone used effectively several times. When I say effectively, I mean that the patient regained ROSC.
I cannot say what the long term outcome was in these situations.
No medication has been shown to positively benefit survival to hospital discharge according to the AHA, but both epinephrine, vasopressin, and amiodarone have been shown to improve ROSC in cardiac arrest.
Kind regards,
Jeff
Am gonna this month for acls certificate…
And Am very glad to find this website
I need to have ACLS Reneal next month. I am glad to find this site. It iks very clear, detail, understandable. I will be confident to take my reneal next month. Thanks
thank you so much this has really been a good tool for me to prepare for acls
i was adivised once that you dont shock for fine v-fib. is this true?
Fine VF is VF and it should be shocked as with a distinct VF. Kind regards, Jeff
Shola with asystole you don’t shock, however, I have read that fine vfib can look like asystole and there is some literature that says you should shock with asystole in case it is really fine vfib
I’m sure the initiation of oxygen is implied at the beginning of the algorithm with the initiation of CPR. Love this site
In the algorithm diagram on this page, application of oxygen is shown in the top blue box. If I you happen notice some places on the site where it is not mentioned (application of oxygen) and should be, kindly let me know and I will get it added in. —Kind regards, Jeff
I have worked in ambulatory surgery and vascular pre and post surgery for years. A new
job is requiring acls certification. Identifying and treating cardiac rhythms has not been part
of my practice! This web site has been so helpful. Seeing the rhythms on the screen with
practice sessions have adequately prepared me for my class. Thankyou for the excellent
site!
This information is most helpfull to me preparing for ACLS re-certerfication.
I can study at home at my convenience.
Thank you so much. I will inform my friends at work.
Just a little comment, according to AHA, PEA is non shockable while VT/VF are shockable. Therefore, VF should not follow PEA algorithm =) It should follow the same algorithm as pulseless VT
That is correct.
Very useful and precise information .Thank you
wow, I really needed thius info
I have been a nurse for years, and am taking the ACLS course for the second time in two years. You have to know your rhythms first, and I wish I had known of this site the first time.
Great work and great site
thanks
I will be doing my ACLS in October, glad I’ve found this site!
Good to be able to see the rhythms in action.Can play over and over until you understand
I will have my Megacode practical test on august 20. Glad I found your website it is helpful for my preparation for the Megacode I hope I will pass the test… Thanks
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i like dis channel…hope i can past my acls course..
I love this website. Decreases my worry on passing Megacode in ACLS. I work on OB and do not regularly work with heart rhythms. I hope I will pass tomorrow. Thanks