ACLS: Ventricular Fibrillation & VTach Flashcards

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Questions and Answers

What is the most important algorithm to know for adult resuscitation?

V-tach

V-fib

V-tach and V-fib (correct)

None of the above

What might bring a patient back quickly if they do not have a pulse?

A precordial thump

What should you do first when encountering a patient in pulseless V-tach?

Get the crash cart

CPR (correct)

Administer Epi 1 mg

Shock

What is a biphasic defibrillator?

A type of defibrillation waveform delivering a shock via two vectors. Signup and view all the answers

What is monophasic defibrillation?

A type of defibrillation waveform delivering a shock from one vector. Signup and view all the answers

Why does V-tach occur?

Repetitive firing of an irritable ventricular ectopic focus. Signup and view all the answers

V-tach can have a pulse.

True Signup and view all the answers

What is the pathophysiology behind V-tach?

Ventricles have areas of normal myocardium alternating with ischemic, injured, or infarcted myocardium. Signup and view all the answers

Which clients are most at risk for V-tach?

Ischemic heart disease, MI, cardiomyopathy, hypokalemia, hypomagnesemia, valvular heart disease, drug toxicity. Signup and view all the answers

Which is more lethal?

V-fib Signup and view all the answers

What are some signs and symptoms of V-tach?

Shock, chest pain, hypotension, shortness of breath, pulmonary congestion, congestive heart failure, acute MI. Signup and view all the answers

What is likely the precursory rhythm to V-fib?

V-tach Signup and view all the answers

What is the pathophysiology of V-fib?

Electrical chaos in the ventricles leading to disorganized impulses. Signup and view all the answers

If V-fib is not treated, how quickly can it be fatal?

3-5 minutes Signup and view all the answers

What chaotic rhythm is possibly the first manifestation of coronary artery disease?

V-fib Signup and view all the answers

What might put a patient at greater risk of developing V-fib?

Myocardial infarction Signup and view all the answers

Who is V-fib most likely to occur in?

Patients with myocardial ischemia, hypokalemia, hypomagnesemia, or following electrocution. Signup and view all the answers

What are the EKG characteristics of V-fib?

Rate cannot be determined, rhythm is rapid and chaotic, P wave not discernible, PR interval not discernible, QRS duration not discernible. Signup and view all the answers

What is the physical assessment for V-fib?

Patient may become faint, lose consciousness, and become pulseless and apneic. Signup and view all the answers

A patient who is not treated for V-fib is dead.

True Signup and view all the answers

What must be done if a patient is in pulseless V-tach or V-fib?

Shock Signup and view all the answers

What is the key to positive outcomes with pulseless V-tach or V-fib?

Early defibrillation Signup and view all the answers

What is the next action nurses should take if a patient in V-tach remains in that rhythm after being shocked?

Establish IV access Signup and view all the answers

Study Notes

Ventricular Fibrillation and Pulseless Ventricular Tachycardia

The most crucial algorithm for adult resuscitation involves V-tach and V-fib management.
A precordial thump may help restore a pulse in cases of pulseless V-tach or V-fib, though it's not covered in ACLS training.
When encountering a patient in pulseless V-tach, start high-quality CPR immediately; defibrillation can follow when additional help arrives.

Defibrillation Techniques

Biphasic defibrillators deliver shocks through two vectors, using fewer joules and becoming the standard over monophasic defibrillators, which rely on one vector and require more joules for effectiveness.

Pathophysiology and Risk Factors

V-tach results from repeated firing of an irritably focused ventricular ectopic site.
V-tach can be stable, presenting a pulse.
Ventricular depolarization in V-tach occurs in a chaotic manner due to alternating normal and ischemic myocardium, contributing to the risk of cardiac instability.
Clients at high risk for V-tach include individuals with ischemic heart disease, myocardial infarctions, cardiomyopathy, electrolyte imbalances, and drug toxicity.

Clinical Significance

V-fib is more lethal than V-tach, leading to sudden cardiac arrest.
Symptoms of V-tach include shock, chest pain, hypotension, shortness of breath, and potential acute myocardial infarction.
V-tach often precedes V-fib and is frequently associated with myocardial infarction.

V-fib Characteristics and Consequences

V-fib arises from electrical chaos within the ventricles, resulting in ineffective contractions and no cardiac output.
If untreated, V-fib can be fatal within 3-5 minutes.
Patients may appear faint and lose consciousness; signs also include fixed dilated pupils and mottled skin.

Assessment and Interventions

EKG characteristics of V-fib show a chaotic and undetermined rate, with no discernible P waves, PR intervals, or QRS durations.
Shock delivery is mandatory for patients in pulseless V-tach or V-fib to restore normal heart rhythm.
Early defibrillation significantly improves outcomes for pulseless VT or VF.

Scenario-Based Actions

After defibrillation in a case of persistent V-tach, the priority is to establish IV access before administering medications such as epinephrine.

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Description

Test your knowledge on the critical algorithms for managing ventricular fibrillation and pulseless ventricular tachycardia. These flashcards cover key concepts and interventions necessary for adult resuscitation. Prepare for emergency situations with essential information that could save lives.