Podcast
Questions and Answers
What is the most important algorithm to know for adult resuscitation?
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?
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?
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?
What is a biphasic defibrillator?
What is monophasic defibrillation?
What is monophasic defibrillation?
Why does V-tach occur?
Why does V-tach occur?
V-tach can have a pulse.
V-tach can have a pulse.
What is the pathophysiology behind V-tach?
What is the pathophysiology behind V-tach?
Which clients are most at risk for V-tach?
Which clients are most at risk for V-tach?
Which is more lethal?
Which is more lethal?
What are some signs and symptoms of V-tach?
What are some signs and symptoms of V-tach?
What is likely the precursory rhythm to V-fib?
What is likely the precursory rhythm to V-fib?
What is the pathophysiology of V-fib?
What is the pathophysiology of V-fib?
If V-fib is not treated, how quickly can it be fatal?
If V-fib is not treated, how quickly can it be fatal?
What chaotic rhythm is possibly the first manifestation of coronary artery disease?
What chaotic rhythm is possibly the first manifestation of coronary artery disease?
What might put a patient at greater risk of developing V-fib?
What might put a patient at greater risk of developing V-fib?
Who is V-fib most likely to occur in?
Who is V-fib most likely to occur in?
What are the EKG characteristics of V-fib?
What are the EKG characteristics of V-fib?
What is the physical assessment for V-fib?
What is the physical assessment for V-fib?
A patient who is not treated for V-fib is dead.
A patient who is not treated for V-fib is dead.
What must be done if a patient is in pulseless V-tach or V-fib?
What must be done if a patient is in pulseless V-tach or V-fib?
What is the key to positive outcomes with pulseless V-tach or V-fib?
What is the key to positive outcomes with pulseless V-tach or V-fib?
What is the next action nurses should take if a patient in V-tach remains in that rhythm after being shocked?
What is the next action nurses should take if a patient in V-tach remains in that rhythm after being shocked?
Flashcards
ACLS Core Algorithm
ACLS Core Algorithm
A critical algorithm for managing V-tach and V-fib in adults.
Precordial Thump
Precordial Thump
Delivering a firm blow to the midsternum, may restart the heart.
First Action for Pulseless V-tach
First Action for Pulseless V-tach
Initiate high-quality CPR immediately upon discovering pulseless V-tach.
Biphasic Defibrillation
Biphasic Defibrillation
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Monophasic Defibrillation
Monophasic Defibrillation
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Cause of V-tach
Cause of V-tach
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Stable V-tach
Stable V-tach
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Electrical Instability in V-tach
Electrical Instability in V-tach
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V-tach Risk Factors
V-tach Risk Factors
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V-fib Definition
V-fib Definition
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Signs of V-fib
Signs of V-fib
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V-fib on EKG
V-fib on EKG
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Treatment for Pulseless V-tach/V-fib
Treatment for Pulseless V-tach/V-fib
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Importance of Early Defibrillation
Importance of Early Defibrillation
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First Step After Defibrillation
First Step After Defibrillation
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Medication After Defibrillation
Medication After Defibrillation
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Who's at risk for V-tach?
Who's at risk for V-tach?
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Which is more Lethal?
Which is more Lethal?
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Symptoms of V-tach
Symptoms of V-tach
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V-tach and V-fib Relationship
V-tach and V-fib Relationship
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What causes the rhythm of V-fib?
What causes the rhythm of V-fib?
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V-fib consequence if untreated
V-fib consequence if untreated
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Mandatory for patients in pulseless VT/VF
Mandatory for patients in pulseless VT/VF
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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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