ECG Video: Ventricular Fibrillation

[ema1171224]

Q=What is ventricular fibrillation?

A=V-Fib is a lethal rhythm which requires immediate intervention. Above is a sample of V-Fib. There are no heart contractions and the ventricles are considered to be "quivering." V-Fib is commonly seen in cardiac arrest.

[rostifer28]

yeah, in vfib there is no pr or st. its totally chaotic.

[tommyvilla47]

or you can page a crash team

[CyanoticFuture]

*monitor

[rilax4444]

Why there isn`t signs of CPR o defib in the monitor? You didn´t start CPR??

[dextrometorphani]

In hospital use defibrilator, 150J for first shock, 200J for second, and 360J for third. Next, application 1mg of norepinephrine iv, eventually amiodaron.

[rilax4444]

Norepinephrine?? AHA CPR Guidelines tell very clearely: Shockeable rythm? Defib at 200(only 1),resume CPR immediately and give 5 cycles, still at shockeable rythm? defib at least 200 (only one) and use epi or vasopressine,another 5 cyles of CPR and defib another time (at least the last dosage of J), only then think about amiodarone, lidocaine or magnesium...norepineprhine? Where are your guidelines from,I would like to read them, really i´m not making fun...

[dextrometorphani]

Aii, mea culpa, epinephrine. I'm not a doctor, I'm hobbist and I will go for life guard studies next year ;)

[mulawin1210]

pls update your acls guidelines its not anymore advised to use 150, 200, then 360.....

[CyanoticFuture]

its a cardiac moniyor stimulator genius

[jmm121884]

LOL at all of you except cyanoticfuture

[jiwhit01]

You don't usually perform cpr for fib, you usually perform cpr for a stopped heart. However you are right, it's interesting there isn't any sign of defib

[LASportsFan4Life]

@jiwhit01 A quivering heart is about as good as a stopped heart. You absolutely DO perform CPR for this, in between shocks and rounds of epi.

[mpfd131]

code blue call in my fire dept

[ryandsucks]

Could this rhythm be Torsades de Pointes? I'm a bit unclear on the difference between that and regular V-tach.

[BumSlave]

With regular V-Tach, the heart rhythym is more or less constant in the terms of amplitude. In Torsades, there appears to be a "twisting of the points". Meaning the rhythym seems to appear wrapping around the isoelectric line. There isn't any Torsades here. There could be possible lead movement, noticable artifacts throughout.

[rakesh7biswas]

Where did you get these?

[scan5267]

Wow its so course it alsmost looks like vtach

[thegrizzly1]

hey usually when someone is in v-fib they have a pulse of 0 just to let you know :)

[homestar216]

Were you able to bring him ut of it?

[kimberlyKfnOphiEAGLE]

Gage:Rampart, patient is in V-Fib!

Dr.Brackett, at Rampart:Defibrillate, charge to 200!

Gage: CLEAR!

WOOM!

Gage, to Rampart base:Rampart, we've defibrillated patient, he's in sinus rhythm.

Brackett, at Rampart: Keep monitoring vitals, and transport as soon as possible!

[kimberlyKfnOphiEAGLE]

CODE BLUE!

Isn't another deadly arrhythmia pulseless ventricular tachycardia?

[aran125]

Yes.

[aran125]

May go to medic school next year possibly. ALS is overated in the area I practice EMS in but the cardiology aspect is cool anywhere. Most people that code really don't make it unless their younger and healthier. Well, it really depends but you know what I mean. Most of the time a bad heart is just a bad heart.

[kimberlyKfnOphiEAGLE]

What are someone's chances, though, with a first responder doing decent CPR, and also using an AED?

[aran125]

Early access is the hands down most important thing right behind defibrilation. That's why people have much greater survival chance's in the ER or if you have a crue right there with a Paramedic. Nontheless, good ALS really starts with good BLS. No matter how many drugs you can push, tube's or hose's you can stick out of people, it's really all about good solid BLS(AED and Good CPR)even though ALS is ideal. Defib won't do anything for PEA or Asystole(flat line).

[Blondetracelacey]

Depending whether you

have a monophasic or biphasic defibrillator 200 or 360 joules STAT!!! Epi/Atropine IV/ET

[VietMedic]

that is some coarse v-fib if i ever saw one.

[grayfang]

charging at 200 volts

im clear your clear and everyones clear

wahaha! the rest of the team were gone because i charged it at 200 volts..

[1992peter]

Charge to 200.

I'm clear, You're Clear, We're All Clear.

BOOOOM

NORMAL SINUS RHYTHM.

Where was this video taken?

Did you guys shock him?

[christopherjoshuarn]

charge to 360?? :) epi 1mg iv q 3-5'.. Man! I really find your videos really amazing and useful! thanks so much!

[omgScrub]

Holyshit! Correct me if I'm wrong, but PR and ST segments seem totally absent here O.O

[MEDiscuss]

Yes. In ventricular fibrillation, no waveform is discernible. It's rapid and bizarre activity which does not result in any physical contraction of the ventricles.

Do you know that VF is one of the 4 arrhythmias that constitute cardiac arrest?