 Hi and welcome to nursing school explaining this video in the ventricular dysrhythmia series about acycline that is also called cardiac standstill. Acycline basically means that there is no systolic activity of the heart at all. So this is also referred to as cardiac standstill or flatline and you've probably seen this before maybe not in real life but maybe in the movies and when there is no cardiac activity that appears on the monitor we always have to make sure that it is a reading of acycline and not equipment failure because there are reasons such as disconnected EKG leads or any disconnected cables or maybe we don't have the amplitude, the height of the EKG monitor set appropriately or maybe the power is off because the EKG monitor ran out of battery life. So before we act on an acystolic rhythm we always have to make sure that we are not dealing with equipment failure and always we have to assess our patient because even if they appear to have a flatline on the EKG monitor but they are talking to us well there's probably something wrong with that picture so always assess your equipment and assess your patient before you move on to any kind of intervention. So looking at this here you can see this is a very classic example of a flatline. There is no rate that we can determine, there's no rhythm or regularity although atrial activity sometimes may be observed so sometimes you might see a tiny little P wave with these acystole rhythms there's no P wave discernible usually and then because of that we won't have a PRI and we really don't have a QRS complex here either. Causes are usually related to extensive myocardial damage so that means that now the blood flow has been interrupted so significantly to the heart that now the heart is starting to be necrotic and cannot function normally. Hypoxia can be another reason hypo and hyperkalemia as well as hypothermia, hydrogen ion meaning acidosis, drug overdoses, ventricular aneurysms, acute respiratory failure and traumatic arrests are other causes for acystole and you might notice that a lot of these start with the letter H so these are similar to the H's and T's of the PEA rhythm that I discussed in a different video. So because there is no ventricular contraction the patient will be pauseless, apneic and unresponsive. Treatment for acystole is CPR right away so we can get the blood circulating again the patient will need intracal intubation as well as IV access and treatment of the underlying cause whatever that might be and we need to follow acyles protocol and medications so we can hopefully get the patient's rhythm back but in the meantime we need to perform CPR to manually circulate that blood and profuse their vital organs and most importantly the brain. Keep in mind here that the treatment for acystole or the intervention does not include defibrillation that's something that you a lot of times see in the movies but that is not true acystole is not treated with defibrillation when there is no underlying cardiac activity we can't shock the patient into having a cardiac activity so we need to stabilize the patient by continuing to pump their blood by performing CPR and then following acyles protocol and determining the underlying rhythm to hopefully reverse this arrhythmia. Here are some references on where you can find rhythm strips that you can use for practicing your EKG interpretation skills and then here is a list of my EKG interpretation playlists specifically here about the ventricular dysrhythmias that go into ventricular tachycardia ventricular fibrillation PEA and acystole. Thanks for watching nursing school explain in this video about acystole see you soon.