Ventricular Fibrillation (V Fib)

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Maria Stewart
BSN,RN,CCRN, CMSRN
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Included In This Lesson

Study Tools For Ventricular Fibrillation (V Fib)

Parts of EKG waveform (Image)
Ventricular Fibrillation (Image)
10 Common EKG Heart Rhythms (Cheatsheet)
EKG Chart (Cheatsheet)
EKG Electrical Activity Worksheet (Cheatsheet)
Heart Rhythms Signs and Symptoms (Cheatsheet)
Heart Rhythm Identification (Cheatsheet)
Hs and Ts of ACLS (Cheatsheet)
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Outline

Overview

  1. Ventricular Fibrillation
    1. Multiple unorganized electrical signals in the ventricles
      1. Causing the ventricles to quiver
        1. Wavy lines
      2. Heart not able to pump blood out
        1. Zero cardiac output
      3. Life threatening emergency
        1. Cardiac arrest

Nursing Points

General

  1. Characteristics of Ventricular fibrillation
    1. Rhythm
      1. Irregular
    2. Rate
      1. Not measurable
    3. P:QRS ratio
      1. Not measurable
    4. PR interval
      1. Not measurable
    5. QRS complex
      1. Not measurable

Assessment

  1. Patient Presentation
    1. Cardiac arrest
    2. Will NEVER have a pulse!

Therapeutic Management

  1. Nursing Interventions
    1. CPR
  2. Follow ACLS guidelines
    1. CPR
    2. Defibrillate
    3. Epinephrine
    4. Amiodarone

Nursing Concepts

  1. EKG Rhythms
  2. Perfusion

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Transcript

So in this lesson we are going to talk about ventricular Fibrillation or V-Fib. It is a very important rhythm to understand because patients in V-fib are in cardiac arrest and we need to do something immediately or they will die! When you see this rhythm, they will go asystole if we don’t treat it. So let’s talk about V-fib.

So in ventricular fibrillation the ventricles are quivering and absolutely no cardiac output there is usually no pulse. So since the ventricles are just sitting there quivering, they are not contracting, there is absolutely no cardiac output and no pulse. So CPR must be initiated immediately. This rhythm is very common in patients that are having a heart attack or have severe coronary artery disease. If left untreated, people will go into asystole and just die. Let’s talk about the characteristics for v-fib.

It’s pretty simple to do cause there is not much to it! The rhythm is irregular, remember the heart is erratically quivering, there is no way to measure a heart rate, there are no P waves so there is not a P to QRS ratio, the PR interval is not measurable and you cannot really count the QRS complex. There is no QRS complex since the heart is just quivering it is not measurable. In step 6, it is obviously V-fib. It is one of those rhythms that you need to make a jump for it and you need to prepare to start CPR, bring the defibrillator and call a code.

So people in V-fib have no cardiac output they are in cardiac arrest, they are dying! The priority nursing interventions are to follow the ACLS guidelines, confirm there is not a pulse and start CPR right away. Defibrillate as soon as possible, it is the only chance they have of going into a normal sinus rhythm. Epinephrine every 3-5 minutes and then Amiodarone bolus and drip. However early defibrillation is the best treatment. So as soon as you see this rhythm, you start CPR, call a code, defibrillate them and give meds and hopefully you will bring the patients back.

So the key points to remember from this lesson are the abnormalities regarding Ventricular fibrillation. The ventricles are quivering and fibrillating, there is no cardiac output so the patients in V-fib are in cardiac arrest. Nursing interventions are to follow the ACLS guidelines immediately and start CPR, defibrillate asap and administer medications. This cycle is repeated every 2 minutes or until the code is called and CPR is terminated or hopefully the patient has regained a pulse. V-fib is not one of those rhythms that you wait to see if this is really happening, you need to take action right away!

I hope you guys have enjoyed this quick lesson regarding V-Fib and feel more comfortable knowing what to do when you see this rhythm. Make sure you check out all of the resources attached to this lesson. Now, go out and be your best self today! And, as always, happy nursing!

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Lesson 5

Concepts Covered:

  • Cardiac Disorders
  • Circulatory System
  • Adult
  • Urinary System
  • Pregnancy Risks
  • Vascular Disorders
  • Terminology
  • Emergency Care of the Cardiac Patient
  • Shock
  • Cardiovascular Disorders
  • Proteins
  • Hematologic Disorders

Study Plan Lessons

Coronary Artery Disease Concept Map
Electrical A&P of the Heart
Advanced Cardiovascular Life Support (ACLS)
Electrolytes Involved in Cardiac (Heart) Conduction
Preload and Afterload
Congestive Heart Failure Concept Map
Echocardiogram (Cardiac Echo)
Performing Cardiac (Heart) Monitoring
Cardiac Stress Test
Nursing Care and Pathophysiology of Angina
Cardiac Terminology
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Heart (Cardiac) and Great Vessels Assessment
Nursing Care and Pathophysiology for Heart Failure (CHF)
Sinus Bradycardia
Cardiopulmonary Arrest
Sinus Tachycardia
Atrial Flutter
Dysrhythmia Emergencies
Pacemakers
Atrial Fibrillation (A Fib)
Heart (Heart) Failure Exacerbation
Arterial Pressure Monitoring
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Ventricular Fibrillation (V Fib)
Ventricular Fibrillation (V Fib)
Cardiac (Heart) Disease in Pregnancy
Nursing Care and Pathophysiology for Cardiogenic Shock
The Heart
Cardiac Cycle
Electrical Activity in the Heart
Blood Pressure (BP) Control
Thrombolytics
Mixed (Cardiac) Heart Defects
ACE (angiotensin-converting enzyme) Inhibitors
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Blood Flow Through The Heart
Brain Natriuretic Peptide (BNP) Lab Values
Cardiac (Heart) Enzymes
Cardiac Anatomy
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Congestive Heart Failure (CHF) Labs
Coronary Artery Disease Concept Map
Dysrhythmias Labs
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Myocardial Infarction (MI) Case Study (45 min)
Myoglobin (MB) Lab Values
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)