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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Study Plan Lessons

Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Electrical A&P of the Heart
Cataracts
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid Pressures
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Alveoli & Atelectasis
Fluid Shifts (Ascites) (Pleural Effusion)
Hiatal Hernia
Macular Degeneration
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Sickle Cell Anemia
Gas Exchange
Isotonic Solutions (IV solutions)
Nasal Disorders
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Hearing Loss
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Fractures
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Meniere’s Disease
Casting & Splinting
The EKG (ECG) Graph
Drawing Blood
EKG (ECG) Waveforms
Levels of Consciousness (LOC)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Calculating Heart Rate
Diabetes Management
Dialysis & Other Renal Points
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Routine Neuro Assessments
Adjunct Neuro Assessments
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Oncology Important Points
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Brain Death v. Comatose
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Phosphorus-Phos
Cerebral Perfusion Pressure CPP
Immunizations (Vaccinations)
Cognitive Impairment Disorders
Normal Sinus Rhythm
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Sinus Tachycardia
Atrial Flutter
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Parkinsons
Atrial Fibrillation (A Fib)
Brain Tumors
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Inserting an NG (Nasogastric) Tube
Hierarchy of O2 Delivery
NG (Nasogastric)Tube Management
Artificial Airways
NG Tube Med Administration (Nasogastric)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Airway Suctioning
Nursing Care and Pathophysiology for Menopause
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Stoma Care (Colostomy bag)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Chest Tube Management
Pain and Nonpharmacological Comfort Measures
Enteral & Parenteral Nutrition (Diet, TPN)
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Albumin Lab Values
Ammonia (NH3) Lab Values
Nursing Care and Pathophysiology for Anemia
AVPU Mnemonic (The AVPU Scale)
Base Excess & Deficit
Blood Urea Nitrogen (BUN) Lab Values
Bronchoscopy
Burn Injuries
Cardiac (Heart) Enzymes
Cardiac Anatomy
Chest Tube Management
Cholesterol (Chol) Lab Values
Nursing Care and Pathophysiology for Heart Failure (CHF)
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
Coronary Circulation
Creatinine (Cr) Lab Values
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Dysrhythmias Labs
Neurological Fractures
Fractures
GERD (Gastroesophageal Reflux Disease)
Glaucoma
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Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Hemodynamics
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Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
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Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Hyperthyroidism
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Nursing Care and Pathophysiology for Hypovolemic Shock
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Nursing Care and Pathophysiology for Lyme Disease
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Pancreatitis
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Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Seizure
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
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Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Pneumonia
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Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Pneumonia Labs
Potassium-K (Hyperkalemia, Hypokalemia)
Preload and Afterload
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Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
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