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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Concepts Covered:

  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Emergency Care of the Respiratory Patient
  • Emergency Care of the Trauma Patient
  • Communication
  • Fundamentals of Emergency Nursing
  • Delegation
  • Studying
  • Circulatory System
  • Neurological Trauma
  • Emergency Care of the Neurological Patient
  • Shock
  • Shock
  • Cardiovascular
  • Disorders of the Posterior Pituitary Gland
  • Endocrine
  • Disorders of the Thyroid & Parathyroid Glands
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Factors Influencing Community Health
  • Preoperative Nursing
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Intraoperative Nursing
  • Respiratory Emergencies
  • Noninfectious Respiratory Disorder
  • Disorders of Thermoregulation
  • Renal Disorders
  • Musculoskeletal Trauma
  • Urinary Disorders
  • Liver & Gallbladder Disorders
  • Upper GI Disorders
  • Immunological Disorders
  • Respiratory System

Study Plan Lessons

1st Degree AV Heart Block
3rd Degree AV Heart Block (Complete Heart Block)
Acute Respiratory Distress
Atrial Fibrillation (A Fib)
Atrial Flutter
Blunt Abdominal Trauma
Conflict Management (Patient, Perioperative Team, Family) for Certified Perioperative Nurse (CNOR)
Crush Injuries
Delegation of Tasks to Assistive Personnel for Certified Emergency Nursing (CEN)
Drugs for Bradycardia & Low Blood Pressure Nursing Mnemonic (IDEA)
Dysrhythmia Emergencies
EKG Basics – Live Tutoring Archive
Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
Head Trauma & Traumatic Brain Injury
Increased Intracranial Pressure
Intracranial Hemorrhage
Premature Ventricular Contraction (PVC)
Sinus Bradycardia
Sinus Tachycardia
Supraventricular Tachycardia (SVT)
Trauma Survey
Triage
Triage in the ER
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Triage Nursing Mnemonic (START)
02.14 Shock Stages for CCRN Review
02.06 Heart Murmurs for CCRN Review
02.02 Cardiomyopathy for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
03.05 Endocrine Practice Questions for CCRN Review
1st Degree AV Heart Block
3rd Degree AV Heart Block (Complete Heart Block)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Renal (Kidney) Module Intro
Addisons Disease
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)
Artificial Airways
Atrial Fibrillation (A Fib)
Atrial Flutter
Brain Death v. Comatose
Burn Injuries
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Stress Test
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cerebral Perfusion Pressure CPP
Chest Tube Assessment Nursing Mnemonic (Two AA’s)
Chest Tube Management
Chest Tube Management
Chronic Kidney Disease (CKD) Case Study (45 min)
Cold Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Complications of Spinal Cord Injuries Nursing Mnemonic (ABCDEFG)
Complications of Thoracentesis Nursing Mnemonic (Patients Sometimes Bleed Internally)
Cushings Assessment Nursing Mnemonic (STRESSED)
Dialysis & Other Renal Points
Endocarditis for Certified Emergency Nursing (CEN)
Fractures (Open, Closed, Fat Embolus) for Certified Emergency Nursing (CEN)
Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
Healthcare-Acquired Infections: Catheter-Associated Bloodstream Infections (CAUTI) for Progressive Care Certified Nurse (PCCN)
Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Hemodialysis (Renal Dialysis)
Hepatic Disorders (Cirrhosis, Hepatitis, Portal Hypertension) for Progressive Care Certified Nurse (PCCN)
Intracranial Pressure ICP
Lacerations for Certified Emergency Nursing (CEN)
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Neurogenic Shock for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypovolemic Shock
Pacemakers
Peritoneal Dialysis (PD)
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Pneumothorax for Certified Emergency Nursing (CEN)
Pneumothorax Signs and Symptoms Nursing Mnemonic (P-THORAX)
Premature Ventricular Contraction (PVC)
Respiratory Alkalosis
Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Spinal Cord Injury
Thoracentesis
Trach Care