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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CVOR

Concepts Covered:

  • Cardiac Disorders
  • Cardiovascular
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock
  • Shock
  • Adult
  • Medication Administration
  • Vascular Disorders
  • Newborn Complications
  • Noninfectious Respiratory Disorder
  • Eating Disorders
  • Intraoperative Nursing
  • Cardiovascular Disorders
  • Terminology
  • Pregnancy Risks
  • Urinary System
  • Upper GI Disorders
  • Studying
  • Disorders of Pancreas
  • Communication
  • Perioperative Nursing Roles
  • Substance Abuse Disorders
  • Acute & Chronic Renal Disorders
  • Pediatric
  • Respiratory Emergencies
  • Postoperative Nursing
  • Emergency Care of the Respiratory Patient
  • Neurological Emergencies
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

02.02 Cardiomyopathy for CCRN Review
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.14 Shock Stages for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
ACE (angiotensin-converting enzyme) Inhibitors
ACLS (Advanced cardiac life support) Drugs
Acute Coronary Syndrome (ACS)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Adenosine (Adenocard) Nursing Considerations
Advanced Cardiovascular Life Support (ACLS)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Angiotensin Receptor Blockers
Arterial Pressure Monitoring
Aspiration for Certified Emergency Nursing (CEN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Blood Flow Through The Heart
Blood Pressure (BP) Control
Calcium Channel Blockers
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Cardiac (Heart) Enzymes
Cardiac (Heart) Physiology
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Course Introduction
Cardiac Cycle
Cardiac Glycosides
Cardiac Labs – What and When to Use Them – Live Tutoring Archive
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Stress Test
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac Terminology
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiopulmonary Arrest
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Congenital Heart Defects (CHD)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
Coronary Artery Disease Concept Map
Digoxin (Lanoxin) Nursing Considerations
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
Electrical A&P of the Heart
Electrical Activity in the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
Endocarditis for Certified Emergency Nursing (CEN)
Epinephrine (EpiPen) Nursing Considerations
General Anesthesia
GERD (Gastroesophageal Reflux Disease)
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart (Heart) Failure Exacerbation
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hemodynamics
Hiatal Hernia
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Intraoperative Positioning
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
MI Surgical Intervention
Midazolam (Versed) Nursing Considerations
Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)
Mixed (Cardiac) Heart Defects
Myocardial Infarction (MI) Case Study (45 min)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Obstructive Heart (Cardiac) Defects
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Pacemakers
Pediatric Advanced Life Support (PALS)
Performing Cardiac (Heart) Monitoring
Pericardial Tamponade for Certified Emergency Nursing (CEN)
Pleural Effusion for Certified Emergency Nursing (CEN)
Post-Anesthesia Recovery
Preload and Afterload
Premature Ventricular Contraction (PVC)
Product Evaluation and Selection for Certified Perioperative Nurse (CNOR)
Pulmonary Embolus for Certified Emergency Nursing (CEN)
Sepsis Labs
Sinus Bradycardia
Sinus Tachycardia
Supraventricular Tachycardia (SVT)
The Heart
Thrombolytics
Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)
Troponin I (cTNL) Lab Values
Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Vasopressin
Ventilator Settings
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Fibrillation (V Fib)