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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4th Semester

Concepts Covered:

  • Renal Disorders
  • Endocrine and Metabolic Disorders
  • Urinary System
  • Shock
  • Musculoskeletal Trauma
  • Postoperative Nursing
  • Preoperative Nursing
  • Cardiac Disorders
  • Renal and Urinary Disorders
  • Cardiovascular Disorders
  • Circulatory System
  • Respiratory System
  • Digestive System
  • Integumentary Disorders
  • Nervous System
  • Pregnancy Risks
  • Neurological Trauma
  • Neurologic and Cognitive Disorders
  • Emergency Care of the Neurological Patient
  • Neurological Emergencies
  • Respiratory Disorders
  • Substance Abuse Disorders
  • Central Nervous System Disorders – Brain
  • Basics of Sociology
  • Statistics
  • Urinary Disorders
  • Fundamentals of Emergency Nursing
  • Prioritization
  • Test Taking Strategies
  • Delegation
  • Documentation and Communication
  • Legal and Ethical Issues
  • Community Health Overview
  • Communication
  • Eating Disorders
  • Noninfectious Respiratory Disorder
  • Integumentary Disorders
  • Disorders of Pancreas
  • Upper GI Disorders
  • Acute & Chronic Renal Disorders
  • Liver & Gallbladder Disorders
  • Respiratory Emergencies
  • Emergency Care of the Cardiac Patient
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

Fluid Volume Overload
Fluid Volume Deficit
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Compartment Syndrome
Nursing Care and Pathophysiology for Rhabdomyolysis
Discharge (DC) Teaching After Surgery
Informed Consent
Performing Cardiac (Heart) Monitoring
Nephrotic Syndrome
Congenital Heart Defects (CHD)
EKG (ECG) Waveforms
The EKG (ECG) Graph
Electrical A&P of the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
Breathing Movements
Breathing Control
Respiratory Functions of Blood
Liver & Gallbladder
Respiratory Structure & Function
Burn Injuries
Spinal Cord
Electrical Activity in the Heart
Cardiac (Heart) Physiology
Nutrition (Diet) in Disease
Blood Cultures
Drawing Blood
Spinal Precautions & Log Rolling
Neuro Assessment
Ischemic (CVA) Stroke Labs
Renal (Kidney) Failure Labs
Sepsis Labs
Dysrhythmias Labs
Anion Gap
Glucose Lab Values
Urinalysis (UA)
Glomerular Filtration Rate (GFR)
Creatinine (Cr) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Liver Function Tests
Total Bilirubin (T. Billi) Lab Values
Albumin Lab Values
Cultures
White Blood Cell (WBC) Lab Values
Hematocrit (Hct) Lab Values
Hemoglobin (Hbg) Lab Values
Red Blood Cell (RBC) Lab Values
Lab Panels
Urinary Elimination
Shock
Triage
Prioritization
Delegation
Documentation Pro Tips
Admissions, Discharges, and Transfers
Legal Considerations
Levels of Prevention
Nursing Care Delivery Models
Advance Directives
What Guides Nurses Practice
Fluid Compartments
Fluid Shifts (Ascites) (Pleural Effusion)
Phosphorus-Phos
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Lactic Acid
Base Excess & Deficit
Burn Injuries
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Chronic Renal (Kidney) Module Intro
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Blunt Chest Trauma
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Brain Death v. Comatose
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizures Module Intro
Spinal Cord Injury
Preload and Afterload
Nursing Care and Pathophysiology of Angina
Heart (Cardiac) Failure Module Intro
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
Normal Sinus Rhythm
Sinus Bradycardia
Sinus Tachycardia
Atrial Flutter
Atrial Fibrillation (A Fib)
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)
Legal Aspects of Documentation
Dehydration
Cerebral Palsy (CP)
Spina Bifida – Neural Tube Defect (NTD)
Vasopressin
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)