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:

  • Cardiovascular
  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Circulatory System
  • Fundamentals of Emergency Nursing
  • Emergency Care of the Neurological Patient
  • Emergency Care of the Respiratory Patient
  • Medication Administration
  • Vascular Disorders
  • Emergency Care of the Trauma Patient
  • Shock
  • Intraoperative Nursing
  • Communication
  • Delegation
  • Postoperative Nursing
  • Studying
  • Legal and Ethical Issues
  • Neurological Trauma
  • Neurological
  • Multisystem
  • Neurological Emergencies
  • Musculoskeletal Trauma
  • EENT Disorders
  • Central Nervous System Disorders – Brain
  • Perioperative Nursing Roles
  • Respiratory Emergencies
  • Health & Stress
  • Shock
  • Disorders of the Posterior Pituitary Gland
  • Endocrine
  • Disorders of Pancreas
  • Hematology
  • Gastrointestinal
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Newborn Complications
  • Nervous System
  • Renal
  • Respiratory
  • Urinary System
  • Respiratory System
  • Noninfectious Respiratory Disorder
  • Immunological Disorders
  • Microbiology

Study Plan Lessons

02.01 Hypertensive Crisis for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF for CCRN Review
02.10 12 Lead EKG- Lead V1-V6 for CCRN Review
02.11 12 Lead EKG- Injuries for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
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)
Abuse
Abuse and Neglect for Certified Emergency Nursing (CEN)
Acute Confusion
Acute Coronary Syndrome (ACS)
Acute Coronary Syndrome (ACS) Module Intro
Acute Coronary Syndrome for Certified Emergency Nursing (CEN)
Acute Respiratory Distress
Adenosine (Adenocard) Nursing Considerations
Aggressive & Violent Patients
Amiodarone (Pacerone) Nursing Considerations
Aneurysm & Dissection
Aneurysm and Dissection 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)
Bleeding for Certified Emergency Nursing (CEN)
Blunt Abdominal Trauma
Blunt Thoracic Trauma
Calling for RRT, Code Blue
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiopulmonary Arrest
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Cardiovascular Trauma for Certified Emergency Nursing (CEN)
Combative: IV Insertion
Conflict Management (Patient, Perioperative Team, Family) for Certified Perioperative Nurse (CNOR)
Crash Cart
Critical Incident Management
Crush Injuries
Day in the Life of an ICU (Intensive Care Unit) Nurse
Delegation of Tasks to Assistive Personnel for Certified Emergency Nursing (CEN)
Discharge Planning for Certified Emergency Nursing (CEN)
Drugs for Bradycardia & Low Blood Pressure Nursing Mnemonic (IDEA)
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
EKG Basics – Live Tutoring Archive
Emergency Drugs Nursing Mnemonic (LEAN)
Emergency Nursing Course Introduction
EMTALA & Transfers
Ethical Dilemmas for Certified Emergency Nursing (CEN)
Fall and Injury Prevention
Flight Nurse
Forensic Nurse
Gastrointestinal Trauma for Certified Emergency Nursing (CEN)
Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
Head Trauma & Traumatic Brain Injury
Heart (Heart) Failure Exacerbation
Hypertension (HTN) Concept Map
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertension for Certified Emergency Nursing (CEN)
Hypertensive Emergency
Increased Intracranial Pressure
Increased Intracranial Pressure (ICP) for Certified Emergency Nursing (CEN)
Injection Injuries for Certified Emergency Nursing (CEN)
Intracranial Hemorrhage
Ischemic (CVA) Stroke Labs
Joint Commission
Lacerations for Certified Emergency Nursing (CEN)
Legal & Ethical Issues in ER
Massive Transfusion Protocol
Maxillofacial Trauma for Certified Emergency Nursing (CEN)
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Seizures
Nursing Case Study for Head Injury
Nursing Skills (Clinical) Safety Video
Patient and Healthcare Team Safety (Disasters, Environmental Hazards) for Certified Perioperative Nurse (CNOR)
Patient Safety for Certified Emergency Nursing (CEN)
Patient Satisfaction for Certified Emergency Nursing (CEN)
Penetrating Abdominal Trauma
Penetrating Injuries for Certified Emergency Nursing (CEN)
Penetrating Thoracic Trauma
Premature Atrial Contraction (PAC)
Premature Ventricular Contraction (PVC)
Procainamide (Pronestyl) Nursing Considerations
Pulmonary Embolism
Pulmonary Embolus for Certified Emergency Nursing (CEN)
Rapid Sequence Intubation
Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)
Respiratory Trauma for Certified Emergency Nursing (CEN)
Restraints
Restraints 101
Risk Management for Certified Emergency Nursing (CEN)
Safety Check Nursing Mnemonic (MADLE)
Safety Checks
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Seizure Management in the ER
Seizure Therapeutic Management
Seizures Case Study (45 min)
Seizures Module Intro
Sexual Assault and Battery for Certified Emergency Nursing (CEN)
Sinus Bradycardia
Sinus Tachycardia
Stress and Crisis
Stroke (CVA) Management in the ER
Stroke (CVA) Module Intro
Stroke Case Study (45 min)
Supraventricular Tachycardia (SVT)
Transfer and Stabilization for Certified Emergency Nursing (CEN)
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
Trauma Nursing Interventions for Certified Perioperative Nurse (CNOR)
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Trauma Survey
Triage
Triage in the ER
Triage Nursing Mnemonic (START)
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Verapamil (Calan) Nursing Considerations
Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)
01.01 CCRN Test Overview for CCRN Review
02.01 Hypertensive Crisis for CCRN Review
02.02 Cardiomyopathy for CCRN Review
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.05 Calculating PAWP on PEEP for CCRN Review
02.12 Myocardial Infarction- Inferior Wall for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
02.14 Shock Stages for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
03.03 Hypoglycemia for CCRN Review
03.04 DKA vs HHNK for CCRN Review
04.01 Hematology for CCRN Review
04.02 Hematology Review Questions for CCRN Review
05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
05.03 Jaundice for CCRN Review
05.04 Ruptured Spleen for CCRN Review
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
06.02 Poisoning for CCRN Review
06.03 Multi-System CCRN Important Points for CCRN Review
07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review
07.02 Neuro Anatomy for CCRN Review
07.03 Uncal Herniation for CCRN Review
07.04 Supratentorial Herniation and Glasgow Coma Scale for CCRN Review
07.05 Supratentorial Herniation: Cushings Triad for CCRN Review
07.06 Increased Intracranial Pressure (ICP) for CCRN Review
07.07 Cerebral Perfusion Pressure for CCRN Review
07.08 Basilar Skull Fracture for CCRN Review
07.09 Meningitis for CCRN Review
07.10 Neurologic Review questions for CCRN Review
09.01 Acute Renal Failure Overview for CCRN Review
09.02 Acute Tubular Necrosis for CCRN Review
09.03 Acute Renal (Pre-Renal vs Renal) Failure for CCRN Review
09.04 Continuous Renal Replacement Therapy for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
09.06 Renal Practice Questions for CCRN Review
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
10.02 Breath Sounds for CCRN Review
10.03 Acute Respiratory Failure for CCRN Review
10.04 Pulmonary Question Review for CCRN Review
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Envenomation Emergencies for Certified Emergency Nursing (CEN)
Increased Intracranial Pressure (ICP) for Certified Emergency Nursing (CEN)
Infection or Inflammation? The Quick & Dirty on CBCs – Live Tutoring Archive
Infection or Inflammation? The Quick & Dirty on CBCs 2 – Live Tutoring Archive
Injection Injuries for Certified Emergency Nursing (CEN)
Mannitol (Osmitrol) Nursing Considerations
Nursing Care Plan (NCP) for Migraines
Respiratory Depression (Medication-Induced, Decreased-LOC-Induced) for Progressive Care Certified Nurse (PCCN)
Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)
Shock Module Intro
Toxic Ingestion, Inhalation, Overdose for Progressive Care Certified Nurse (PCCN)