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

Sepsis Concept Map
Shock
Shock Module Intro
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sinus Bradycardia
Sinus Tachycardia
Skin Cancer
Spinal Cord Injury Case Study (60 min)
Spinal Precautions & Log Rolling
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
Stages of Hepatitis Nursing Mnemonic (PIP)
Sterile Field
Sterile Gloves
Stoke Assessments Nursing Mnemonic (FAST)
Stomach Cancer (Gastric Cancer)
Stroke (CVA) Module Intro
Stroke Assessment (CVA)
Stroke Concept Map
Stroke for Certified Emergency Nursing (CEN)
Stroke Nursing Care (CVA)
Stroke Therapeutic Management (CVA)
Surgical Incisions & Drain Sites
Surgical Prep
Surgical Counts for Certified Perioperative Nurse (CNOR)
Sympatholytics (Alpha & Beta Blockers)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Tension and Cluster Headaches
Tetracycline (Panmycin) Nursing Considerations
The 5-Minute Assessment (Physical assessment)
Thoracentesis
Thrombocytopenia
Thrombolytics
Thromboembolic Disease- Deep Vein Thrombosis (DVT) for Certified Emergency Nursing (CEN)
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
Trach Care
Trach Suctioning
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Troponin I (cTNL) Lab Values
Tuberculosis (TB) Case Study (60 min)
Urinary Elimination
Urinary Tract Infection Case Study (45 min)
Vancomycin (Vancocin) Nursing Considerations
Vent Alarms
Ventilator Settings
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Vessels & Fluid
Vitamin D Lab Values
Warfarin (Coumadin) Nursing Considerations
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Wound Infections for Certified Emergency Nursing (CEN)
Wounds (Infectious, Surgical, Trauma) for Progressive Care Certified Nurse (PCCN)
Wound Dressing Maintenance for Certified Perioperative Nurse (CNOR)
Wound Classification for Certified Perioperative Nurse (CNOR)
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)
02.14 Shock Stages 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)
ACE (angiotensin-converting enzyme) Inhibitors
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Kidney Injury Case Study (60 min)
Acute Renal (Kidney) Module Intro
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Adjunct Neuro Assessments
Admissions, Discharges, and Transfers
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Advance Directives
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Airway Suctioning
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Alteplase (tPA, Activase) Nursing Considerations
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Amputation
Amputation Concept Map
Anemia for Progressive Care Certified Nurse (PCCN)
Anesthetic Agents
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Anti-Infective – Antitubercular
Anti-Platelet Aggregate
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Antidiabetic Agents
Antimetabolites
Antineoplastics
Antinuclear Antibody Lab Values
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
ASA (Aspirin) Nursing Considerations
Aspiration for Certified Emergency Nursing (CEN)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Asthma for Certified Emergency Nursing (CEN)
At Risk for Gout Nursing Mnemonic (MALE)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
Azithromycin (Zithromax) Nursing Considerations
Barriers to Health Assessment
Blood Flow Through The Heart
Blunt Chest Trauma
Bowel Obstruction Concept Map