Techniques that May Actually Save Your V-Fib Patient

Winning teams have depth, and games are often won from the bench or deep in the batting order. That is certainly true when competing against ventricular fibrillation, and a few tools you might not know can help these patients.   A 55-year-old man with severe coronary heart disease and previous four-vessel coronary artery bypass surgery collapsed at a mall. He also had an unprotected left main atherosclerotic plaque. Bystanders immediately began chest compressions, and the available AED, unfortunately, advised no shock. Paramedics started bag-valve-mask ventilation and high-quality mechanical compressions with a Lucas device. The initial rhythm was ventricular fibrillation, and multiple defibrillation attempts were unsuccessful. Amiodarone and epinephrine were given, along with more shocks between high-quality chest compressions without success.   The patient was intubated, and ventilations were provided with the ResQPod impedance threshold device. ACLS-driven resuscitation continued in the ED with defibrillation and additional doses of amiodarone, lidocaine, magnesium, epinephrine, and vasopressin, all with no return of spontaneous circulation. Cardiac ultrasound showed no organized cardiac activity.   Ventricular fibrillation is a rapidly fatal rhythm. Patients have no organized electrical activity or cardiac output. VF is often precipitated by myocardial ischemia, and it never terminates spontaneously. It is often the initiating event of sudden cardiac death. Treatments ...
Source: Spontaneous Circulation - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs