Cardiac arrest rhythms, VF, VT, Asystole and PEA

this patient is in sinus rhythm at the moment let's just keep an eye on now patients now go into ventricular fibrillation and in ventricular fibrillation is fast none of them as machines alarming to tell me that's good I have noticed so in ventricular fibrillation is fast chaotic uncoordinated contraction of areas of the myocardium different bits of the myocardium doing its own thing is twitching and quivering and in this rhythm there's no effective cardiac output the blood pressure is going to be zero now the causes of this can be ischemic heart disease such as myocardial infarction severe war congenital heart disease electrolyte imbalance rapid changes in the levels of potassium or calcium in the blood for example could be electrocution severe hypoxia and we notice the rhythm is irregular with poorly formed wide QRS complexes and I would certainly classify this as a course ventricular fibrillation but because we're not treating it it will become finer over time we're going to find a very relation so now we can see it's becoming fine if it's not as the amplitude is less than it was and the finer ventricular fibrillation is harder to treat Circus is much finer now and the longer we don't treat this the finer will tend to become [Music] the finer it is the more difficult it is to respond to defibrillation this verse is quite a lot course an absence should respond to defibrillation more readily patients of course in ventricular fibrillation is going to be very rapidly unconscious no pulses agonal or no respirations as a first aid treatment we would have to give CPR but then the treatment for fibrillation is electrical defibrillation now this rhythm is a ventricular tachycardia vitia very rapid ventricular contraption but with the degree of coordination now this is quite a severe ventricular tachycardia and this patient will probably be unconscious but in sort of ventricular tachycardia as the patient can remain conscious for periods of time indeed hours although they'll feel very unwell and if we don't treat this condition this ventricular tachycardia it will become a ventricular fibrillation as the rhythm gets finer and we have to treat this with defibrillation it's one of the shockable rhythms so there's only two shot algorithms as ventricular fibrillation and this one which is ventricular tachycardia if the patient's not unconscious we have to of course Anitha ties them try to administer in the shock now this patient is in a systolic cardiac arrest there is no systolic contraction at all the ventricles and indeed the atria are not moving when a systole a means without of course this is the rhythm you would get with anyone who was dead but if someone's gone into this with him recently we would try to try to reverse it by inducing a shockable rhythm such as ventricular fibrillation so that's a systolic cardiac arrest now there's another type of cardiac arrest called pulseless electrical activity and that's exactly what it says there is no pulse but there is still electrical activity going on in the heart and the wave form of that electrical activity can vary quite a bit but it could look something like this like almost like a normal in this case sinus bradycardia but the key thing is there was no kinetic movement of the heart so the depolarization of the ventricular and a trio of myocardium is going on as normal but the heart muscle is unable to respond to that so we would need to try and correct the underlying causes of this and indeed that's true with any cardiac arrest we need to try and correct the underlying causes and this is where the v h is and the v T's come in as causes of cardiac arrest that we can use to prevent cardiac arrest but we can also use it to try and revert a patient who's in cardiac arrest and the v h is causes of cardiac arrest are hypoxia not enough oxygen getting to the myocardium hypovolemia Laden of blood getting to the myocardium hypothermia when the body temperature is too low hypo or hyper Kaleem iya both can cause cardiac arrests whether the potassium is too low or too high and v H is hydrogen ions which of course is the cause of an acidosis so there's more hydrogen ions the pH will be lower because the patient will be more acid optic and then the five teasers causes a cardiac arrest one is tension pneumothorax where there's a buildup of pressure in the pleural space cardiac tamponade Tifa tamponade where there's increasing pressure within the pericardial sac constricting the heart Tifa toxins and potential drugs of course and then t4 thrombosis which could be pulmonary thrombosis and t4 thrombosis would become the coronary thrombosis so this shows the importance of not just looking at the monitor but assessing the patient's overall condition and palpating central and as well as possibly peripheral pulses [Music]

Channel: Dr. John Campbell

Views: 402,834

Rating: 4.8888383 out of 5

Keywords: cardiology, cardiac arrest, EKG, ECG, VT, ventricular fibrallation, ventricular tachycardia, asystolie, pulseless electrical activity

Id: Xq0gNFcBJXc

Length: 8min 54sec (534 seconds)

Published: Thu Apr 12 2018