Guptashutosh wrote:
defebrilator / dc shock
Defribrillation and shock, not DC shock, DC shcok direct current ! dc SHOCK IS NOT USED FOR VF
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
mjl1717 wrote:
its more then that for PGY-1
You still need to know this for Step 2. It is part of ACLS !
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
- Electrical external defibrillation remains the most successful treatment of VF. A shock is delivered to the heart to uniformly and simultaneously depolarize a critical mass of the excitable myocardium. The objective is to interfere with all reentrant arrhythmia and to allow any intrinsic cardiac pacemakers to assume the role of primary pacemaker.
- Successful defibrillation largely depends on the following 2 key factors: duration between onset of VF and defibrillation, and metabolic condition of the myocardium. VF begins with a coarse waveform and decays to a fine tracing and eventual asystole. These electrical changes that occur over minutes are associated with a depletion of the heart's energy reserves. CPR slows the progression of these events, but defibrillation is the primary treatment to interrupt the process and return the heart to a perfusing rhythm.
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| mjl1717
Forum Hero
Topics: 958
Posts: 5,465
|
Since many including nurses, many on this forum and PGY 1s or interns may freak out or wouldnt be able to handle this DEATHLY serious situation this is how v fib is treated!!!!
Outside hospital
1) check responsiveness
2)activate emergency response
3)call for defibrillator
4)open airway head tilt jaw thrust
5)provide ventilation
6) give chest compressions
7)defibrillate at 200J, 300J and 360 J up to 3 times
After 3 shocks/ ****persistent v. fib or v. tach!!
Do ABCDs again// this time BIG TIME by bagging the patient or intubating.
confirm and secure the AIRWAY!!! Confirm effecitve oxygenation and ventilation BIG TIME for real!!
[C] is circulation, establish I.V.// identify rhythm, monitor, administer drugs appropiate for rhythm.
The time D is for Differential Diagnosis, search for and treat reversible causes.
Next.
1)Give Epi. 1 mg IV push repeat every 3-5 minutes or vasopressin 40U IV, single dose 1 time only.
Resumed attemptss to defibrillate [1 time 360 J. within 30 to 60 seconds]
Consider antiarrhythmics such as Amiodarone, Lidocaine or Procainamide for persistent v. fib or pulseless v. tach and if magnesium is low give Magnesium/ Last,resume attempts to defibrillate at 360 Joules maybe 3 times.
Does this sound easy?
Edited by mjl1717 on 12/15/06 - 08:08 PM
___________________
Smell the coffee! "Is That an Osler move??"
|
|
| |
| | | | | 
