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VF/Pulseless VT

Treatment of Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (VT) is


included in the Pulseless Arrest Algorithm. VF and pulseless VT are shockable rhythms
and treated in similar fashion. Asystole and PEA are also included in the pulseless arrest
algorithm but are nonshockable rhythms.
Ventricular fibrillation and ventricular tachycardia are treated using the left branch of the
puslesless arrest arrest algorithm. Click below to view the pulseless arrest algorithm
diagram. When done click again to close the diagram. Pulseless Arrest Algorithm
Diagram. or Members Download the Hi-Resolution PDF Here.
Many of the patients that experience sudden cardiac arrest demonstrate VF at some
point in their arrest, therefore, training emphasis is placed on the pulseless arrest
algorithm.

Rapid treatment of VF using the pulseless arrest algorithm has been established as the
best scientific approach to restoring spontaneous circulation.

There are several important points that should be considered when initiating the
pulseless arrest algorithm:
High-quality CPR should be performed until the defibrillator is attached the
patient.
Interruptions in chest compressions should be kept to a minimum.
Rapid use of the defibrillator should be emphasized.
If possible, use a manual defibrillator over an AED since the use of the AED can
result in prolonged interruptions in chest compressions for rhythm analysis and shock
administration.

No longer are stacked shocks used. CPR is resumed for 5 cycles between each shock.

Defibrillation and the Shock


Most defibrillators used today are biphasic. Biphasic means that the electrical current
travels from one paddle to the other paddle and then back in the other direction. The
biphasic shock also requires less energy to restore normal heart rhythm and is believed
reduce skin burns and cellular damage to the heart. When using a biphasic
defibrillator in VF and/or pulseless VT, you will use a dose of 120-200 Joules to shock.
Start with 120J and increase the dosing in a stepwise fashion up to 200 Joules as
needed.

To ensure safety during the shock, providers should always announce the following
statement, I am going to shock on three. One, Im clearTwo, youre clearThree,
everybody is clear.
Do you know the difference between defibrillation, synchronized cardioversion, and
unsynchronized cardioversion? Find out here.

Vasopressors
A vasopressor is a medication that produces vasoconstriction and a rise in blood
pressure. The vasopressors that can be used in the treatment of VF/Pulseless VT are
epinephrine and/or vasopressin.Epinephrine is primarily used for is vasoconstrictive
effects. Vasoconstriction is important during CPR because it will help increase blood
flow to the brain and heart. Vasopressin is also used for its vasoconstrictive effects and
has been shown to have effects similar to those of epinephrine.

Rhythm checks should be performed after 5 cycles of CPR. Limit rhythm checks to less
than 10 seconds to minimize interruptions in CPR

Antiarrhythmic Drugs
Amiodarone, lidocaine, and magnesium are antiarrhythmic medications that are used in
the pulseless arrest algorithm. To learn more detailed information about these
medications go here.