Choose one serious arrhythmia.   Describe the hemodynamic effect on the patient.

  Then plan collaborative care for a patient experiencing it. 

ECG description:
 Completely disorganized
waves
Source: https://www.aclsmedicaltraining.com/adult-cardiac-
 NO discernable P waves,
arrest-vtach-and-vfib/
QRS complexes or T waves

Hemodynamic effect on
patient:
 Fainting
 Loss of consciousness Ventricular Fibrillation
 Pulseless DANGER! Life threatening!
 Apneic
 NO BP and heart -needs intervention within 3-5 minutes
sounds
 Respiratory and  Ventricles just quivers → increased
metabolic acidosis oxygen demand
 Seizures  No pulse and CO → no brain, heart
 Pupils fixed and and body perfusion
dilated (within
minutes)
 Cold and mottled skin

Collaborative care:
 High quality CPR needs to be initiated until
defibrillator is attached (follow ACLS protocol).
 Do 5 cycles of CPR (in 2 minutes) in between
shocks.
 Airway needs to be established
 Monitor BP and rhythm
 Give antidysrhythmic drugs (e.g. magnesium
sulfate)
Real Life Experience:

During my ED rotation last semester, a male patient in his late 50’s was admitted due to generalized weakness, dizziness and loss of consciousness. I was helping
a nurse on a different patient at that time, however since a new patient came in the ED I was trying to figure out what happened to him while the MD and the
nurses were trying to get his vitals and test done. Suddenly, the MD and the nurses urgently asked for help to stabilize the patient. I just heard them that his
pulse stopped, and his rhythm became V-Fib. They immediately used a defibrillator to stabilize his rhythm, conducted CPR, then made sure that he is getting
enough oxygen. Fortunately, those interventions stabilized him. Last thing I heard before my shift ended is that he is probably going to get an implantable
cardioverted defibrillator (ICD) due to his risk of getting another VFib.