Ventricular Fibrillation: Causes, Treatment and Nursing Management

Definition of Ventricular Fibrillation (VE):

Ventricular fibrillation is ventricular arrhythmia characterized by very rapid and irregular, 1netfective &uncoordinated ventricular activation with no mechanical effect. It is the commonest causes of sudden death.

Ventricular fibrillation
Fig: Ventricular fibrillation

Causes of Ventricular Fibrillation (VE):

It includes-

  • Acute MI,
  • Electrolyte imbalance especially hypokalemia,
  • Electrocution,
  • Drug overuse (Digitalis & adrenaline),

Clinical Features of Ventricular Fibrillation (VE):

  • History of ischemic heart disease.
  • History of taking anti-arrhythmic drug.
  • The patient becomes rapidly unconscious and is pulseless.

On examination:

  • Pulse-Absent,
  • BP-Non recordable,
  • Respiration-Ceases/absent,
  • Pupil-Dilated, less or no reaction to light,
  • Heart sound-Absent.

ECG- It shows chaotic, bizarre, irregular ventricular complex.

Treatment of Ventricular Fibrillation (VE):

  • Defibrillation is the only effective treatment for ventricular fibrillation.
  • Defibrillation with biphagic shock of 150 joules.
  • If normal rhythm is not restored, a further shock of 150-200 joules is given.
  • If unsuccessful, a 3rd shock of 150-200 joules is given.
  • If these 3 shocks are unsuccessful then.
  • 1 mg of adrenaline IV & a further 1 min of cardio-pulmonary resuscitation are given before trying a further sequence of up to 3 shocks each at 150-200 joules.

Nursing Management of Ventricular Fibrillation:

  1. Avoid causing intense emotional situations.
  2. Avoid too hot cold patient.
  3. Prevents decision making when patients are under severe stress.
  4. Refrain from giving oral stimulants.
  5. Refrain from entering anal lubricant.
  6. Refrain from taking rectal temperature.
  7. Refrain from doing a rectal or vaginal examination.
  8. Limit environmental stimuli.
  9. Delays shower if appropriate.
  10. Restrict smoking.
  11. Encourage competitive.
  12. Instruct the patient to progressive exercise.
  13. Instruct the patient or family on the symptoms of heart compromise shows need for rest.
  14. Patient identity method of handling stress.
  15. Perform relaxation therapy if appropriate.
  16. Monitor patients for self-care ability,
  17. Monitor patient’s need for adaptive devices for personal hygiene, dressing, toileting, and eating.
  18. Provide the desired personal article.
  19. Provide assistance until the patient is fully able to assume self-care.
  20. Assist patients in receiving the dependency needs.
  21. Use a consistent repetition of routine health care as a way of setting them.
  22. Encourage independence, but the intervention when the patient cannot perform.
  23. Teach parents or family to encourage self-reliance, to increase only when the patient i1 unable to perform.
  24. Establish a routine for self-care activities.
  25. Consider patient age when promoting self-care activities.

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