Ventricular Fibrillation

Ventricular FibrillationCLINICAL SIGNS:

* brutal loss of consciousness and circulatory arrest chart:

– loss of pulse and high blood pressure.

– disappearance of the noises of the heart.

– then respiratory arrest and mydriasis confirming brain death.

* syncope if transient fibrillation.

ETIOLOGY:

* complications of infarction or acute coronary insufficiency.

* worsening of a TV, a torsade de pointe.

* Digitalis intoxication.

* hyperkalemia .

* advanced cardiomyopathy that is dilated, hypertrophic or obstructive.

* Arrhythmogenic dystrophy of the right ventricle.

* electrocution.

* Hypothermia below 28 ° C.

DIAGNOSTIC TESTS:

* scope , SpO².

* ECG :

– oscillations of irregular shape and amplitude.

– high frequency at more than 300 per minute.

No visible P wave.

TREATMENT:

* electric shock defibrillation as soon as possible :

– start with 200 joules (J) (3 J / kg in the child), then if failure, make a new shock at: 200 J, then if failure at 360 J.

– then intubation (oxygen therapy) and poses venous route.

– if failure, Adrenaline: 1 to 3 mg IV / 3 min.

– if failure, new defibrillations up to 3 shocks of 360 J.

– then, if failure: Xylocaine, 1 mg / kg IV.

– if failure, new series of 3 electric shocks of 360 J.

– if failure, bicarbonates: 1 mmol / kg IV every 10 minutes.

– if failure, return to adrenaline IV.

– if successful, take preventive measures: Xylocard 1-3 mg / min or Cordarone 600 mg / day with an electric syringe.

– 200 joules

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Editor-in-chief of the Medical Actu website; general practitioner graduated from the Faculty of Medicine of Algiers in 2005 currently practicing as a liberal.

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