CLINICAL 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
