Ventricular fibrillation (VF) is a life-threatening condition in which the signaling in the ventricles of the hearts is no longer coordinated. The loss of this coordinated signaling causes rapid, random and chaotic signaling leading to spasms of the ventricular walls. During VF, blood is not being circulated to the brains and the rest of the body and is therefore deprived of oxygen. This condition can be reversed by using a defibrillator, which sends an electric discharge of direct current to the victim (1). Improper signaling of electrical activity in the heart can also lead to a rapid heart rate. This type of tachycardia is called ventricular tachycardia (VT) and may lead to VF (Figure 1). Pulseless VT is also with defibrillation and VF and VT are both considered shockable heart rhythms (2,3).
A large and increasing proportion of patients presents with non-shockable rhythms in out-of-hospital cardiac arrest (OHCA). These non-shockable rhythms are pulseless electrical activity (PEA) and asystole. During PEA, a normal heart rhythm is observed on the electrocardiogram (ECG), but without cardiac output. Asystole is a condition without ventricular complexes. The heart muscles fail to contract due to the lack of cardiac electrical activity. Both PEA and asystole are treated with cardiopulmonary resuscitation (CPR) without defibrillation, combined with epinephrine administered intravenously (4). Non-shockable rhythms are associated with high mortality. The survival rates of PEA
The abnormally fast heartbeat caused by SVT, lasts in episodes lasting for several hours. During an episode
There are approximately 5.7 million people in the United States diagnosed with heart failure and about half of those diagnoses will die due to causes related to heart failure within five years (“Heart Failure”, 2016). Heart failure related deaths vary by geographic locations; however, they are most predominant among men and offer a greater risk to women if left untreated. Heart failure is a serious medical condition, if diagnosed and treated early enough, the chance of preventing death increase.
This case study discusses the management of a 68 year old male who presented with chest palpitations secondary to rapid atrial fibrillation. Atrial fibrillation is a common cardiac arrhythmia with serious complications if not treated correctly. This essay will discuss the initial clinical presentation of the patient and examine the management and outcome of the interventions applied. The significance of atrial fibrillation including its pathophysiology and aetiology will also be discussed.
Supraventricular tachycardia or SVT is a heart condition where the sufferer’s heart beats very fast for reasons such as exercise, high fever, caffeine or stress. For the majority of people who have supraventricular tachycardia, the heart still works as normal where it pumps blood across the body. During an episode of supraventricular tachycardia, the heart's electrical system doesn't work properly, causing the heart to beat very fast. The heart will beat at least 100 beats per minute and may reach up to 300 beats per minute. After medical treatment or treatment of its own, the heart will usually return to a normal rate of around 60 to 100 beats per minute. Supraventricular Tachycardia may start suddenly and then end suddenly, and you may not
The patient is a 72-year-old female who arrived to the emergency department in cardiac arrest. Emergency medical services reports the patient was last seen eating breakfast at her nursing home and was found an hour later face down and unresponsive. After it was determined the patient was in asystole, an intravenous catheter was started and two rounds of Epinephrine was administered. Upon arrival to the emergency department the patient had pulseless electrical activity with sinus tachycardia on the monitor. Airway management was in process with a bag valve mask on 100% oxygen and chest compressions in progress. After intubation and stabilization the
Most physicians and people who acquired the problem usually know it as A-FIB, a shorter term for atrial fibrillation. Atrial fibrillation deals with the cardiovascular system, in particular, the heart in the body. It is defined as, “the electrical signals that control this system are off-kilter. Instead of working together the atria do their own thing, causing fast fluttering heartbeat, also known as arrhythmia” (WEBMD). In a normal pumping blood of the heart the atria would squeeze first, followed by the ventricles of the heart. A-fib can be a serious issue if not treated, due to the inadequate pumping of the blood, causing a higher chance of heart failure. It is also a higher chance in getting a stroke, because improper flow of the blood can cause clots in the
Charging to 200....Stand clear…Shocking! CPR....EMS providers experience the adrenaline and rush of a patient in cardiac arrest. Trying to bring dead back to life is not a simple task by far, especially with the limitations and resources of the field. But, what happens after the patient makes it to definitive care? Annually, around 300,000 adults in the United States experience out-of-hospital cardiac arrests (AHA), and EMS providers only see the results of the short term survival of the patient, but rarely the actual patient care and recovery after an arrest. Patients undergo intense, aggressive treatment and recovery measures in the hospital post-code. These patients have a variety of treatment regimens
This paper will be going over a scenario involving a real patient and what things could have been different with EMS care. It will also be covering what exactly cardiac arrest is and what rhythms produce it. And for every cardiac rhythm in cardiac arrest, there is a specific treatment plan paramedics can follow.
What is atrial fibrillation? Atrial fibrillation, also known as afib, is an irregular heartbeat that produces disorganized electrical signals within the heart. This results in quivering of the atria, or top chambers of the heart which allows blood to pool. Stagnant blood in the atria increases the risk of developing a blood clot.1 The blood clot can enter the bloodstream and travel to the brain resulting in a stroke. Atrial fibrillation is associated with a 5 times increased risk for stroke, and approximately 15-20 percent of people who experience a stroke have atrial fibrillation.2 Symptoms of atrial fibrillation are heart palpitations, shortness of breath, weakness, chest pain, dizziness, nausea, and fatigue.1(p6) The incidence of afib increases
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P
The evidence surrounding the topic of therapeutic hypothermia post cardiac arrest is one lathered in potentially advantageous benefits, as well as harmful side effects. Although this procedure has potentially lifesaving and neurologically preserving implications, it does come with various side effects which can be dangerous in general or if left untreated. This paper will first address the many benefits, some of which include prolongation of life, retention of neurological function. It will then shed light upon some of the subsequent risks and harmful effects that are associated with therapeutic hypothermia. Lastly the paper will discuss why or why not the overall benefits outweigh the aggravating factors. Thus, being a topic of much controversy
The research team hopes to use the numerical model they have designed to link modifications that take place at the cellular and tissue level when a heart fails to a numerically computed ECG. This, they wish, will assist to determine what it is that triggers ventricular fibrillation (VF), and to recognize the risk of VF.
Other hemodynamic effects have also been reported with usage of ivabradine. In a study by Kurtoglu et al, ivabradine was seen to improve heart rate variability in non-ischemic patients with heart failure. (26). De Luca et al showed that addition of ivabradine to optimal medical therapy in patients with stable heart failure with preserved ejection fraction with New York Heart Association (NYHA) class II, left ventricular ejection fraction (LVEF) > 50% and heart rate > 70 bpm, significantly improved physical performance by increasing exercise capacity (27). Another study in patients with stable ischemic heart failure, NYHA functional class II and LVEF ≤ 40%, confirmed these findings and additionally showed an improved gas exchange (with improvement
Today millions of Americans live or have lived with Atrial fibrillation. The main concern with this health issue is that many people who lived with it sometimes are not aware of it. Atrial fibrillation is defined by Mayo Clinic (2012) as “an irregular and often rapid heart rate that commonly causes poor blood flow to the body”. It occurs when the four chambers of the heart have a disrupted rhythm. The abnormal functionality of health may lead to a stroke because of the possible blood clot that will be formed. The Atrial fibrillation or Afib put the body in a situation without oxygen and nutrients because the body is not well supplied by a heart that is became weak. In general, only few people will feel change in their heartbeat. They may verbalize
Without early intervention on average 360,000 people out of the hospital succumb to cardiac arrest. “ Cardiac arrest and sudden death account for 60 percent of all deaths from coronary artery disease”,(Bledsoe, Porter, & Cherry, 2011,2007,2004, p. 1229)There are several causes of sudden cardiac arrest. Most are caused by ventricular fibrillation. “During ventricular fibrillation, the ventricles do not beat normally. Instead they quiver rapidly and irregularly.” When this occurs, the heart pumps very little and blood does not get circulated throughout the body. “ Most of the cases found with sudden cardiac death are related to undetected cardiovascular disease.("Sudden Cardiac Death," 2015, para. 2)Sudden cardiac arrest are immediate and drastic that includes sudden collapse, no pulse, not breathing, and loss of consciousness. “Four rhythms produce pulseless cardiac arrest: ventricular fibrillation, rapid ventricular tachycardia, pulseless electrical activity and asystole.”("Circulation ," 2005, p. IV-58)Other signs and symptoms that could occur prior to sudden cardiac arrest, include fatigue,