What would be the first line of treatment is a patient who develops the condition as represented in the picture below after intravenous injection of potassium chloride?
A. I.V Atropine.
B. I.V Adrenaline.
The condition shown in the picture above represents ventricular fibrillation.
Ventricular fibrillation (VF)
- It is a life-threatening cardiac arrhythmia in which the coordinated contraction of the ventricular myocardium is replaced by high-frequency, disorganized excitation, resulting in failure of the heart to pump blood
- VF is the most commonly identified arrhythmia in cardiac arrest patients.
- Initiate CPR by giving 30 chest compressions, then open the airway and deliver 2 breaths. Continue CPR in this compression-to-ventilation ratio (30:2) until the AED/defibrillator arrives and is set up.
- External electrical defibrillation remains the most successful treatment for VF.
- Defibrillation should be carried out immediately (as early as possible), even before intubation or insertion of an intravenous device.
- Immediate Defibrillation is the resuscitative measure of choice in all patients in cardiac arrest due to ventricular fibrillation on ventricular tachycardia (Shockable Rhythms) irrespective of the cause.
- Vasopressors (epinephrine or vasopressin) are given per the asystole/pulseless electrical activity ACLS algorithm:
- Antiarrhythmic agents can be given before or after the shock.
- Amiodarone or lidocaine
- If torsade de pointes is present, consider magnesium sulfate.