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?
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.