Hi. I'm Mark from ACLS Certification Institute and welcome back to Rapid Algorithm Review. Today, ventricular fibrillation. Step one, establish unresponsiveness. Poke him with a stick. Establish unresponsiveness and check for breathing. Again, we're just looking for breathing no more than about five seconds.
If the patient is unresponsive, not breathing, immediately call the code. Get some help coming. If you're in a hospital, call the code. If you're out in the field, call 911. Get help coming.
Next, immediately begin chest compressions. Continue chest compressions until a defibrillator or the AED arrives. Continue the chest compressions while you're hooking up the AED, applying the pads. Once the machine is fully charged and you're ready to administer that shock, administer the shock and defibrillate the patient.
Now, remember to clear the patient before you administer that shock. You have to look from head to the toe of the patient. I'm shocking in three, two, one, administer the shock. I guess, he didn't hear me. Still, my bad. I'm responsible. We'll make sure no one's touching that patient when I administer the shock.
After the shock, immediately resume chest compressions. Start bagging the patient. Start getting your vascular access. Now, IV access can be difficult in a full arrest because of the low blood pressure. Generally, sixty seconds, two attempts. If you can't gain traditional IV access, go immediately to intraosseus infusion but gain vascular access.
Administer your first drug. First drug up, Epinephrine, 1 milligram every three to five minutes. Now, remember you can replace the first or second dose of Epinephrine with Vasopressin. Administer 40 units of Vasopressin. Again, you can replace the first or second dose of Epinephrine.
After two minutes of quality chest compressions and administering the Epinephrine, reassess the rhythm. If it's a shockable rhythm, again, administer the shock and after the shock, immediately begin chest compressions. After each shock, immediately resume chest compressions.
Next drug up, an antiarrhythmic, Amiodarone, 300 milligrams IV push. If it's determined the patient is not in a shockable rhythm, they may be in PEA, pulseless electrical activity or Asystole. Immediately move to and follow that algorithm.
If you're in PEA or Asystole and the patient goes back into a shockable rhythm, immediately return to the Vfib algorithm and administer the shock. If, at any time, your patient has a return of spontaneous circulation, immediately move to that algorithm and follow your return to spontaneous circulation algorithm.
Quick fire review, patient's unresponsive, not breathing, activate the EMS or call the code. Begin chest compressions immediately. Remember, thirty to two, at least 2 inches at rate of at least a hundred compressions per minute.
As soon as the defibrillator arrives, attach the defibrillator and continue chest compressions until we're ready to shock that patient. Clear the patient, administer the shock. Immediately after administering the shock, resume chest compressions. Immediately gain vascular access. If a traditional IV can't be started because of the low blood pressure, go to IO, intraosseus infusion.
First drug up, Epinephrine, 1 milligram every three to five minutes. Remember, 40 units of Vasopressin can replace the first or second dose of Epinephrine. If it's determined it's not a shockable rhythm, the patient may be in PEA, pulseless electrical activity or Asystole. Immediately move to that algorithm. If, at any time, your patient has a return to spontaneous circulation, immediately move to your ROSC algorithm.
I'm Mark for ACLS Certification Institute. This has been Rapid Algorithm Review for Vfib. Thanks for watching and I'll see you in the next algorithm.