In today’s micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis discusses ECG and ventricular fibrillation.
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In today’s micro-lecture we’re going to talk about ventricular fibrillation. Now you may have already heard this term before in your readings on know a little bit about it. Now ventricular fibrillation is exactly as the name suggests. It’s when the ventricles of the heart are quivering instead of contracting nice and forcibly like this, this hand representing the atria or the top chambers of the heart, this hand representing the ventricles of the heart.
Instead of the heart contracting rhythmically like this you have a situation whereby the heart is completely quivering rather than contracting. So what that means is none of the blood in the heart is actually being pumped around the body. Now if you were to put shock pads, shock or AV pads on a patient and turn the machine on it will analyze ventricular fibrillation as a shockable rhythm. It will say to you, shock advised.
Do not touch the patient charging. And this is what it looks like. So for those of you who are getting ready to do workshop two this is really a rhythm that you’re going to need to be able to recognize because paramedics do tend to use manual recognition of shockable rhythms rather than AUDs. So if you were to look at this, now the idea of rhythm recognition is to get you guys to look at a rhythm that is shockable or non-shockable and to try and determine what to do next without putting too much thought into it.
Now you will of course, have to learn how to interpret and ECG using the STEP approach. But when you look at this rhythm really what we want you to be saying is, that’s VF and the reason it’s VF if because there’s no pattern to it. Now of course if you’re never seen, if you’ve skipped all the other ECG lectures or you’ve come straight to this lecture you’re unlikely to have seen what a normal sinus rhythm looks like and what a PQRS and T complex looks like.
If you haven’t and you’re okay with that, great. So the reason this is VF is because its chaotic. It’s described as chaos and there’s no pattern to it. And when you look at this you should automatically be thinking that’s VF. We need to shock that. You need to charge the defibrillator and shock it. Now as with other morphology, ECG morphologies VF doesn’t always look exactly like that. Here’s a range of other different VFs.
Excuse me. That’s a bit of craziness just happened right there. So let’s have a look at this. So this is what it looks like in a 12 lead ECG. Now somebody would have had this 12 lead already attached to the patient before they actually, before the patient went into VF. It’s unlike the patient was in VF and then they said, “Quick. Let’s attach an ECG.” because it doesn’t work like that. If ever you see VF you need to be delivering a shock first.
It would always be a shock. Now there are different types of ventricular fibrillation including varicose VF which looks like this one. Then there’s cose VF. Then there’s fine and very fine. They are all the same thing but they’re all operating at slightly difficult strengths. So that’s ventricular fibrillation.
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