Ventricular Fibrillation, Emergency Medicine

Marie-France Petchy and Richard E. Wolfe Reviewed 06/2017
 


Basics

Description

  • Ventricular fibrillation (VF) is completely disorganized depolarization and contraction of small areas of the ventricle without effective cardiac output.

  • Cardiac monitor displays abse...

Diagnosis

Signs and Symptoms

  • Loss of consciousness

  • Seizure

  • Transient gasping followed by apnea

  • Absent pulse and heart sounds

  • Death if the rhythm remains untreated:

    • VF is the initial rhythm in ∼5–70% of pati...

Treatment

  • Early defibrillation of VF is the most important determinant of survival, and each minute without defibrillation reduces survival by 7–10%.

  • Single shock defibrillation strategy is the current...

Follow-Up

Disposition

Admission Criteria

All patients who survive need admission to the ICU/CCU. 

Discharge Criteria

No patient who suffers a VF arrest may be discharged from the ED. 

Issues for Referral

Pa...

Pearls and Pitfalls

ACC/AHA guidelines recommend that patients with an acute myocardial infarction should have their serum potassium maintained above 4 mEq/L to prevent ventricular dysrhythmias 

Additional Reading

  • de Jong  JS, Marsman  RF, Henriques  JP, et al. Prognosis among survivors of primary ventricular fibrillation in the percutaneous coronary intervention era. Am Heart J.  2009;1...

Codes

ICD9

427.41 Ventricular fibrillation 

ICD10

I49.01 Ventricular fibrillation 

SNOMED

  • 71908006 Ventricular fibrillation (disorder)

  • 429243003 Sustained ventricular fibrillation (disorder)

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