CARDIAC EMERGENCY SOP # 111 Persistent Ventricular Fibrillation / Pulseless Ventricular Tachycardia Assessment Unresponsive, pulseless Persistent ventricular fibrillation/tachycardia or return to this rhythm post ROSC/ other rhythm changes For use after SOP # 110 Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol has been ineffective. If there is no change in V-Fib Complete 5 cycles of CPR, check rhythm and pulse Repeat defibrillation. Resume CPR without further pulse checks If there IS a change in V-Fib Apply new defibrillation pads at new sites Complete 5 cycles of CPR, check rhythm and pulse Repeat defibrillation, pause 5 seconds maximum to check rhythm and pulse Resume CPR Notes: Recurrent ventricular fibrillation/tachycardia is successfully broken by standard defibrillation techniques, but subsequently returns. It is managed by ongoing treatment of correctible causes and use of anti-arrhythmic medication therapies. Refractory ventricular fibrillation/tachycardia is an arrhythmia not responsive to standard external defibrillation techniques. It is initially managed by treating correctible causes and medications. Prolonged cardiac arrests may lead to tired providers and decreased quality. Ensure compressor rotation, summon additional resources as needed, use mechanical CPR device if available and ensure provider rest and rehab during and post event.
CARDIAC EMERGENCY SOP # 111 Persistent Ventricular Fibrillation / Pulseless Ventricular Tachycardia Assessment Unresponsive, pulseless Persistent ventricular fibrillation/tachycardia or return to this rhythm post ROSC/ other rhythm changes For use after SOP # 110 Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol has been ineffective. If there is no change in V-Fib Complete 5 cycles of CPR, check rhythm and pulse Repeat defibrillation. Resume CPR without further pulse checks If there IS a change in V-Fib Apply new defibrillation pads at new sites Complete 5 cycles of CPR, check rhythm and pulse Repeat defibrillation, pause 5 seconds maximum to check rhythm and pulse Resume CPR Notes: Recurrent ventricular fibrillation/tachycardia is successfully broken by standard defibrillation techniques, but subsequently returns. It is managed by ongoing treatment of correctible causes and use of anti-arrhythmic medication therapies. Refractory ventricular fibrillation/tachycardia is an arrhythmia not responsive to standard external defibrillation techniques. It is initially managed by treating correctible causes and medications. Prolonged cardiac arrests may lead to tired providers and decreased quality. Ensure compressor rotation, summon additional resources as needed, use mechanical CPR device if available and ensure provider rest and rehab during and post event.
TN-Protocol-07282016.docx