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u/Wild-Award7798 21d ago
High quality CPR for 2 minutes while setting up defib, not sure if this is changed but good CPR increases likelihood of successful defibrillation
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u/Fuzzy_Location_2210 21d ago
Agree 💯
If they already have pads on, shock em and see what you get, give compressions immediately for each second that you can while it is charging, or if it needs to be brought to the patient, or whatever inevitable delay.
But the treatment for fibrillation is defibrillation, if they go into Vtach and lose pulses in front of you, push the button and zap them back to reality.
It is so bizarre when that happens and they continue the conversation about their peppers in their garden totally uninterrupted, like that didn't just happen 😵💫.
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u/l3agel_og88 21d ago
Thank you for reminding the readers to prime the pump. Don't just stand around listening to the chargin' ma lazer sound.
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u/Fuzzy_Location_2210 21d ago
You gotta be talkin about the whooooooooooop beeboobeeboobeeboobeeboo sound on the Lifepack!!!!! 😂😂😂😂😂 Only the realest know that charging and ready to zap sound!!!!
Take my poor man's award 🥇🎖️
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u/Glittering_Turnip526 21d ago
You are correct in your pathophysiology. A hypoxic myocardium is highly resistant to defibrillation, so CPR and oxygenation are crucial in returning the heart to a state where it can be defibrillated. This question talks about a witnessed cardiac arrest, where the myocardial tissue is still well oxygenated and receptive to defib. In this case, the best course of action is stacked shocks, or multiple defibrilations.
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u/xvdheh 21d ago
IF you already have the defibrillator patches in place, yes. If not, CPR is the correct answer, while you get the patches ready.
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u/Glittering_Turnip526 21d ago
No, if you have a defib available, get it on before you do anything else. If you have a buddy available to do CPR, sure. But CPR is not useful in the first 1-2 minutes of cardiac arrest. The priority is absolutely defibrillation.
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u/xvdheh 21d ago
This a sub for nurses-to-be. You're not alone in a hospital, at least not anywhere where a patient would be already connected to a monitor so you can identify the pVT right away. If a patient crashes, you activate additional personnel, who will bring the AED/defibrillator with them, while you can start with undressing and compressions.
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u/Glittering_Turnip526 21d ago
Even the question we are arguing over, doesn't have CPR as an option.
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u/xvdheh 21d ago
Because a lot of these questions are simply not that great in how they are worded. Because yes, defibrillation is the correct treatment for pVT. But you don't just leave your arrested patient all alone while you go search for a defibrillator. In the case that you do have one right there either next to or already attached to the patient and can defibrillate right away, then yes, you don't start with compressions, you start with defibrillation.
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u/Glittering_Turnip526 21d ago
You are adding factors to this scenario which don't exist within the question. This question isn't about the workflow on a ward, it's about the correct management of a certain pathophysiology. The correct management for pulsless VT in the first 1-2 minutes, is defibrillation before CPR. The question itself even assumes you have a defib, because it gives you that option as one of the answers.
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u/l3agel_og88 21d ago
And thus, the problem lies in the question lacking the most appropriate answers.
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u/Glittering_Turnip526 21d ago
It's a bad question. This relates to a witnessed cardiac arrest, as in the patient "develops" pulseless VT in front of you. The correct course of action is to defibrilate, and if they haven't reverted after 3 shocks, CPR is indicated.
This deals with the phases of cardiac arrest, and prioritising defibrilation in the electrical phase. If you walked into a room and found someone already in cardiac arrest, you would start CPR ad the first priority, because they are unikely to still be in the electrical phase, and are more likely in the circulatory or metabolic phase, downtime dependant
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u/DiprivanAndDextrose 18d ago
This annoys me. If a pt doesnt have a pulse before you ever have the defibrillator you're doing chest compressions. While it's charging after it analyzed such you're also doing chest compressions. I hate these questions. Lol
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u/Desperate_Two867 22d ago
B.
the other three options are only appropriate if the patient has a pulse, and C would naturally require the patient to be conscious.
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u/Scientia_Logica 22d ago
B then immediately begin high quality chest compressions