An unconscious patient is bought in by EMS into an ER trauma ...

[craiczarry]

An unconscious patient is bought in by EMS into an ER trauma room. Patient has no detectable pulse, and the ECG baseline waveform shows grossly irregular fluctuations with a zigzag pattern.
 
  What is the course of action to treat this patient?
  1. Rapid defibrillation
  2. Cardiopulmonary resuscitation
  3. Administration of oxygen
  4. Administration of an antiarrhythmic medication
  a. 1, 2, and 3 only
  b. 2 and 4 only
  c. 3 only
  d. 1, 2, 3, and 4

Question 2

Which of the following is NOT a common characteristic of a premature ventricular complex (PVC)?
 
  a. No P wave prior to the QRS complex
  b. Widened QRS complex
  c. Bizarre QRS complex
  d. Narrow QRS complex

[bobsmith]

Answer to Question 1

ANS: D
Ventricular fibrillation (VF) is the most life-threatening arrhythmia and is defined as erratic quiv-ering of the ventricular muscle mass. It causes the cardiac output to drop to zero; the patient be-comes unconscious and represents a true medical emergency. The electrocardiographi c tracing of ventricular fibrillation shows grossly irregular fluctuations with a zigzag pattern. Treatment calls for rapid defibrillation, cardiopulmonary resuscitation, and administration of oxygen and anti-arrhythmic medications, as well as treatment of the underlying cause of the ischemia. Survivors of VF usually receive an internal cardioverter-defibrillator (ICD).

Answer to Question 2

ANS: D
PVCs are easy to recognize because they cause a unique and bizarre QRS complex, which is much wider than normal (Figure 18-16). The QRS complex of a PVC is wider than normal, be-cause the ectopic focus is using channels outside the normal conduction system to move the im-pulse throughout the myocardium. PVCs have no P wave preceding them and may occur as a singular event or, more commonly, as a temporary run of PVCs.