atrial fibrilliation

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SO I am with my family.

I am practicing taking pulse and BP on my Dad.

He was diagnosed and is being treated for atrial fibrillation.

He is on meds for this.

Is there anything anyone can tell me, how during the pulse or BP check I can detect the condition?

According to wikipedia, it can be asymptomatic or an "irregular pulse".

Any suggestions on how to practice my skills on my Dads condition?

I am not trying to treat him. He is under regular care of an MD, just having him be my "guinea pig"

Thank you.
 
When you take a pulse or blood pressure on him, his pulse will feel/sound irregular. "Regular" being like the rhythmic tick of a clock, and irregular being erratic and arrhythmic. However, just because you hear an irregular HR on a pt, do not immediately assume and fixate on A-fib. There are several different things that can cause the heart to beat irregularly, such as PA/J/VC's, RSA, heart blocks, and a few others. Being able to note abnormalities when taking basic vitals is a good skill to practice, though.
 
In A-FIB the heart basically quivers instead of Beating. most people with serious A-fib issues have pacemaker/defibs implanted. as does one of my family members. Very cool pieces of equipment, very useful. I know someone who actually feels there heart stop when it goes into A-FIB. V-tach however can be detected while doing basic V/S by checking the pulse because the heart will be skipping around and be very very irregular. i could have some of my info wrong so if a better experienced forum member has something to add please do so.
 
You can't detect AFib with a pulse check alone, but you can be suspicious of it if the pulse is irregularly irregular, i.e. no pattern of beats. There are other rhythms that are also irregularly irregular, so you can't be sure without an EKG.

There's no consistent BP with AFib. Patients can be hypertensive, hypotensive, or anywhere in between.
 
According to wikipedia, you might be able to tell by irregularly timed beats, which would be evident when taking a pulse or bp. This assumes that he is constantly symptomatic. You made your intentions clear in your post, but remember that giving medical advice is generally frowned upon on this forum.
 
jjesusfreak01 said:
According to wikipedia, you might be able to tell by irregularly timed beats, which would be evident when taking a pulse or bp. This assumes that he is constantly symptomatic. You made your intentions clear in your post, but remember that giving medical advice is generally frowned upon on this forum.
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Once again. I am not treating him. He is under treatment by an MD. He goes for weekly tests, etc.

I am using his condition as and educational tool for myself, with his consent.
 
jjesusfreak01 said:
This assumes that he is constantly symptomatic.
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PTs can be in a-fib without being symptomatic. Also, they do not always have pacemakers. Go to a SNF and count how many pts are in controlled a-fib. Typically a pt who is in a-fib will be on diltiazem and coumadin if they do not have an implanted pacemaker (another hint along with an irregular HR that can point you In The Direction of a-fib, though you need an ECG to be definitive). In regards to the blood pressure, I don't think the OP was referring to an actual systolic/diastolic reading, but the ability to hear the pulse while checking the BP.
 
Just practice pulse checks on him. You will tell when he is in Afib. After doing this for a long time, you will get the feel for it.
I can feel a pulse and tell it is Afib, before even applying the monitor. Once I feel the pulse, I will normally ask the pt if they have hx of it.

It takes time, but you will get to know it.
 
reaper said:
Just practice pulse checks on him. You will tell when he is in Afib. After doing this for a long time, you will get the feel for it.
I can feel a pulse and tell it is Afib, before even applying the monitor. Once I feel the pulse, I will normally ask the pt if they have hx of it.

It takes time, but you will get to know it.
Click to expand...

So it will feel irregular?
 
It will feel not only irregular, but irregularly so. If you take your own pulse, you'll notice that you can anticipate when the next beat will be felt. With certain rhythms, you'll be able to note when someone misses a beat or has one out the norm. It will feel "early" or "late" from what you're used to, and you'll be able to anticipate when that happens. With A-fib, you can't anticipate when the next pulse will be without looking on a monitor. To your fingers, it's always going to be a surprise when the next one is felt.

A-fib has a very distinctive feel to it. Once you get the feel of it, you'll pretty much be able to know when the patient is in A-fib. The irregularly irregular feel, some kind of "blood thinner" like coumadin, some kind of med like digoxin and/or diltiazem or verapamil. Sometimes all they're trying to do is keep clots from developing in the atria and controlling the ventricular response rate.

Pulmonary embolus and thrombotic CVA are major complications...
 
If i recall 80% of people with irregular heart beats suffer from AF.

Its fairly common especially amongst older patients. The only definitive way to diagnose it is ECG.

You can alos get AF with a rapid ventricular response (RVR) where AF is uncontrolled with a fast HR. Had a 30 year old pt the other day who suffers from intermittent AF. HR was around 150 and irregular. Treatment for him is cardioversion as he stated that the various drugs (adenosine etc) do not work on him.
 
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