VF artifact

Melclin

Melclin

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Went to an arrest today and as always she was DOA (as always when I'm working :glare: ).

Anyways I was printing a strip as a formality and noticed some "electric blanket VF". I just moved the monitor and didn't give it much thought, but afterwards a thought came to me.

This was the first job I've been to where FD have turned out for medical first response (its for arrests only and only in certain areas). Not having any medical training beyond what I suppose you guys would call the FR level, they don't really seem to be able to decide when resus is and isn't appropriate. They had tried to start a resus on this lady and had got as far as applying their AED when we arrived.

Not having much experience with AEDs, I was wondering, if they had plopped their AED on the bed like I did my monitor and got a bit further, would the thing be clever enough to know that the above rhythm wasn't VF?
 
AirbourneMedic said:
I would think so, as the AED takes 10-15seconds to analyze the hearts conduction
Click to expand...

How does that help? Just means it gets 10-15 seconds of that rhythm.
 
AED's are programmed to recognize certain parameters as VF. It may also recognize the hum of 50 or 60 cycle AC power. While at a glance the waveform looks like VF, it may very well be "too spikey" for an AED to recognize that as VF, so it probably won't discharge.
 
"Shock not advised. Get the wristwatch".

ANALYZE RYTHM => DOES IT MATCH LIBRARY OF SHOCKABLE RYTHMS? => no => NO SHOCK ADVISED.

AED doesn't need to know anything, just quickly match parameters against observation.

Firefighters, since they are not second level diagnosticians, are required most places to start a resuscitation; an inappropriate CPR can be reversed, an inappropriate no-code usually can't.
 
I can't find the specifications posted online, but the algorithms used to determine VF and VT are pretty good. I have seen compression artifact (when quick, rythmic and consistent) identified as VT, but the example in your case is so far off that I would expect that the defib would not sock it.
 
Interesting.

I heard a rumour once that a crew had trouble calling it for a fairly obviously deceased bloke who had been hit by a train because of the artefact looking like VF. I've seen overhead powerline artefact and if it was anything like that, the crew can't have been too quick between the wickets. Don't recall if they actually toasted the bloke or not.

mycrofft said:

Firefighters, since they are not second level diagnosticians, are required most places to start a resuscitation; an inappropriate CPR can be reversed, an inappropriate no-code usually can't.
Click to expand...

Yeah I wasn't hanging s**t on those blokes, I understand the position the were in. Its just that the whole idea of poorly trained people working in the formal prehospital environment is still a relatively unknown quantity here. The MFR and rural FR programs are relatively new so its a bit of a shock to the system when we run into the issues that their poor training creates.

The woman's daughter was so confused about why fire fighters turned up when she had called the ambulance. We explained the MFR thing and she still wasn't too happy about it.
 
Maybe i misread...

So did you put your monitor on the patients bed?
 
It's never dull, Mel

Before AED's (1988), local FD responded to a pt who was in the last stages of electro-mechanical dissociation (EMD). We all knew he was going out, but they had no protocol to treat that rythm, which was pulseless, but electronically looked viable for a little while.
 
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