ADDRESSING ASYSTOLE AND OTHER LETHAL HEART RHYTHMS

Updated 7/25

The image above shows a Code blue in progress. This is 
happening in the emergency Room. Always follow your

Institution's policies and procedures for Code Blue. 

What is the role of the nurse who is assigned to the Code Blue?

The nurse has an important role in effective communication.
There are many responsibilities.

- staying calm in a chaotic situation
- giving clear instructions to coworkers
- ensuring that MD orders are conveyed correctly

- proper documentation of vital signs and all treatments /
  interventions that take place ( defibrillation for example)
  - the nurse becomes the " binding force.

Addressing lethal EKG rhythms

There are some EKG rhythms that are considered to be lethal.

Instant intervention is necessary for good outcomes. Here are
the most lethal rhythms:

Asystole - sometimes referred to as " flat-line. The electrical
heart's conduction system is not functioning. There are no
ventricular contractions. The patient is pulseless and
unresponsive. immediate action has to be taken. 

Ventricular Tachycardia - There may or may not be a pulse
present. The ventricles are beating rapidly and there is no atrial
activity. Blood flow to the vital organs is compromised.

Ventricular Fibrillation -  There is a chaotic rhythm and no
atrial activity. The ventricles are quivering , so there is no 
cardiac output. There is no pulse and the patient may become
unresponsive. Immediate action to defibrillate is usually done.

***American Heart Association has protocols in place for each 
EKG rhythm.

The postoperative patient is at risk for hypothermia.
Fluid loss and exposure in the surgical suite, may predispose
 to hypothermia. A lethal cardiac arrhythmia may result.

 Hypothermia increases the body's demand for oxygen

 and if left untreated can lead to a myocardial infarction
 (heart attack). Trauma resulting in excessive blood loss, 
 as well as alcohol ingestion, may also lead to hypothermia.