Asystole Prove It

I can give a scientific view to Asystole
In Asystole your patients heart is DEAD Zero electrical activity So Lets Prove It
There is a difference between discontinuity and a real Rhythm on the monitor
A Flat Line is usually never real check LEADS
Asystole is defined as a cardiac arrest rhythm in which there is no discernible electrical activity on the ECG monitor Asystole is sometimes referred to as a flat line Confirmation that a flat line is truly asystole is an important step in the ACLS protocol

Put in a new Compressor

Switching out to a fresh Compressor gives you a baseline for the compressions This will get you good compressions for at least the next minute

During Compressions with new Compressor check for Carotid Femoral Pulses Pulses dont have to be great but THEY MUST BE PRESENT or the compressions are useless to the patient

If you dont feel pulses start fluids immediately 200 500 ml NS over 1 minute

Has anyone checked the Rectum It may sound funny but its not a Joke

A diaper can hold 2 liters of blood and you would never know unless you look If the patient isnt wearing a diaper well then theres nothing in the way to help you see all that blood if they are bleeding out

This doesnt change what your doing but it may explain why your not going to be successful

Think a little Bright Red Blood in the diaper or coming out the rectum

A GI bleed is usually a slow process and now your pushing on their chest

Check the IVIO line If the asystole is real FLUIDS may be your only reversible cause at this point

Make sure the IV line is patent and flows freely If the line has infiltrated then its useless

An Intraosseous access line will not even flow without a pressure bag attached

Unless your pushing fluids manually Use a pressure bag

Did the patient get what you intended to administer

If the fluids arent getting to the patient you wont be very successful with asystole

Epinephrine 1 Mg in 10 ml of every 3 minutes

Did you make a change in the patient with the above steps​​​​​​

Anything is better that asystole Whats on the cardiac monitor

Ventricular Fibrillation Great Job dont forget to defibrillate

PEA Pulse Electrical Activity Again Great Job Your patient MAY have a chance

PEA is the precursor to asystole So to get PEA after asystole your going in the right direction

With PEA give another Fluid Bolus 500 ml NSl

If you still have asystole well you didnt make them any worse

Then GOTO Step 1 and do it again

Your getting closer to Proving the asystole may be real

After doing the above twice with the same results you can conclude its not you or your actions but that the patient is REALLY in asystole
To this day there isnt any proof of a single patient coming back from the dead Asystole isnt Asystole until you prove it
Discontinuity can give you Asystole without a blood flow from the heart to the skin continuity cannot be accomplished So the most important thing to do in asystole is give fluids Thats why the protocols tell you to give fluids VOLUME is your friend in PEA and Asystole
If you dont feel a carotid pulse during CPR your compressions are bad or your patient may have had an aneurysm that ruptured carotid aortic etc guess what More Fluids Please
If you dont feel a Femoral pulse during CPR your compressions are bad or your patient may have had a AAA rupture guess what More Fluids Please
If the IVIO line isnt working your patient didnt get any fluids So its important to check that your line is functional
In a cardiac arrest theres only so much you can do to help your patients heart start
1 The most important thing to do is SHOCK a shock able rhythm any time you see it
a After that shock CPR immediately
i Unless your patients heart was beating a second ago it takes 30 seconds to a minute of compression after the shock to develop a circulation Checking for a pulse after the defibrillation is useless theres no guarantee it will keep going unless you help it Thats what compressions do after the shock they help develop a circulation Otherwise that heart may start and stop until its dead Help the heart develop a circulation
ii Your vascular system has to be functioning in order for a blood pressure to
2 Fluids everyone in cardiac arrest should get fluids
a Fluids in a cardiac arrest are your friend
i You see asystole you start CPR now you see Ventricular Fibrillation Vfib

All you did was create a connection to the patient Your compressions got the blood flow needed to measure what was inside that patients chest the whole time
You just gave fluids and the asystole just became Vfib This is explained very easily A dead heart will not change back to anything but more dead if you made asystole change look back at what you just did it was Fluids and CPR

Our biggest problem in CPR is chest compression and fluids We do compression as best we can but if a human is involved well then it can vary a little
Look at the cardiac arrest stats on patients over 400 lbs Youll find witnessed cardiac arrest to have the best results on that category of patients Why Once the blood leaves the chambers of the heart your CPR may not be effective enough to get blood back to the heart Hence best outcomes when the vascular system is still primed We do reach a point of non functionality this is a mechanical coefficient In other words even if the compressor is twice the size of the patient you still wont be able to move enough blood to the heart This is due to the patients body not allowing recoil of the chest adipose tissue 30+kg absorbing the compression resulting in much less force to the chest When you add the final factor how high is that chest if their 400+lbs Even if everything we do is correct the bariatric patient is a fragile one Once blood leaves that heart your fighting a head wind
Bedside defibrillator as a minimum for any bariatric patient that needs monitoring The amount of time it takes to leave the room and get the equipment could be detrimental in trying to reverse even Ventricular Fibrillation
Just a little of my input on asystole
Hope it helps