Agonal Ventricular Fibrillation: 12-Lead ECG

Report:

Ventricular fibrillation 160/min

Comment:

It is instructive to compare the lead 2 rhythm strip at the bottom with the simultaneously recorded leads above. This demonstrates continuous undulating activity even where, in a single lead, there appears to be a ‘clean’ isoelectric line.

It is rarely mentioned that the rate of VF may be well below that of ventricular flutter, sometimes as low as 150/min92.

She was cold, unresponsive and groaning. The ECG was taken following endotracheal intubation. The drugs used were xylocaine 50 mg, succinylcholine 100 mg an thiopentone 250 mg IV. The ABGs at the time of the ECG recording showed pH 7.25, PO2 180 and PCO2 41. Pulses became impalpable just as the ECG recording started. She was pronounced dead three minutes after the ECG was taken.

Thiopentone, anyone?

97. 65 year old man with acute-on-chronic renal failure following a gastrectomy. Potassium was 7.9 mEq/L when he arrested, but rising.

If you have any suggestions for or feedback on this report, please let us know.