A nurse is using an AED on a client who has ventricular tachycardia. The nurse turns on the AED and follows the voice prompts. The AED says:
A.
“Shock advised. Charging. Stand clear.”
B.
“No shock advised. Check pulse. Start CPR.”
C.
“Shock not advised. Check electrodes. Call 911.”
D.
“No shock needed. Check breathing. Give oxygen.”
The Correct Answer and Explanation is:
The correct answer is B: “No shock advised. Check pulse. Start CPR.”
Explanation:
When using an Automated External Defibrillator (AED), the device is programmed to analyze the heart rhythm and provide guidance based on the detected arrhythmia. In the case of ventricular tachycardia (VT), the AED’s response depends on whether the VT is with or without a pulse.
- Understanding Ventricular Tachycardia (VT):
- Ventricular Tachycardia (VT) is a rapid heartbeat originating from the ventricles, often exceeding 100 beats per minute. VT can be stable or unstable, depending on whether the patient has a pulse and is responsive. An unstable VT without a pulse can lead to sudden cardiac arrest.
- AED Response to VT:
- If the AED detects VT but the patient has a pulse, the AED will indicate “No shock advised. Check pulse. Start CPR.” This is because VT with a pulse might still indicate that the heart is not effectively pumping blood, and CPR is necessary to maintain blood flow to vital organs.
- AED Voice Prompts:
- “Shock advised. Charging. Stand clear.” – This prompt is used when the AED detects a shockable rhythm such as ventricular fibrillation (VF) or pulseless VT. It means the AED has determined that a shock is required to restore a normal rhythm.
- “No shock advised. Check pulse. Start CPR.” – This prompt indicates that the AED has detected a rhythm that is not shockable or that the patient has a pulse, and immediate CPR is needed to support the patient’s circulation.
- “Shock not advised. Check electrodes. Call 911.” – This option might be seen in situations where there are issues with electrode placement or other technical issues. It is not typically used for VT.
- “No shock needed. Check breathing. Give oxygen.” – This option is not used for VT scenarios as it refers to situations where the heart rhythm is normal or stable, and there is no immediate need for a shock or CPR.
- Clinical Implications:
- For a patient with VT and a pulse, the focus is on assessing the patient’s condition, which includes checking the pulse and starting CPR if necessary, while preparing for possible advanced interventions. Immediate CPR can improve the chances of survival and stabilizing the patient until advanced medical help arrives.
In summary, when an AED indicates “No shock advised. Check pulse. Start CPR,” it is directing the nurse to continue with CPR as the patient may have a pulse but still require resuscitation efforts to ensure proper blood flow and oxygenation.