Asystole (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 Hi, welcome to our video series on electrocardiograms.

    00:05 This one is the most serious of all, this is asystole.

    00:11 That means nothing is going on in the heart.

    00:15 Now at this point, we all know this is a normal ECG, but what happens if it looks like this instead? From the get go, this clearly looks very scary, but what does it mean? Let's find out together.

    00:31 This ECG is asystole.

    00:36 Now when you compare it to a normal sinus rhythm (B), you can see they're completely different.

    00:43 a- means "without", -systole is the phase of the heartbeat when the heart muscle contracts, and blood pumps from the chambers into the arteries.

    00:52 So asystole means "without pumping".

    00:57 So we can't do the seven steps.

    01:00 There's no discernible electrical activity on the ECG monitor.

    01:04 So consequently, it's sometimes referred to as flatline.

    01:09 Always assess your patient.

    01:12 Okay, keep in mind that this may not be asystole.

    01:16 So that's why it's so important that you are on your A game, that you're ready to go immediately to your patient and assess them to see what's going on, because there are some other reasons that you might see this lack of electrical activity on a strip that are not asystole.

    01:33 There might be some loose or disconnected leads, maybe the ECG monitor has lost power, or there's some reason there's a loss of signal gain on the ECG monitor.

    01:44 The important thing is, immediately go to your patient and assess them.

    01:48 If this is asystole, we'll talk about what you do, but you want to rule out that the leads are connected.

    01:54 If the patient can talk to you, they are not in asystole.

    01:58 You'll need to problem solve with something else.

    02:01 Now in this one, we are still putting the chart in because we wanted to stay consistent with you so you can look at the major differences.

    02:08 So a normal P wave in a normal sinus rhythm.

    02:12 No P waves - we don't have any discernible waves in asystole.

    02:16 So while the rhythm is regular in normal sinus rhythm, and just might vary with respirations, there is not anything going on in asystole.

    02:26 So we couldn't say the ventricular rhythm is regular because the heart is not even pumping blood.

    02:32 There is no ventricular activity.

    02:35 Now in normal sinus rhythm, the rate range between 60 and 100.

    02:39 Remember, nothing is going on in asystole, the heart is not pumping blood, so we can't measure the heart rate.

    02:48 There is no rhythm, you can't discern a P or a QRS.

    02:52 There's no PR because we don't have any discernible waves, and we have no discernible QRS complexes.

    03:01 That is the basic overall structure of why this is asystole.

    03:06 Now there's one point we wanted to bring to your attention.

    03:09 It's really difficult sometimes to differentiate between ventricular fibrillation and asystole.

    03:17 Remember, the ventricular fibrillation is just like a little bit of squiggly, but asystole should be no electrical activity.

    03:24 So be aware, sometimes this is very difficult to differentiate between the two, and the treatment options for the two are also very different.

    03:33 Hey, thanks for watching this part of our video series.

    About the Lecture

    The lecture Asystole (Nursing) by Rhonda Lawes, PhD, RN is from the course Analysis of Abnormal ECG Strips (Nursing).

    Included Quiz Questions

    1. Assess the client
    2. Call Code Blue
    3. Notify the health care provider
    4. Inform the client's family member
    1. It has no P waves
    2. There is no movement of the heart
    3. The heart is not pumping blood
    4. It has a sawtooth P waves
    5. The PR interval is more than 0.20 seconds

    Author of lecture Asystole (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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