Asystole?

Typically, when you think of asystole, you would think of a flat line on the cardiac monitor right? Well, our monitors out on the tele floor are just very sensitive to movement and such, and sometimes, the asystole alarm will ring with a rhythm full of artifact. Unfortunately, the nurses on the floor have become a little complacent because these alarms ring off all of the time for nonserious things. But the other night, it so happened that it rang off for asystole, and this time the rhythm was not full of artifact, but instead looked like there was a slight ventricular beat but that was about it. Being the astute student nurse that I am, I said to the charge nurse.. "hey, this one is for real." I took off immediately for the pt's room to check the pt.

He was arousable, and I immediately checked all of his leads. Got him to sit up on the side of the bed, and finally the charge nurse decides to come down to the room. She asks the other nurse at the monitor was it said now, and they told her that his hr was in the 70's, so she left. (not exactly the best thing to do, but it was her last night at the hospital as she was moving away, so i dunno if she cared?) i got a BP on the man, and it was about where he had been running. I told him that his rhythm had changed and we had to make sure he was ok. I told him to lie on his back or on the other side for a bit and we would be back soon to check on him.

I went up to the desk and got the print out of this rhythm and took it over to the unit for the nurses there to look at. They said that his pacemaker wasn't firing, and that is why his rhythm looked like it did. They asked if he was okay, and I said he seemed fine. I went back in to check on the patient, and he was still sitting at the side of the bed. I checked his leads once again, and when he had moved, his red lead had come off, so I fixed that and let him go back to sleep. There were no further incidents the rest of the night.

Now the man was admitted with vertigo and dizziness. When his pacemaker failed for those 3 minutes, the reasoning behind his symptomology became clear the next day for the doctor who evaluated this occurrence and all of the symptoms he had been having. Luckily, we were able to capture it on the monitor for evaluation. His pacemaker was failing and would need to be replaced. He may not have been a true asystole, but it was a serious incident that will hopefully get these nurses at the tele station to realize that they need to pay much more attention to those monitors. (in my opinion, anyhow).