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ACLS Rhythms Cheat Sheet

ACLS Rhythms Cheat Sheet. Amanda Hooper 2008-2009. Normal Sinus Rhythm. Arrest Rhythms. Asystole PEA Vfib / pulseless Vtach. Agonal Rhythm/Asystole. Pulseless Electrical Activity (PEA). Note that PEA can look like any rhythm (any organized electrical activity), but if no pulse it is PEA.

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ACLS Rhythms Cheat Sheet

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  1. ACLS Rhythms Cheat Sheet Amanda Hooper 2008-2009

  2. Normal Sinus Rhythm

  3. Arrest Rhythms Asystole PEA Vfib/pulselessVtach

  4. Agonal Rhythm/Asystole

  5. Pulseless Electrical Activity (PEA) Note that PEA can look like any rhythm (any organized electrical activity), but if no pulse it is PEA

  6. Course Ventricular Fibrillation

  7. Fine Ventricular Fibrillation

  8. Non-Arrest Rhythms

  9. One very important thing that seems like it should be easy but I always have to remember how to do: determine the rate… • Find a QRS complex that is closest to a dark vertical line. Then count the number of “big boxes” until the next QRS complex. For each “big box” you pass, select the next number off the mnemonic "300-150-100-75-60-50" to estimate the rate. • Alternatively, you can count the number of big boxes between two QRS complexes and divide 300 by that number.

  10. Sinus Tachycardia Note the rate is > 100 bpm

  11. Atrial Fibrillation Note it is “irregularly irregular” and there are no definite p waves

  12. Atrial flutter Note the “saw-tooth” pattern

  13. Reentry Supraventricular Tachycardia This is a regular, narrow complex tachycardia without P waves, usually with a sudden onset and cessation

  14. Monomorphic Ventricular Tachycardia With ventricular rhythms, QRS is usually wide. V tach is more organized electrical activity than v fib, but v tach often deteriorates into v fib so both are very bad!

  15. Polymorphic Ventricular Tachycardia

  16. Torsades de Pointes A special type of polymorphic Vtach- Note the “spindling” in the QRS complexes

  17. Sinus Bradycardia Note the rate <60 bpm. Could be physiologic or symptomatic depending on the patient.

  18. 1st Degree AV Block Note the increased PR interval

  19. 2nd Degree AV Block: Mobitz type I (Wenckebach) Note the progressive lengthening of the PR interval until one P wave (arrow) is not followed by a QRS

  20. 2nd Degree Block: Mobitz type II Note the regular PR interval until beats are dropped.

  21. 3rd Degree AV Block Note the regular P waves and regular ventricular “escape beats” but no relationship between the P waves and escape beats.

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