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Basic Dysrhythmia &Recording ECG

Basic Dysrhythmia &Recording ECG. Kamlya balgoon 2009. Ventricular Rhythms. General characteristics Wide QRS. NO P wave Mostly very fast Could be Lethal . Ventricular Rhythms. Premature Ventricular Contraction ( PVC ) Ventricular Tachycardia ventricular Fibrillation ( V-tach.)

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Basic Dysrhythmia &Recording ECG

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  1. Basic Dysrhythmia &Recording ECG Kamlya balgoon 2009

  2. Ventricular Rhythms • General characteristics • Wide QRS. • NO P wave • Mostly very fast • Could be Lethal kemo 2009

  3. Ventricular Rhythms • Premature Ventricular Contraction ( PVC ) • Ventricular Tachycardia • ventricular Fibrillation ( V-tach.) • No electrical Activity ( Asystole ) kemo 2009

  4. 1- Premature Ventricular Contraction ( PVC ) • It impulse start ventricle before next normal sinus impulse • Premature = comes early with bizarre shape. • Most of the time accompany sinus rhythm. PVCs ( early, wide and bizarre) kemo 2009

  5. PVCs … continued Multifocal ( different shape ) kemo 2009

  6. Premature Ventricular Contraction ( PVC ) Unifocal kemo 2009

  7. PVCs … continued 3- Couplets ,tow in arow pair Couplets kemo 2009

  8. PVCs … continued 4- Bigeminy every other beat is PVC kemo 2009

  9. PVCs … continued 5- Trigeminy every third complex is PVC kemo 2009

  10. Premature Ventricular Contraction ( PVC ) • Ventricle & a trial rate : depend on rhythm • Ventricle & a trial rhythm : irregular due to early QRS creating PR interval is shorter • QRS shape & duration : duration 0.12 second or more . Bizarre , abnormal shape • P wave shape : visibility p wave depend time of PVC may absent or in front QRS • P-R interval : less than 0,12 second • Each P followed by a QRS • P: QRS ratio : 0 :1 , 1 :1 kemo 2009

  11. 2- Ventricular Tachycardia( V-tach.) • It three or more PVC in arow • A whole strip with PVCs. • No P waves. • If there is no pulse, it is lethal • Always check the Pulse and BP kemo 2009

  12. Ventricular Tachycardia( V-tach.) • Ventricle & a trial rate : ventricle rate 100 – 200beats /m • QRS shape & duration : duration 0.12 second or more . • P wave shape : very difficult to detect • P-R interval : very irregular if see p wave • Each P followed by a QRS • P: QRS ratio : more QRS then p wave kemo 2009

  13. Ventricular Tachycardia( V-tach.) Treatment • lidocaine • Synchronized cardioversion kemo 2009

  14. 3- ventricular Fibrillation • No P waves, No QRS, only electrical activity present. • Lethal, always check Pulse and BP kemo 2009

  15. ventricular Fibrillation • Ventricle rate ; greater than 300 per mint • Ventricle rhythm : irregular • QRS shape & duration irregular kemo 2009

  16. No electrical Activity( Asystole) • No QRS, no electrical activity, • P waves may present. • No heart rate ,pulse kemo 2009

  17. Thank you kamlya kemo 2009

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