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Ventricular Dysrhythmias, Asystole and Paced Rhythms

Objectives. Discuss where ventricular arrhythmias originateList characteristics of each ventricular rhythmExplain how to interpret ventricular arrhythmias on an ECG strip. DysrhythmiasVentricular Escape Complexes and RhythmsAccelerated Idioventricular RhythmPremature Ventricular ContractionsV

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Ventricular Dysrhythmias, Asystole and Paced Rhythms

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    1. Ventricular Dysrhythmias, Asystole and Paced Rhythms

    2. Objectives Discuss where ventricular arrhythmias originate List characteristics of each ventricular rhythm Explain how to interpret ventricular arrhythmias on an ECG strip

    3. Dysrhythmias Ventricular Escape Complexes and Rhythms Accelerated Idioventricular Rhythm Premature Ventricular Contractions Ventricular Tachycardia Related Dysrhythmia Ventricular Fibrillation Asystole Artificial Pacemaker Rhythm Dysrhythmias Originating in the Ventricles

    4. Origin Ventricular arrhythmias originate in the ventricles below the bundle of HIS They occur when electrical impulses depolarize the myocardium using a different pathway from normal impulses the atrium does not depolarizes and atrial kick is lost decreasing CO May be benign but are potentially lethal because they are ultimately responsible for CO

    5. Premature Ventricular Contractions Etiology Single ectopic impulse resulting from an irritable focus in either ventricle. Causes may include myocardial ischemia, increased sympathetic tone, hypoxia, idiopathic causes, acid–base disturbances, electrolyte imbalances, or as a normal variation of the ECG. May occur in patterns Bigeminy, trigeminy, or quadrigeminy. Couplets and triplets. Dysrhythmias Originating in the Ventricles

    6. Premature Ventricular Contractions Clinical Significance Malignant PVCs More than 6/minute, R on T phenomenon, couplets or runs of ventricular tachycardia, multifocal PVCs, or PVCs associated with chest pain. Ventricles do not adequately fill, causing decreased cardiac output. Dysrhythmias Originating in the Ventricles

    7. Premature Ventricular Contractions Treatment Non-malignant PVCs do not usually require treatment in patients without a cardiac history. Cardiac patient with nonmalignant PVCs . Administer oxygen and establish IV access Malignant PVCs: Lidocaine 1.0 –1.5 mg/kg IV bolus. If PVCs are not suppressed, repeat doses of 0.5-0.75 mg/kg to max dose of 3.0 mg/kg. If PVCs are suppressed, administer lidocaine drip 2–4 mg/min. Reduce the dose in patients with decreased output or decreased hepatic function and patients > 70 years old. Dysrhythmias Originating in the Ventricles

    8. Dysrhythmias Originating in the Ventricles

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