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Name That Rhythm!

Name That Rhythm!. Sinus Bradycardia (SB). Normal except HR<60. V-paced. Spike before the QRS. Clogged blood vessels = i oxygen to the heart = heart attack. Electricity blocked from traveling normally = arrhythmia.

sigourney-emerson
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Name That Rhythm!

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  1. Name That Rhythm!

  2. Sinus Bradycardia (SB) • Normal except HR<60

  3. V-paced Spike before the QRS

  4. Clogged blood vessels = ioxygen to the heart = heart attack Electricity blocked from traveling normally = arrhythmia What’s the Difference Between Heart Blockage & Block?

  5. Idioventricular Rhythm • Ventricular beats, but… at a slow rate Your patient is Going down the Drain if he stays In this rhythm very Long!

  6. Pulseless Electrical Activity (PEA) • Normal rhythm, but… • No Pulse* Gabriel is blowing his horn!! Call Code!

  7. normal longer longer dropped QRS Mobitz I: Wenkebach • PR interval gradually longer until a QRS is dropped • Pattern repeats

  8. Bigeminy • Every second beat is a PVC Geminy Cricket!

  9. Atrial Fibrillation (Afib) • Irregular • No definable P waves unable to count the # of waves

  10. Premature Ventricular Contraction (PVC) • Early ventricular beat

  11. Normal Values Heart Rate: 60-100 beats per minute .12-.20 seconds PR Interval: QRS Interval: < .11 seconds

  12. Couplet

  13. Failure to Capture • Pacer spike is fired, but no beat follows

  14. Blocked QRS Mobitz II • PR interval consistent except some QRS missing Example PR intervals: .16 – B - .16 – B - .16 - .16 - B

  15. Normal Sinus Rhythm (NSR) • Rhythm is normal • Rate normal 60-100 • PR normal .12-.20 • QRS normal < .11

  16. Junctional Rhythm • No P wave or PR < .12

  17. Pause • Period of no electrical activity, then resumes

  18. 6 Beats of VT

  19. QRS look similar in shape Paroxysmal Atrial Tachycardia (PAT) • Sudden rate change > 150 bpm • QRS shape is similar before & after rate change

  20. 1 º AVB PR interval >.20 PR intervals: .24 - .24 - .24 - .24 - .24

  21. Sinus Tachycardia (ST) • Normal except HR >100 bpm

  22. Ventricular Tachycardia (VT) • Ventricular beats (wide QRS’s) • Rate > 150 bpm Call Code!

  23. Sinus Arrhythmia (SA) • Normal except irregular

  24. Asystole • No electrical activity Call Code! My heart may stop if This guy was swimming With me!!!

  25. Trigeminy Every 3rd beat is a PVC

  26. normal normal blocked blocked blocked blocked blocked short 3rd Degree AV Block(3º AVB) Atria & ventricles act independently • Regular P waves • Regular QRS complexes But…P waves and QRS not working together • PR interval varies (but not in Wenkebach pattern) • Harmful -- patient needs a pacemaker soon! Example PR intervals: .14 – B - .20 – B – B - .12 – B - .44 - .32 - B

  27. Torsades de Pointes • A form of VTach which looks like the rhythm strip is twisting Call CODE!

  28. SINUS ATRIAL JUNCTIONAL VENTRICULAR Steps to Interpret Rhythms • 1. Are the beats at regular or irregular intervals apart? • 2. Do you see P, QRS, T pattern? • 3. What is the HEART RATE? • 4. What is the PR interval? • 5. What is the QRS interval?

  29. A-paced A spike before the P wave site

  30. Mobitz II PR regular except some QRS are dropped PR intervals: .12 – B - .12 - .12 – B - .12 – B QRS

  31. Atrial Flutter • Numerous P waves that you can count

  32. Premature Beats PVC PJC PAC Wide QRS PR<.12 PR=.12-.20

  33. Wenkebach PR gradually longer until QRS dropped PR intervals: .12 - .18 - .24 – B - .12 - .18 - .24 – B

  34. Ventricular Fibrillation (VF) • Squiggly line Call CODE!

  35. Failure to Sense • Heart is beating just fine, but pacemaker fires anyway • Spikes are not in a consistent place before P or QRS --seen in many different places

  36. exits enters ST Elevation QRS exits higher than it starts

  37. Wandering Atrial Pacemaker (WAP) • P waves vary in shape (at least 3 different P waves)

  38. 3º AVB PR interval varies, but not in Wenkebach pattern PR intervals: .12 – B - .20 – B – B - .16 - .44 – B - .32

  39. Premature Beats 3 Types Premature AtrialContraction (PAC) Premature JunctionalContraction (PJC) Premature Ventricular Contraction (PVC)

  40. Bundle Branch Blocks (BBB) QRS >.11

  41. AV-paced Spikes before the P wave site & QRS

  42. Premature JunctionalContraction (PJC) • Early beat • No P wave or PR interval is <.12

  43. // A V First Degree AV Block(1º AVB) • PR interval > .20 Example PR intervals: .28 - .28 - .28 - .28 - .28 - .28

  44. enters exits ST Depression QRS exits lower than it starts

  45. QRS look different in shape Paroxysmal Supraventricular Tachycardia (PSVT) • Sudden rate change >150 bpm • QRS may look different after rate change

  46. First Degree 1°AVB • Second Degree • Third Degree 3°AVB Wenkebach Mobitz II Types of AV Blocks

  47. Premature Atrial Contraction (PAC) • Early beat • Normal PR interval The alarm clock Always goes off PREMATURELY!!

  48. Triplet

  49. Which rhythms are a CODE Blue? • VT • VFib • Asystole • Torsades • PEA

  50. WAY TO GO!You’re catching on!

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