Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download EKGs - KentuckyOne Health
Document related concepts
Heart failure wikipedia , lookup
Hypertrophic cardiomyopathy wikipedia , lookup
Jatene procedure wikipedia , lookup
Cardiac contractility modulation wikipedia , lookup
Ventricular fibrillation wikipedia , lookup
Arrhythmogenic right ventricular dysplasia wikipedia , lookup
Atrial fibrillation wikipedia , lookup
Transcript
Name That Rhythm! Sinus Bradycardia (SB) • Normal except HR<60 V-paced Spike before the QRS What’s the Difference Between Heart Blockage & Block? Clogged blood vessels = ioxygen to the heart = heart attack Electricity blocked from traveling normally = arrhythmia Idioventricular Rhythm • Ventricular beats, but… at a slow rate Your patient is Going down the Drain if he stays In this rhythm very Long! Pulseless Electrical Activity (PEA) • Normal rhythm, but… * No Pulse* Gabriel is blowing his horn!! Call Code! Mobitz I: Wenkebach • PR interval gradually longer until a QRS is dropped • Pattern repeats normal longer longer dropped QRS Bigeminy Every second beat is a PVC Geminy Cricket! Atrial Fibrillation (Afib) • Irregular • No definable P waves unable to count the # of waves Premature Ventricular Contraction (PVC) •Early ventricular beat Normal Values Heart Rate: 60-100 beats per minute PR Interval: .12-.20 seconds QRS Interval: < .11 seconds Couplet Failure to Capture • Pacer spike is fired, but no beat follows Mobitz II • PR interval consistent except some QRS missing Blocked QRS Example PR intervals: .16 – B - .16 – B - .16 - .16 - B Normal Sinus Rhythm (NSR) • • • • Rhythm is normal Rate normal 60-100 PR normal .12-.20 QRS normal < .11 Junctional Rhythm • No P wave or PR < .12 Pause • Period of no electrical activity, then resumes 6 Beats of VT Paroxysmal Atrial Tachycardia (PAT) • Sudden rate change > 150 bpm • QRS shape is similar before & after rate change QRS look similar in shape 1 º AVB PR interval >.20 PR intervals: .24 - .24 - .24 - .24 - .24 Sinus Tachycardia (ST) • Normal except HR >100 bpm Ventricular Tachycardia (VT) • Ventricular beats (wide QRS’s) • Rate > 150 bpm Call Code! Sinus Arrhythmia (SA) • Normal except irregular Asystole • No electrical activity Call Code! My heart may stop if This guy was swimming With me!!! Trigeminy Every 3rd beat is a PVC 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! blocked normal blocked blocked short blocked normal blocked Example PR intervals: .14 – B - .20 – B – B - .12 – B - .44 - .32 - B Torsades de Pointes • A form of VTach which looks like the rhythm strip is twisting Call CODE! Steps to Interpret Rhythms 1. Are the beats at regular or irregular intervals apart? 2. Do you see P, QRS, T pattern? SINUS 3. What is the HEART RATE? ATRIAL JUNCTIONAL 4. What is the PR interval? VENTRICULAR 5. What is the QRS interval? A-paced A spike before the P wave site Mobitz II PR regular except some QRS are dropped PR intervals: .12 – B - .12 - .12 – B - .12 – B QRS Atrial Flutter • Numerous P waves that you can count Premature Beats PVC PJC PAC Wide QRS PR<.12 PR=.12-.20 Wenkebach PR gradually longer until QRS dropped PR intervals: .12 - .18 - .24 – B - .12 - .18 - .24 – B Ventricular Fibrillation (VF) • Squiggly line Call CODE! 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 ST Elevation QRS exits higher than it starts exits enters Wandering Atrial Pacemaker (WAP) • P waves vary in shape (at least 3 different P waves) 3º AVB PR interval varies, but not in Wenkebach pattern PR intervals: .12 – B - .20 – B – B - .16 - .44 – B - .32 Premature Beats 3 Types Premature Atrial Contraction (PAC) Premature Junctional Contraction (PJC) Premature Ventricular Contraction (PVC) Bundle Branch Blocks (BBB) QRS >.11 AV-paced Spikes before the P wave site & QRS Premature Junctional Contraction (PJC) • Early beat • No P wave or PR interval is <.12 First Degree AV Block (1º AVB) • PR interval > .20 A // V Example PR intervals: .28 - .28 - .28 - .28 - .28 - .28 ST Depression QRS exits lower than it starts enters exits Paroxysmal Supraventricular Tachycardia (PSVT) • Sudden rate change >150 bpm • QRS may look different after rate change QRS look different in shape Types of AV Blocks •First Degree 1°AVB •Second Degree Wenkebach Mobitz II •Third Degree 3°AVB Premature Atrial Contraction (PAC) • Early beat • Normal PR interval The alarm clock Always goes off PREMATURELY!! Triplet Which rhythms are a CODE Blue? • • • • • VT VFib Asystole Torsades PEA WAY TO GO! You’re catching on!
