Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download PowerPoint Presentation - McGraw Hill Higher Education
Transcript
5 Regularity Fast & Easy ECGs, 2nd E – A SelfPaced Learning Program Fast & Easy ECGs, 2E 1 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Rhythm • Another initial step of analyzing an ECG rhythm is determining its rhythm or regularity Q Fast & Easy ECGs, 2E 2 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Rhythm • Normally the heart beats in a regular, rhythmic fashion I Fast & Easy ECGs, 2E 3 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Rhythm • Irregularities in the heart rhythm are considered abnormal and can indicate serious conditions or deteriorate into deadly cardiac dysrhythmias Fast & Easy ECGs, 2E 4 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Determining Regularity • The regularity of a rhythm can be determined by looking at the R-R intervals and P-P intervals Fast & Easy ECGs, 2E 5 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Determining Regularity • If the distance of the R-R intervals and P-P intervals is the same the rhythm is regular I Fast & Easy ECGs, 2E 6 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Determining Regularity • If the distance differs, the rhythm is irregular Fast & Easy ECGs, 2E 7 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Determining Regularity • Several methods can be used to determine rhythm regularity including: – Paper and Pen Method – Caliper Method – Counting the Small Squares Method I Fast & Easy ECGs, 2E 8 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Paper and Pen Method • Simple and quick and requires no special tools. To perform: – Place the straight edge of a piece of paper above or over the ECG tracing so that the intervals are still visible – Identify a starting point and place a mark on paper in the corresponding position above it – Find peak of the next consecutive R wave or P wave and place a mark on the paper in the corresponding position above it. – Move the paper across the ECG tracing, aligning the two marks with succeeding R-R intervals or PP intervals I Fast & Easy ECGs, 2E 9 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Caliper Method • Requires special, easy to use tool. To perform: – Place ECG tracing on a flat surface – Position one point of caliper on a starting point – Open calipers by pulling the other leg until the point is positioned on the next R wave or P wave – With the calipers open in that position and keeping the point positioned over the second P wave or R wave rotate the calipers across to the peak of the next consecutive P waves or R waves I Fast & Easy ECGs, 2E 10 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Counting the Small Squares Method • Requires no special tools but is time consuming. To perform: – Count the number of small squares between the peaks of two consecutive R waves (or P waves) and then compare to the other R-R (or P-P) intervals – If the number is the same, the rhythm is regular, if it isn’t it is irregular I Fast & Easy ECGs, 2E 11 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Practice Makes Perfect • For this tracing, determine if the rhythm is regular or irregular I Fast & Easy ECGs, 2E 12 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Practice Makes Perfect • For this tracing, determine if the rhythm is regular or irregular I Fast & Easy ECGs, 2E 13 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Practice Makes Perfect • For this tracing, determine if the rhythm is regular or irregular I Fast & Easy ECGs, 2E 14 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Types of Irregularity • An irregularity in the rhythm can range from being occasionally irregular to being totally irregular I Fast & Easy ECGs, 2E 15 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Occasionally Irregular • An occasionally irregular rhythm is mostly regular but from time to time there is an area of irregularity I Fast & Easy ECGs, 2E 16 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Very Irregular • A very irregular rhythm has many areas of irregularity Fast & Easy ECGs, 2E 17 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Slightly Irregular • May appear to change only slightly as the P-P intervals and R-R intervals vary just a bit • One cause is a pacemaker that changes location from site to site Q Fast & Easy ECGs, 2E 18 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Sudden Changes in Heart Rate • A normal rate that suddenly accelerates to a rapid rate or slows abruptly produce an irregularity in the rhythm Fast & Easy ECGs, 2E 19 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Totally Irregular • There is no consistency to the irregularity I Fast & Easy ECGs, 2E 20 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Patterned Irregularity • Also referred to as regularly irregular, this type of regularity repeats itself in a cyclic fashion Fast & Easy ECGs, 2E 21 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Varying Conduction Ratio Irregularity • Is seen when the number of atrial impulses preceding the ventricular impulses varies I Fast & Easy ECGs, 2E 22 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Practice Makes Perfect • For this tracing, determine the regularity I Fast & Easy ECGs, 2E 23 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Practice Makes Perfect • For this tracing, determine the regularity I Fast & Easy ECGs, 2E 24 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Practice Makes Perfect • For this tracing, determine the regularity I Fast & Easy ECGs, 2E 25 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Practice Makes Perfect • For this tracing, determine the regularity I Fast & Easy ECGs, 2E 26 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Practice Makes Perfect • For this tracing, determine the regularity I Fast & Easy ECGs, 2E 27 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Summary • Determining regularity is an initial step of analyzing an ECG rhythm • Irregular rhythms are considered abnormal and can be caused by a variety of conditions • If the distance of the R-R intervals or P-P intervals is the same, the rhythm is regular – if the distance differs, the rhythm is irregular Fast & Easy ECGs, 2E 28 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Summary • Several methods can be used to determine rhythm regularity, including using calipers, marking a paper with a pen, and counting the small squares between each R-R interval • Irregularity may be occasionally irregular, very irregular, or slightly irregular • A normal rate that suddenly accelerates to a rapid rate or slows suddenly produces an irregular rhythm Fast & Easy ECGs, 2E 29 © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Summary • A totally irregular rhythm has no consistency to the irregularity • Patterned irregularity is where the irregularity repeats in a cyclic fashion • Irregularity can also be seen in dysrhythmias that have a varying atrial-to-ventricular conduction ratio Fast & Easy ECGs, 2E 30 © 2013 The McGraw-Hill Companies, Inc. All rights reserved.
