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4 lead ECG Rules/ Practice Flashcards

1
Q

5 Rules to reading 4 Lead ECG ?

A
  1. Rate
  2. Regularity
  3. P Wave 1:1 QRS:P wave ratio
  4. PRI
  5. QRS
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2
Q

Sinus Rhythm

A

Rate 60-100
Regular
P wave: Upright 1:1
PRI 0.12-0.20
QRS 0.10- 0.12 Narrow

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3
Q

Sinus Tachycardia

A

Rate +100 Regular
P wave: Upright 1:1
PRI 0.12-0.20
QRS 0.10- 0.12 Narrow

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4
Q

Sinus bradycardia

A

Rate Less than 60 BPM
Regular
P wave: Upright 1:1
PRI 0.12-0.20
QRS 0.10- 0.12 Narrow

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5
Q

Name the Atrial Rhythms

A
  1. Atrial Pacemaker,
  2. Atrial Flutter
  3. Atrial Fibrillation
  4. Supraventricular Tachycardia
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6
Q

Atrial Pacemaker

WAP/MAT

A

Rate 60-159
Usually Regular
P wave: Varying P wave morphology
QRS:P wave ratio- 1:1
PRI 0.12-0.20
QRS 0.10- 0.12 Narrow

Note:
HR 60-100 Wandering Atrial Pacemaker (WAP)
HR 100+ Multifocal atrial tachycardia (MAT)

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7
Q

Atrial Flutter

A

Rate Any 100+ RVR
Regular or Regularly Irregular
P wave: Flutter (F) wave morphology
QRS:F wave ratio- Varying 1:2 + Ratio
PRI: N/A
QRS 0.10- 0.12 Narrow

Note: Over 100+ HR is Atrial Flutter with RVR
Over HR 150+ Normally need treatment

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8
Q

Atrial Fibrillation

A

Rate Any 100+ RVR
Irregularly Irregular
P wave: Fibrillation-Waving baseline
PRI: N/A
QRS 0.10- 0.12 Narrow

Note: Over 100+ HR is Atrial Fibrillation with RVR
Over HR 150+ Normally need treatment

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9
Q

Supraventricular Tachycardia

A

Rate HR +150
Very Regularly Regular
P wave:Upright or hidden in the T wave 1:1 Ratio
PRI: 0.12 -0.20
QRS 0.10- 0.12 Narrow

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10
Q

What are the Ventricular Rhythms?

A
  1. Ventricular escape rhythm,
  2. Accelerated idioventricular rhythm,
  3. Ventricular tachycardia (Mono/Poly),
  4. Ventricular Fibrillation
  5. Asystole
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11
Q

Ventricular escape rhythm
(Idioventricular Rhythm)

A

Rate Under 40 BPM
Regular
P wave:No P Waves
PRI: N/A
QRS Over 0.12 Wide

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12
Q

Accelerated idioventricular rhythm

A

Rate 40 -100 BPM
Regular
P wave:No P Waves
PRI: N/A
QRS Over 0.12 Wide

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13
Q

Ventricular tachycardia

A

Rate Over 100 BPM
Regular
P wave:No P Waves
PRI: N/A
QRS Over 0.12 Wide

Run of VT - is 4 or more beats with wide QRS
Monopohmic- One waveform
Polymophic -Variable QRS morphology-Torsades de Pointes

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14
Q

Ventricular Fibrillation

A

Rate Not Discernible
N/A
P wave:No P Waves
PRI: N/A
QRS Not Discernible -Waving basline

Base line of Fibrillation

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15
Q

Asystole/Agonal

A

Rate Not Discernible
N/A
P wave:No P Waves
PRI: N/A
QRS Not Discernible - Flat line or P waves

P wave Asystole - Just P wave no QRS

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16
Q

Pulseless electrical activity (PEA)

A

Pulseless electrical activity occurs when a patient has cardiac electrical activity but no pulse.

Use of cardiac ultrasound,auscultation heart tone, and Arterial Line waveforms can be used at tool to assess for PEA .

17
Q

What are the AV Blocks?

A
  1. 1st Degree AV Block
  2. 2nd Degree Type 1 AV Block
  3. 2nd Degree Type 2 AV Block
  4. 3rd Degree AV Block
18
Q

1st Degree AV Block

A

PR interval +0.20 every time/ Same PRI with every beat

Rhythm otherwise identical to underlying rhythm

19
Q

2nd Degree Block – Type I

A

Other names Wenkebach or Mobitz I

PRI varying “ long longer Drop” with a droped QRS Complexs

20
Q

2nd Degree Block – Type II

A

Other name Mobitz II

Same PRI with a droped QRS Complexs

21
Q

3rd Degree Block

A

Complete heart block
P wave are dissortited with the QRS complexs
Regular P wave and QRS
QRS Wide

22
Q

What are the Junctional Rhythms?

A
  1. Junctional Rhythms
  2. Accelerated Junctional
  3. Junctional Tachycardia
23
Q

Junctional Rhythms

A

Rate 40-60
Very Regularly Regular
P wave: Inverted,Biphasic, Not present 1:1 Ratio
PRI: Narrow less than 0.12
QRS 0.10- 0.12 Narrow

24
Q

Accelerated Junctional

A

Rate 60-100
Very Regularly Regular
P wave: Inverted,Biphasic, Not present 1:1 Ratio
PRI: Narrow less than 0.12
QRS 0.10- 0.12 Narrow

25
Q

Junctional Tachycardia

A

Rate Over 100 Bpm
Very Regularly Regular
P wave: Inverted,Biphasic, Not present 1:1 Ratio
PRI: Narrow less than 0.12
QRS 0.10- 0.12 Narrow

26
Q

What are the Premature Contractions?

A
  1. Premature Atrial Contraction (PAC)
  2. Premature Junctional Contraction (PJC)
  3. Premature Ventricular Contraction (PVC)
27
Q

Premature Atrial Contraction (PAC)

A

Premature beat with narrow QRS and narrow/normal PRI with diffrent morphology

Morphologically like a sinus or atrial beat, but is out-of-place with regards to rhythm. P wave may look different from the others

28
Q

Premature Junctional Contraction (PJC)

A

Premature beat with a narrow QRS and a Inverted,absent or biphasic P wave

Looks similar to a sinus beat, but is out-of-place with regards to rhythm and has an inverted, absent, or biphasic P wave

29
Q

Premature Ventricular Contraction (PVC)

A

Premature beat with a wide QRS

Wide, bizarre QRS, out-of-place beat

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