AV Blocks Flashcards
What are considered advanced heart blocks?
2nd degree type 2 and 3rd degree
What is a 1st degree block
Just delayed conduction from SA to AV node
Hallmarks of 1st degree block
EKG: Prolonger PR interval >0.2 sec
Hallmarks of 2nd degree block type 1
AKA Wenckebach block
- PR gets longer and longer until there is a dropped qrs
- Narrow QRS (issue is above the AV node)
- Only symptomatic if bradycardic <50
Treatment for 2nd degree type 1?
ABCs, IV, O2, Monitor
Just depends:
Brady and unstable: treat with atropine .5mg IV q3-5min
**If that doesn’t work begin transcutaneous pacing
Brady and stable: look for causes
Stable and Normal HR: MEDADIVCE but otherwise good to go
What will a 2nd Degree block type 2 usually end up doing?
Progressing to type 3
- There is definite structural damage to the nodal conduction system
Where is the block in 2nd degree type 2?
Just below AV in bundle of HIS
Hallmarks of 2nd degree type 2?
EKG:
Normal PR interval and then dropped QRS
QRS is more prolonged than normal since disease is below the AV node
- Fatigue, dyspnea, just worsening symptoms
Treatment of 2nd degree type 2?
Transcutaneous pacing
Look for unstable signs (MISHA)
- Atropine .5mg IV
- Dopamine
- EPI
MEDEVAC
Follow on care and disposition of 2nd degree type 2?
MEDEVAC to cardiologist for pacemaker
Electrolyte levels
3rd degree block
COMPLETE HEART BLOCK
Just not getting any solid cardiac output
Hallmarks of 3rd degree heart block
EKG:
Disassociation of P waves and QRS
At the AV node so narrow QRS
- Fatigue, Syncope, worsening symtoms
Treatment for 3rd degree heart block
Same as 2nd degree type 2
Transcutaneous pacing
Unstable:
- Atropine .5mg IV
- Dopamine
- Epi
MEDEVAC
Follow on Care and disposition for 3rd degree?
MEDEVAC
EKG for AMI
Cardiologist for pacemaker
Electrolytes
