basic EKG and arrhythmia treatment Flashcards
inherent rates
SA node: 60-100 (full electricity)
AV node: 40-60 (generator)
Ventricles: 20-40 (candles)
polarization
“ready” or resting state
depolarization
“firing” state or contraction
repolarization
return to “rest”
impulse formation: cardiac cells
2 types:
Myocardial cells: cause muscle to contract
Pacemaker cells: specialized cells of the conduction system which generate and conduct the electrical impulses (generate electrical pulses to tell myocardial cells to contract)
lead II
best for learning EKG
all strips we learned are lead II
12 lead EKG is used for
diagnosis
telemetry monitoring
-ability to watch a prsons heart rate and rhythm from a distance
-assists in rapidly diagnosing dysrhythmias, ischemia, and infarction
-Two types: central monitoring (observes groups of pts)
storage monitoring (detection and storage of data that is retrieved later)
EKG paper
horizontal= time vertical=voltage one small box=0.04 secs and 1mm one large box is 0.2 secs and 5mm 5 large boxes= 1 sec
irregular rhythms
have to cheat to get rate
for every 6 # of QRS (or Pwaves) X 10
not cheating way to count rhythm
300/ # of large boxes
1500/ # of small boxes
QRS
ventricular contraction
atrial relaxation
P wave
atrial contraction
PR interval
SA node fires
- Atrial contraction
- impulse movement to AV node
Twave
ventricular relaxation
Waveform analysis
rate: fast or slow
rhythm: regular/irregular
P wave: present? upright?
PR interval: 0.12-0.20 secs
QRS wave:
Normal sinus rhythm
Rhythm: regular Rate:60-100 P Waves:present/upright, w/QRS PRI: 0.12-0.2 QRS:
sinus pause/arrest
Rhythm: unpredictable Rate: 80 or less P Waves: present/upright, W/QRS, underlying rhythm PRI:0.12-0.2 QRS:
sinus bradycardia
Rhythm: regular Rate: less than 60 P Waves: Present/upright, W/QRS PRI:0.12-0.2 QRS:
sinus tachycardia
Rhythm: regular Rate: 100-160 P Waves: Present/upright, W/QRS, riding on Twave PRI: 0.12-0.2 QRS:
premature atrial contractions (PACs)
Rhythm: an early beat Rate:unpredictable P Waves: Present/upright, W/QRS,different shape PRI: 0.12-0.2 QRS:
paroxsysmal atrial tachycardia (PAT)
Rhythm: regular Rate: 150-250 P Waves: present/upright(if seen), w/QRS, rides on T PRI: 0.12-0.2 (if p wave seen) QRS:
atrial fibrillation
Rhythm: irregular Rate: atrial is chaotic, ventricular is variable P Waves: none seen PRI: unable to measure QRS: 100 (uncontrolled Afib) do not have flat isometric line due to quivering atria -grossly irregular -risk for blood clots and PE
junctional EKG waveforms
SA node doesnt work, AV node takes over, rates 40-60
Junctional rhythm
Rhythm: regular
Rate: 40-60
P Waves: Inverted before and after QRS, or not seen
PRI:
Premature junctional contractions
Rhythm: an early beat
Rate: unpredictable
P Waves: inverted before & after QRS, or not seen
PRI:
Supraventricular Tachycardia
consists of 4 rhythms: -sinus tachycardia (100-160) -PAT (150-250) -Atrial flutter (250-350) -junctional tachycardia (100-180) -each is treated differently (flutter=more p waves than QRS)
Premature Ventricular contraction
Rhythm: an early beat Rate:unpredictable P Waves: none PRI: unable to measure QRS: >0.12 Treatment: amiodarone, lidocaine potassium levels off, does not perfuse anything
bigeminy
PVC
every other beat is a PVC
Trigeminy
every 3rd beat is a PVC
unifocal
PVCs all look alike
-1 hotspot
multifocal
PVCs look different
-more than one hotspot: #of differences= # of hot spots
Ventricular tachycardia (VT)
Rhythm: regular Rate: 150-250 (may be as low as 101) P Waves: none PRI: unable to measure QRS: >0.12 Treatment: defibrillation, epinephrine, vasopressin, amiodarone, lidocaine, magnesium -letha, no pwaves, no BP -Vtach w/ pulse = leftover beats
torsade de pointes
-form of vtach
-monomorphic- defibrillation
polymorphic
ventricular fibrillation (V-fib, VF)
Rhythm: irregular Rate: none P Waves: none PRI: unable to measure QRS: none Treatment: defibrillation, epinephrine, vasopressin, amiodarone, lidocaine, magneium (ACLS) -coarse or fine -ventricles quivering- not contracting, no BP, no perfusion
asystole
Rhythm: none Rate: none P Waves: none PRI: unable to measure QRS: none Treatment: CPR, epinephrine -flat line, nothing moving in heart. -need a copy of strip being flat lined in 2 different eads. ALWAYS check in second lead(couldve fallen off)
