Cardiac Rhythm Interpretation Flashcards
Placement of Five lead EKG
White- RA
Black- LA
Red- LL
Green RL
Brown close to heart- 4th intercoastal space
P wave
upright
firing of SA node
Atrial depolarization and contraction
PR interval
normal interval is 0.12-0.20
QRS
ventricular depolarization and contraction
normal interval 0.06-0.12
commonly viewed in lead 2
RT on T phenomonon
abnormal impulse of sufficient electrical strength that trigger prematurely or late
can result in life threatening dysrhythmia’s ( vtach, Vfib, torsade’s)
if t wave is flattened it can mean
hypokalemia, ischemia
if T wave is inverted
ischemia
if T wave is peaked/tall
hyperkalemia
ST segment elevation or depression means
MI or ischemia
normal QT interval
< 0.40 seconds
NSR
Regular rhythm
rate 60-100
p precedes each QRS
PR interval 0.12-.0.20
QRS duration 0.06-0.12
common causes of dysrhytmia’s
FE imbalances
MI/ ischemia
hypoxia
failure of conduction system
drugs/ toxins
hypo/ hyperthermia
toxins
cardiac Tamponade
tension pneumothorax
sinus tachycardia
Atrial and ventricular rates >100
regular rhythm
normal PR and QRS duration
tachycardias
narrow complex with wide QRS > 0.12 seconds
VTACH incompatible with life
common causes of tachycardia
dehydration
blood loss
hypoxia
PE
Panic attack/ Anxiety
Pain
Fever
Cocaine/ Heroin/ Meth
Hyperthyroidism
Acute MI
Acute HF
Shock
sinus bradycardia
rate <60 bpm
everything else is normal
when do you treat bradycardia?
only when symptomatic
symptoms include hypotension, dizziness, syncope, SOB, CP, Altered mental status, decreased LOC
how do you treat symptomatic bradycardia
determine cause
increase CO
IV atropine
IV dopamine or epinephrine
if meds don’t work transcutaneous pacemaker
emergent transvenous pacemaker
adverse effects of atropine
widened QRS
large dilated pupils, urinary retention
SVT/VTACH
dry mouth, blurry vision, vasodilation, flushing
sinus arrythmia
irregular rhythm
everything else is normal
