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ECG > ECG > Flashcards

ECG Flashcards

1
Q

First Degree Block Always has an underlying rhythm

A 
Regular or Irregular Rhythm
Rate: Varies
P wave: normal, upright, 1:1
PRI: >0.20 and constant
QRS: <0.12
QT: < 1/2 of the R-R interval
TREAT THE CAUSE
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2
Q

Second Degree Heart Block - Mobitz I/Wenckebach

A 
Rhythm is ALWAYS IRREGULAR
Rate: varies
P wave: More P's than QRS, upright
PRI: lengthens until QRS complex is dropped
QRS: <0.12
TREAT THE CAUSE
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3
Q

Second Degree Heart Block - Mobitz II FIXED

A

Rhythm is ALWAYS REGULAR
Rate: varies
P wave: More P’s than QRS, upright
PRI: constant
QRS: <0.12
Treatment: NO mechanical treatment
Pharmacological: Dopamine drip 400mg/250 mL start at
5-20 mcg/kg/min
Epinephrine drip 4mg/250 mL start at 2-10 mcg/min
Electrical treatment: TCP Transcutaneous Pacemaker

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4
Q

Second Degree Heart Block - Mobitz II Variable

A

Rhythm is ALWAYS IRREGULAR
Rate: varies
P wave: More P’s than QRS, upright
PRI: constant
QRS: <0.12
QT: <1/2 RR interval
Treatment: NO mechanical treatment
Pharmacological: Dopamine drip 400 mg/250 mL start at
5-20 mcg/kg/min
Epinephrine drip 4mg/250 mL start at 2-10 mcg/min
Electrical: TCP transcutaneous pacemaker

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5
Q

COMPLETE HEART BLOCK (lethal rhythm)

A

Rhythm is ALWAYS REGULAR
Rate: varies depending on focus
ventricular focus 20-40
junctional focus 40-60
P wave: varies is NOT constant and DOES NOT lengthen
Treatment: NO mechanical treatment
Pharmacological: Dopamine drip 400 mg/250 mL start at
5-20 mcg/kg/min
Epinephrine drip 4mg/250 mL start at 2-10 mcg/min
Electrical treatment: TCP transcutaneous pacemaker

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6
Q

TORSADES (lethal rhythm)

A 
Rhythm is irregular
NO P wave
NO PRI
Rate could be 101-150
Looks like an hour glass shape on EKG
Treatment: Mechanical treatment is CPR
Pharmacological: Epinephrine 1 mg IV push every 3-5 mins. NO MAX.
Magnesium 1-2 g over 1 -2 mins
Amiodarone 300 mg 1st dose; 2nd dose 150 mg.
Max 2.2 g/24 hr
Electrical: defibrillate
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7
Q

VENTRICULAR FIBRILLATION (lethal rhythm)

A

Never has pulse!
Chaotic
Treatment: mechanical treatment is CPR
Pharmacological: Epinephrine 1 mg IV push every 3-5 mins. NO MAX.
Amiodarone 300 mg IV push 1st dose. 2nd dose is 150 mg. Max of 2.2 g/24 hour

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8
Q

ASYSTOLE

A 
NO electrical activity!
NO P wave
NO PRI
NO QRS
Always check on 2 leads b/c it could be fine V-fib.
Treatment: mechanical treatment is CPR
Pharmacological: Epinephrine 1 mg every 3-5 mins. No MAX.
Electrical: NONE
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9
Q

PULSELESS ELECTRICAL ACTIVITIY (PEA) lethal

A

Can be any rhythm w/ electrical impulse but NO mechanical contraction. NO pulse beat.
Treatment: mechanical is CPR
Pharmacological: epinephrine 1 mg every 3-5 mins.
NO MAX.
Electrical: NONE

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10
Q

Premature Ventricular Complex

A 
Regular rhythm EXCEPT where PVCs are
Rate: varies. DO NOT count PVCs in rate
P wave: varies
QRS: 0.12 or greater; usually wide and bizarre
T wave goes in OPPOSITE direction of QRS
TREAT THE CAUSE! NOTIFY MD
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11
Q

IDIOVENTRICULAR RHYTHM (IVR) lethal

A 
Rhythm is REGULAR
Rate: 20-40
NO P wave
NO PRI
QRS: wide 0.12 or greater
Treatment: mechanical is CPR
Pharmacological: epinephrine 1 mg IV push every 3-5 mins. NO MAX>
Electrical: NONE b/c impulse is coming from ventricles and already 20-40.
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12
Q

Accelerated Idioventricular Rhythm

A 
Rhythm is REGULAR
Rate: 41-100
NO P wave
NO PRI
QRS: 0.12 or greater
NO TREATMENT
usually benign. AIVR is perfusion of heart
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13
Q

VENTRICULAR TACHYCARDIA

A 
Rhythm is REGULAR
Rate: >100 (101-150)
NO P wave
NO PRI
QRS: 0.12 or greater
If PULSE then treatment is:
NO mechanical
Pharmacological: Amiodarone drip 150 mg in 100 mL D5W over 10 mins. Max is 2.2 g/24 hr.
Electrical: Cardioversion
If PULSELESS then treatment is:
Mechanical: CPR
Pharmacological: Epinephrine 1 mg IV push every 3-5 mins. NO MAX.
Amiodarone 300 mg IV push 1st dose. 2nd dose is 150 mg. Max of 2.2 g/24 hr
Electrical: Defribillate
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14
Q

Sinus Arrhythmia

A 
Rhythm is IRREGULAR
Rate: varies
P wave: normal, upright, 1:1
PRI: normal 0.12 to 0.20
QRS: normal <0.12
QT: normal 1/2 RR interval
NO TREATMENT
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15
Q

TREATMENT
Mechanical: NONE
Pharmacological:
>Atropine 1 mg every 3-5 min. Max of 3 mg.
>Dopamine drip 400 mg/250 mg start at 5-20
mcg/kg/min.
>Epinephrine drip 4mg/250 mg start at 2-10 mcg/ min.
Electrical: TCP transcutaneous pacemaker

A

SINUS BRADYCARDIA
SINUS ARREST
SINUS BLOCK
JUNCTIONAL ESCAPE

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16
Q

TREAT THE CAUSE!

A 
FIRST DEGREE BLOCK
SECOND DEGREE BLOCK MOBITZ 1 WENCKEBACH
PREMATURE VENTRICULAR COMPLEX (PVC)
SINUS TACHYCARDIA
ACCELERATED JUNCTIONAL
PREMATURE ATRIAL COMPLEX
17
Q

TREATMENT
Mechanical: Vagal maneuver if stable
Pharmacological: Adenosine 6 mg rapid IV push, wait 1-2 mins then 12 mg rapid IV push. MAX of 18 mg.
Electrical: cardioversion IF UNSTABLE

A

SUPRAVENTRICULAR TACHYCARDIA

JUNCTIONAL TACHYCARDIA

18
Q 
TREATMENT
Mechanical: no mechanical
Pharmacological: Cardizem/Beta Blockers
Anticoagulant: Heparin/Lovenox
Electrical: Cardioversion if unstable
A

ATRIAL FLUTTER

19
Q

TREATMENT
Mechanical: CPR
Pharmacological: Epinephrine 1 mg IV push every 3-5 mins. NO MAX.
Electrical: NONE

A

ASYSTOLE
IVR
PEA

20
Q

TREATMENT
Mechanical: CPR
Pharmacological: Epinephrine 1 mg IV push every 3-5 mins. NO MAX.
>Amiodarone 300 mg IV push 1st dose. 2nd dose 150 mg. Max of 2.2 g/24 hr
Electrical: defibrillate

A

VENTRICULAR FIBRILLATION - VF

PULSELESS VENTRICULAR TACHYCARDIA - VT

21
Q

OBSERVE

A

PREMATURE JUNCTIONAL COMPLEX

NORMAL SINUS RHYTHM

22
Q

TREATMENT
Mechanical: NONE
Pharmacological: Amiodarone drip 150 mg in 100 mL D5W over 10 min. Max 2.2 g/ 24 hr
Electrical: CARDIOVERSION IF UNSTABLE

A

VENTRICULAR TACHYCARDIA WITH A PULSE

23
Q 
TREATMENT
Mechanical: CPR
Pharmacological: Epinephrine 1 mg every 3-5 mins.
NO MAX.
Magnesium 1 -2 g over 1 -2 mins
Amiodarone 300 mg IV push 1st dose
2nd dose 150 mg
Max of 2.2 g/24 hr
Electrical: Defibrillate
A

TORSADES

ECG (1 decks)

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