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Diploma Paramedic Science > ECGs > Flashcards

ECGs Flashcards

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1
Q

1st Degree Heart Block

A

1st Degree Heart Block

  • PR equal to or longer than 5 small boxes/1 large box
  • Most straight forward - everything about the ECG will be completely normal
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2
Q

Asystole

A

Asystole

Dead, non shockable

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3
Q

Supra Ventricular Tachycardia (SVT)

A

Supra Ventricular Tachycardia

  • No P wave, heart overworked, try val salva (to stimulate vagal nerve)
  • HR above 150bpm
  • Umbrella term for all tachycardia rhythms that originate above the ventricals
  • Specific cause and diagnosis complex & the differentiation won’t change your pre-hospital treatment
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4
Q

Ventricular Fibrillation

A

Ventricular Fibrillation

  • Quivering heart, no pulse/no rhythm - shockable
  • Don’t need to check for a pulse
  • 3 types - course, fine, very fine
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5
Q

Atrial Fibrillation

A

Atrial Fibrillation

  • No P wave, atrium not firing properly, asymptomatic or symptomatic
  • no pre-hospital drugs to correct
  • may suffer from symptoms such as rate related chest pain if they present with Rapid Atrial Fibrillation (rates over 100bpm)
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6
Q

2nd Degree Heart Block Type 1

A

2nd Degree Heart Block Type 1

  • Longer longer drop
  • Prolonged PR interval over 5 small boxes/1 large box (0.20 secs) which gets longer and longer with each conduction until there is a ‘skipped’ or ‘missed’ QRS complex
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7
Q

Premature Ventricular Contraction

A

Premature Ventricular Contraction

‘Extra Heart Beat”, a concern if consistent

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8
Q

ECG - The 6 Second Method

A

ECG - The 6 Second Method

Get 6 seconds of ECG tracing (ie 30 big boxes) and count the number of R waves that appear within that 6 second period and multiply by 10

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9
Q

Right Bundle Branch Block

A

Right Bundle Branch Block

  • Lead V1 Big ‘M’ shape (goes up/down twice)
  • Do not require pre-hospital management
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10
Q

Pulseless Electrical Activity (PEA)

A

Pulseless Electrical Activity (PEA)

  • Electrical activity, but no pulse, continue CPR
  • Generally PEA rhythms will appear as Sinus Rhythm but can present as any rhythm
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11
Q

Shockable Rhythms

A

Shockable Rhythms Ventricular

  • Fibrillation (VF)
  • Pulseless Ventricular Tachycardia (Pulseless VT)
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12
Q

Sinus Tachycardia

A

Sinus Tachycardia

  • ‘Normal’ fast heart rate, >100bpm
  • Reassure pt to calm and decrease HR
  • Unless SVT, no clinical way to improve HR
  • Consider other symptoms linked to tachycardia that you can treat eg low BP
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13
Q

Reading the ECG

A

Reading the ECG

  1. Rate - HR (6 Second/300 or 1500 method) and strength (palpate radial or corotid pulse)
  2. Rhythm - regular, irregular regular (irregular rhythm on regular basis), irregularly irregular (all over the place)
  3. P Wave - present, before every QRS, smooth, upright, rounded
  4. PR Interval - 3-5 small boxes (short = electrical signal too fast)
  5. QRS Complex - upright, 1.5 - 3 small boxes
  6. T Wave - after every QRS, upright tall, no more than 1/3 height of R Wave
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14
Q

Left Bundle Branch Block

A

Left Bundle Branch Block

  • V6 Bunny ears (double R wave)
  • Do not require pre-hospital management
  • A new presentation can be an indication of an Acute Myocardial Infarction
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15
Q

Atrial Flutter

A

Atrial Flutter

  • ‘Shark Teeth’, stomach butterflies in the heart
  • No treatment required pre-hospitalisation
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16
Q

ECG - The 1500 Method

A

ECG - The 1500 Method

Count how many small boxes there are between 2 R waves and divide that number into 1500 eg 1500/8 small boxes = 187.5bpm

17
Q

3rd Degree Heart Block

A

3rd Degree Heart Block

  • Random P wave and QRS complexes with no correlation between them
  • No communication between atriams and ventricals
  • Complete block through the AV node
18
Q

Ventricular Tachycardia (Pulseless/with Pulse)

A

Ventricular Tachycardia (Pulseless/with Pulse)

  • QRS complexes wide and bizarre
  • ventricals running riot, can shock if pulseless
  • In the ventricals so not SVT
19
Q

2nd Degree Heart Block Type 2

A

2nd Degree Heart Block Type 2

  • Dropped QRS
  • PR interval always the same length which may vary from pt to pt, but will be consistent
20
Q

ECG Lead Views

A

ECG Lead Views

21
Q

NSTEMI

A

NSTEMI

  • ‘ST Depression’
  • Partial thickness infarction
22
Q

Sinus Bradycardia

A

Sinus Bradycardia

  • ‘Normal’ slow heart rate, <60bpm
  • Requires close monitoring to ensure brain is receiving adequate blood supply
  • No drugs in current scope to treat
23
Q

STEMI

A

STEMI ‘ST Elevation’

  • Sudden onset of crushing chest pain
  • Full thickness infarction
24
Q

Sinus Rhythm

A

Sinus Rhythm

‘Normal’

25
Q

ECG - The 300 Method

A

ECG - The 300 Method

Count how many large boxes there are between 2 R waves and divide that number into 300 eg 300/3.5 large boxes = 85.71bpm

26
Q

The ECG Times/Boxes

A

The ECG Times/Boxes

PR Interval = 0.12 - 0.2 secs (3-5 small boxes)
QRS Duration = 0.08 -0.10 secs (2-3 small boxes)
QT Interval = 0.4 - 0.43 secs (2 large boxes)
RR Interval = 0.6 - 1.0 secs (3-5 large boxes)

Diploma Paramedic Science (8 decks)

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