EKG Flashcards
Regular
Rate Fast (100-250 bpm)
P Wave Absent
PR Interval Not measurable
QRS Wide (>0.12 sec), bizarre appearance
Notes
VTACH Ventricular Tachycardia
May be irregular
Rate Normal (60-100 bpm)
P Wave Changing shape and size from beat to beat (at least three diffferent forms)
PR Interval Variable
QRS Normal less .12 seconds
Notes T wave normal. If heart rate exceeds 100 bpm, then rhythm may be multifocal atrial tachycardia (MAP)
Wandering Pacemaker
Regular
Rate Fast (150-250 bpm)
P Wave Merged with T wave
PR Interval Normal (0.12 sec)
QRS Normal (.12 sec)
Notes PR interval can be difficult to measure
SVT Supra Ventricular Tachycardia
Irregular
Rate The underlying rate
P Wave Absent
PR Interval Not measurable
QRS Wide (> 0.12 sec), bizarre appearance
Notes Two PVCs together are termed a couplet while three PVCs in a row with a fast rhythm is ventricular tachycardia
PVC premature ventricular Contraction
Regular, but atrial and ventricular rhythms are independent
Rate Characterized by Atrial rate usually normal and faster than ventricular rate
P Wave Normal shape and size, may appear within QRS complexes
PR Interval Absent: the atria and ventricles beat independently.
QRS Normal, but wide if junctional escape focus
3rd Degree or Complete AV Block
Regular
Rate Normal (60-100 bpm)
P Wave Normal (positive & precedes each QRS)
PR Interval Normal (0.12-0.20 sec)
QRS Normal less .12 seconds
Normal Sinus Rhythm
Irregular
Rate Usually normal but depends on underlying rhythm
P Wave Premature, positive and shape is abnormal
PR Interval Normal or longer
QRS less .12 seconds QRS will be absent after a non conducted PAC
PAC-Premature Atrial Contraction
Regular
Rate Fast (100-180 bpm)
P Wave Present before, during (hidden) or after QRS, if visible it is inverted
PR Interval Absent or short
QRS Normal less .12 seconds
Junctional Tachycardia
5 steps to Rhythm Interpertation
QRS
QRS Complexes
Are they present? Are they the same shape or does shape very?
Regular
Rate Normal (60-100 bpm)
P Wave Present before, during (hidden) or after QRS, if visible it is inverted
PR Interval Not measurable
QRS Normal less .12 seconds
Accelerated Junctional
Highly irregular
Rate Unmeasurable
P Wave Absent
PR Interval Not measurable
QRS None
Notes EKG tracings is a wavy line
V-FIB Ventricular Fibrillation
Regular
Rate Slow (< 60 bpm)
P Wave Normal
PR Interval Normal (0.12-0.20 sec)
QRS Normal less then .12 seconds
Sinus Brady Cardia
5 steps to Rhythm Interpertation
P waves
Present? Relationship to QRS? Any p’s not followed by QRS? Are all the P’s same shape? Is P-P interval the same?
Regular with premature beats
Rate The underlying rate
P Wave Present before, during (hidden) or after QRS, if visible it is inverted
PR Interval Absent or short
QRS Normal .12 seconds or less
PJC premature junctional contraction
Regular or irregular
Rate Fast (250-350 bpm) for Atrial, but ventricular rate is often slower
P Wave Not observable, but saw-toothed flutter waves are present
PR Interval Not measureable
QRS Normal less .12 seconds 3:1 conduction equals 3 flutter
Atrial Flutter
5 steps to Rhythm Interpertation
Rate
Greater then 100=tachy
less then 60=brady
Regular
Rate The underlying rate
P Wave Normal p wave for every QRS
PR Interval Prolonged (>0.20 sec)
QRS Normal less .12 seconds
Notes A first degree AV block occurs when electrical impulses moving through the Atrioventricular (AV) node are delayed (but not blocked). First degree indicates slowed conduction without missed beats.
1st degree AV block
Not present
Rate Absent
P Wave Absent
PR Interval Absent
QRS Absent
Notes Confirm with multiple leads
Asystole
Irregular, varying with respiration
Rate Normal (60-100 bpm) and rate may increase during inspiration
P Wave Normal
PR Interval Normal (0.12-0.20 sec)
QRS Normal (0.06-0.10 sec)
Notes Heart rate frequently increases with inspiration, decreasing with expiration
Sinus Arrhythmia
Irregular but with progressively longer PR interval lengthening
Rate The underlying rate
P Wave Normal
PR Interval Progressively longer until a QRS complex is missed, then cycle repeats
QRS Normal less .12 seconds
Type 1 Second Degree AV Block
5 steps to Rhythm Interpertation
PRI
Are intervals within normal limits? Are they Too long or to short? Are intervals constant on strip or do they vary from beat to beat?
Regular
Rate Slow (40-60 bpm)
P Wave Present before, during (hidden) or after QRS, if visible it is inverted
PR Interval Not measurable
QRS Normal less .12 seconds
Junctional Escape
Regular
Rate Fast (> 100 bpm)
P Wave Normal, may merge with T wave at very fast rates
PR Interval Normal (0.12-0.20 sec)
QRS Normal less .12 seconds
Notes QT interval shortens with increasing heart rate
Sinus Tachycardia
5 steps to Rhythm Interpertation
Regularity
Regular, regular but interupted, irregular
Regular (atrial) and irregular (ventricular)
Rate Characterized by Atrial rate usually faster than ventricular rate (usually slow) usually bradycardiac
P Wave Normal form, but more P waves than QRS complexes p-p interval is regular
PR Interval Normal or prolonged
QRS Normal or wide
Type 2 Second Degree AV Block
Regular
Rate Slow (20-40 bpm) bradycardia
P Wave Absent
PR Interval Not measurable
QRS Wide (>0.10 sec), bizarre appearance
Idioventricular
Irregular
Rate Very fast (> 350 bpm) for Atrial, but ventricular rate may be slow, normal or fast
P Wave Absent - erratic waves are present
PR Interval Absent
QRS Normal but may be widened if there are conduction delays
A-FIB Atrial Fibrillation
