EKG Review Flashcards
Osborne waves or notched j oints
hypothermia
order of electrical pathway
SA to AV to bundle HIS to purkinje fibers to ventricles
easy way to count rate
300 150 100 75 60 50 43 37
how to count rythym on 3 sec strip
number of QRS complexes in 30 boxes times 10
what are 4 possible irregular rythyms
sinus arrhythmia
wandering pacemaker
multifocal atrial tachycardia
atrial fibrillation
sinus arrhythmia description
considered normal yet irregular rhythm that varies with respiration
P waves should look identical
wandering pacemaker description
p waves shape varies as location varies
rate is under 100 bpm
considered irregular ventricular rhythm
what pts are at risk for Wandering pacemaker
COPD pts
multifocal atrial tachycardia
p waves shape varies
rate is over 100 bpm
irregular rhythm
COPD pt
atrial fib description
continuous chaotic atrial spikes
no p waves
irregular ventricular rhythm
sinus arrest with 60-80 bpm is called
atrial escape rhythm
sinus arrest with beats 40-60 per min called
junctional escape rhythm
ventricular escape rhythm description
idioventricular rhythm 20-40 min
what leads to an atrial escape beat
a sinus block - get atrial escape beat then SA node resumes pacing
3 types of premature beats
PAC, PVC and PJB (premature junctional beat)
7 tachyarrythmias
paroxysmal atrial tachycardia paroxysmal junctional tachycardia paroxysmal ventricular tachycardia atrial flutter ventricular flutter atrial fibrillation ventricular fibrillation
AV block first degree has ____ PR interval
prolonged, more than .2 seconds
2nd degree type I mobitz aka wenckebach
pr lengthens .. going going gone dropped QRS
2nd degree av block mobitz II
some P waves don’t produce a QRS
3rd degree AV block aka ____
complete heart block
no relationship between P and QRS
treat with pacemaker
RBBB criteria
R prime in V1
and S wave in v 6
LBBB criteria
R prime in v 5 or v6
plus rS in V1
what leads are your thumbs when trying to figure out axis
left hand thumb is lead one
right hand thumb is aVF
If both up = normal axis
+ deflection in one only = left axis
+ deflection in aVF only = right axis
both - deflection = ..??
right atrial enlargement findings
large diphasic P wave in lead II (tall initial peak)
LAE findings
large diphasic P with wide terminal component (camel humps)
in lead II
while horizantle s wave in V1
RVH findings
V1: large r wave gets smaller from v2-v4
LVH findings
large s wave in V1 leads to large R wave in V5 over 35 mm
t wave inversion signals
ischemic injury
always compare to old ekg
ST segment elevation means
acute injury
(depressions also signal this)
MONA (oxygen first, asa, nitro then morphine)
don’t give ___ if RV is involved in infarction
nitroglycerin
why? worry about preload - can induce cardiogenic shock
changes in leads II, III and aVF signal what type of mi and artery
inferior wall MI and RCA involved
changes V1-V4 __ MI
anterior or anteroseptal
artery: LAD
changes v5-v6, I, aVL
lateral MI
artery: LCA involved
ST depression in V1, V2 signals
posterior MI
LCA or RCA
how to treat SVT
vagal maneuver
carotid massage (push fast and flush)
adenosine 6 mg
if rate is over 160 you know its not __
SVT
tx a flutter
CCB - diltiazem
tx afib
coumadin
what is bigeminay PVC concern for?
irregular rhythm development
pulseless vtach shock __-
at 200 j biphasic
v tach with pulse and unstable
synchronized 100J cardiovert
vtach with pulse and stable
amiodarone
