EKG Rhythms Flashcards
https://www.google.com/search?client=ms-android-att-us-rvc3&sca_esv=3248254e93e9ddf0&sxsrf=ACQVn08Y0r5bxY9ntwKOJz4EKIMDQ42r6g:1709339875450&q=normal+sinus+rhythm&uds=AMwkrPs4mDHqV7QfY9nYaKRHgvE9AI0J0atYelitCDhmQLPn4TrKHQI66QYWfNC_V-PVx3o6OykGSAIjnUeSps9P0Pleynub4I2ufBRLvBjy5ReD0xsjrFZnppZSX0xU7zTDvdUsOPIIurhlnudk-LExlcO2Dh-x78kePl4mEuLtu7n2qU0Czest34JLe6vqcNJYs6VIQRvm6sYMO1G8FrkuMzJLUyGPs4Mp1Vy6W998Dp10kwvodR-3NEy0IrobxW2O97CZ6GKUQvIQ8xdhLvBY6OnH8fjpGjnelMUSWvTBZyWotqUJNodH0c99lJi14g5Fs-tAX2DMf9P6RoW1zfs0nzwmz6uglOOOamTKZAPixcoh9eEDLRc&udm=2&prmd=ivsnbmhtz&sa=X&ved=2ahUKEwjjl8ugq9SEAxXKhIkEHWECD5cQtKgLegQIChAB&biw=384&bih=700&dpr=2.81#vhid=duXVGu_1NvZ7_M&vssid=mosaic&vwlns=WyIwQ0JjUWg2Y0dhaGNLRXdqNHhJaXBxOVNFQXhVQUFBQUFIUUFBQUFBUUJBIl0=&lns=W251bGwsbnVsbCxudWxsLG51bGwsbnVsbCxudWxsLG51bGwsIkVrY0tKRGN6WldGalkyTTRMVEUxTjJNdE5ETmpNQzA0TVRrekxURmhOREF6WkRjNVpUSmpaaElmTkhkelpWSndUaTE1V1UxbFVVVjFlRFl4WHpJd1dFUTRUMHBNU2pONFp3PT0iXQ==
Normal Sinus Rhythm
Normal healthy Rhythm
https://www.google.com/search?q=bradycardia%20ecg%20vs%20normal%20ecg&hl=en&udm=2&uds=AMwkrPsrGS83aWYAdC1M2PI7VcGaAhSee3CQ9kHe2B-zZgX49JQzGqoESUuY4z4VwnR9fJpJpi4K_7ISsBfiW6kmDsJXzeWbwjutCgFp5fJ7l6ONzsDIjvz8oOVhsSfUxk4cOitVP1-Mzm2EE0K5h3g6Y18KtJZkORQWjNNTPEwHn9hVG7CtulNvAWwisnb7G_neXZ4OcKSYCNiD8mweEHc1qWzw1b8PQPF1WYEElnndRppOtHun4aJA-Z3sfFYHPKiuPHe_ph2COFvYUTKz_tnRo1IF01OVCEdT51DZgRBPmF25DKlln74oilViNqs0mYODT4ZiRth-O4c3mxcEjoEqJnlnnlPSNzCEcecSmXtfUF_gfYnxAiE&sa=X&ved=0CBoQtI8BKABqFwoTCNDz_Jys1IQDFQAAAAAdAAAAABAa&biw=384&bih=700&dpr=2.81#vhid=yupyr8xIDlZ7WM&vssid=mosaic
Bradycardia <60 bpm
Chemical treatment for Bradycardia
Why is it given
Atropine
Only if symptomatic showing low perfusion.
(Pale, Cool, Clammy)
Atropine
What is it used for
Atropine increases heart rate.
Used for Bradycardia
Memory Trick
Makes HR High like being on a pine tree.
Causes of Bradycardia (3)
Atropine will correct this state
Vagal maneuver
CCB, Beta Blockers
https://my.clevelandclinic.org/health/diseases/21878-ventricular-fibrillation
V Fib
V Fib Treatment
1st treatment
Defib
Stop CPR to do it & before drugs
No synchronization needes
3 drugs given for V Fib
Lidocaine
treats cardiac arrest caused by ventricular fibrillation or ventricular tachycardia that Doesn’t respond to defibrillation.
Amiodarone
Amiodarone is a common treatment for arrhythmias like atrial fibrillation (AFib). It helps the heart stay in a normal rhythm, especially in people with underlying heart problems, like heart failure
Procainamide
Lidocaine
Amiodarone
Procainamide
Are given for
V fib
Causes of V fib
Untreated V Tach
Post MI
Proarrythmic meds
Electrolyte imbalance
https://my.clevelandclinic.org/health/diseases/23215-monomorphic-ventricular-tachycardia
Ventricular Tachycardia
Causes of Ventricular Tachycardia
Post MI
Hypoxia
Low K
Low Mg
Treatment for Ventricular Tachycardia
No pulse / pulse
D Fib
No pulse = shock immediately
Pulse = Synchronize, Sedate, Cardiovert
https://www.jnj.com/innovation/5-things-we-now-know-about-atrial-fibrillation
A fib
A fib is a lack of the wave
P wave
Causes
Valvular disease
Heart failure
Pulmonary HTN
COPD
after heart surgery
A fib
A fib
Causes
Valvular disease
Heart failure
Pulmonary HTN
COPD
after heart surgery
Treatment: A Fib
Cardioversion
(After TTE to rule out clots)
How to cardiovascularvet
Which medicines is given for A Fib
(What to check before giving this medication)
Push Sync first
Medicine #1 = Digoxin = A Fib Treatment
Check: ATP
Apical Pulse (listen 60 seconds)
Toxicity (Max 2 Range) (Assess for Visual Disturbance, N / V, Anorexia
Potassium <3.5 (Higher Risk for Toxicity)
Medicine #2 = Anticoagulants: Warfarin (Monitor INR, Vit. K “Antidote”, moderate green leafy veggies
https://www.google.com/search?client=ms-android-att-us-rvc3&sca_esv=0fb65671f12eb866&sxsrf=ACQVn09nYoT56te6tfNA_Rp7wyxSjgE91g:1709407558779&q=atrial+flutter&uds=AMwkrPtzlylVkfcph75f4oh2NPkuWBdMhWjuS7TUl0miFr1x8N-tIH_kRasvRdDScixx3olYgk9hePCx2AfXHZtpYskwqBiaxG2XIbg36fXJ-Nvo5dhHzPvBn7eCnvZWvGUptb65abR3j9WtZdR22n-EZZ5TTj5U03-eYlJRFoIN9Oy-cMq–Ur0UD58gT9JZ1NWt_KqxFKZ6oeuD3-0PK-jARdQopw3uOE5UieIGIBEHw0ACzNIi42fwLSyOQ6FDXnAHOOoAZcJggwAkvq-Shy8WG2poOxODfv2F1gzR-xd_CnDcjk04lhbDKIMS54vohkTzfuZUhPHcBoW7hRRtR-eGQUB1BmbVFjDxD3gvS7FCiCxLbUxkXY&udm=2&prmd=ivsnbmhtz&sa=X&ved=2ahUKEwjc0MSyp9aEAxV1l4kEHecNDkkQtKgLegQICxAB&biw=384&bih=700&dpr=2.81#vhid=bL_yGcM_mMHEWM&vssid=mosaic
Atrial Flutter
Saw tooth pattern is this Strip
Atrial Flutter
Atrial Flutter (Saw tooth) has the same Casues & Treatment as ….
Atrial Fibrillation
https://www.aclsonline.us/rhythms/supraventricular-tachycardia/
Supraventricular tachycardia
Stimulants, Strenuous exercise, hypoxia, heart disease
SVT
Supraventricular tachycardia
Supraventricular tachycardia
Causes
Stimulants, Strenuous exercise, hypoxia, heart disease
Treatment (least to most invasive)
Vagal Maneuver / Ice pack around neck
Adenosine- Rapid Push & Flush with NS- HR may stop
Cardioversion “controlled shock”
Push Sync
SVT
Supraventricular tachycardia
Which medication should be held 48-hours prior to a Cardioversion for SVT
Digoxin
Due to increased ventricular irritation
Client with SVT has the following data
HR 200, BP 78 / 40, RR 30
Priority action
Synchronized Cardioversion
https://www.google.com/search?client=ms-android-att-us-rvc3&sca_esv=a574099b913213c9&sxsrf=ACQVn09BlMW3F3r9-XAeKU2ceDCoEzjz5w:1709409746203&q=torsades+de+pointes+ecg&uds=AMwkrPtR6LTZZi0qBdp0efgGc8BlHGcjIfzw-6zaKQQCmJ1tgNchg46_fsy3Argdrw8vt_T-nBM9PCvJV77OUIZZbnXWE6okrkqdzC1Np8Mkc4_LxgIbP2edly2dhzoO5SUs6fyH5TewOcaBNYmDjSdy-4UyAqXJAbRw9q5iuJqF7R1rEs3dGBP2hd3aoNTuzabNmXS-E4gh2Km8dI1QPX5mFa2OFR1XUf8XZbElRsa3sM88hdHGCmKYrDiOh8tE-chkmU8AhxBTZlnA5xIxqzbdS5wum9F6avyqUuq-y4gdlJ4YY8eB83rnf9GfTx0LD96cF_SpWFMZWoXJvambPvTURrN4zmADz4Y6VLl3Lqe8uqvCReWYa88&udm=2&prmd=ivsnmbhtz&sa=X&ved=2ahUKEwj4rMrFr9aEAxXtIzQIHQ2IDI8QtKgLegQICxAB&biw=384&bih=700&dpr=2.81#vhid=zmdHzv8KugvNqM&vssid=mosaic
Torsades de Pointes
Memory trick
Tornado Pointes
Causes:
Post MI, Hypoxia, *Low Magnesium
Treatment: Magnesium Sulfate
Torsade de Pointes
What does taking Mg do to the heart
Mellows out the heart
Asystole
Describe
Treatment
Flatline
Epinephrine, Atropine, CPR
Do you have to synchronize defibrillator before giving a shock to Asystole
Don’t give shock for Asystole
P wave =
Atrial rhythm
QRS wave =
Ventricular Rhythm
Lack of QRS complexes =
Asystole
Wide bizarre QRS complex =
V tach
Chaotic rhythm with no P waves =
Chaotic rhythm without QRS complexes =
Chaotic rhythm with no P waves =
Atrial Fibrillation
Chaotic rhythm without QRS complexes = Ventricular Fibrillation
Bizarre rhythm with wide QRS complexes
Ventricular Tachycardia
( V Fib / V Tach )
Causes: Post MI, Electrolytes Imbalance, Proarrthymia Drugs, Untreated V Tach
Treatment:
1. Defib, no synch
2. Drugs: Lidocaine, Amiodarone, Procainamide
(V Fib / V Tach)
Causes: Post MI, Low K / Mg, Hypoxia
Treatment:
Early Defib
No Pulse = Defib
Pulse = Cardioversion
V Fib - Floppy Squiggly Lines
Causes: Post MI, Electrolytes Imbalance, Proarrthymia Drugs, Untreated V Tach
Treatment:
1. Defib, no synch
2. Drugs: Lidocaine, Amiodarone, Procainamide
V Tach - Tombstone
Causes: Post MI, Low K / Mg, Hypoxia
Treatment:
Early Defib
No Pulse = Defib
Pulse = Cardioversion
( A Fib / V Fib )
Causes: Post MI, Electrolytes Imbalance, Proarrthymia Drugs, Untreated V Tach
Treatment:
1. Defib, no synch
2. Drugs: Lidocaine, Amiodarone, Procainamide
(A Fib / V Fib)
Causes: Valvular Disease, HF, Pulmonary HTN, COPD, After Heart Surgery
Treatment:
1. Cardioversion (After TTE to rule out clots)
- Digoxin (Longterm)
- Warfarin
V Fib
Causes: Post MI, Electrolytes Imbalance, Proarrthymia Drugs, Untreated V Tach
Treatment:
1. Defib, no synch
2. Drugs: Lidocaine, Amiodarone, Procainamide
A Fib
Causes: Valvular Disease, HF, Pulmonary HTN, COPD, After Heart Surgery
Treatment:
1. Cardioversion (After TTE to rule out clots)
- Digoxin (Longterm)
- Warfarin
Before Cardioversion as the primary treatment for A Fib / A Flutter
TRANSTHORACIC ECHOCARDIOGRAM
To rule out clots
Before giving Digoxin for A Fib assess for these (3)
ATP
Apical Pulse
Toxicity Max level 2,
Toxicity symptoms: Visual Disturbances, N/V, Anorexia
Potassium <3.5 (increase risk for Toxicity)
( Supraventricular Tachycardia / Ventricular Tachycardia)
Causes: Post MI, Low K / Mg, Hypoxia
Treatment: Early Defib
No Pulse = Defib
Pulse = Cardioversion
( Supraventricular Tachycardia / Ventricular Tachycardia)
Causes: Stimulants, Strenuous Exercise, Hypoxia, Heart Disease
Treatment:
1. Vagal maneuver/ Ice around neck
2. Adenosine: Rapid Push, Flush w/ NS - HR may stop
3. Cardioversion- Push Sync
Ventricular Tachycardia
Causes: Post MI, Low K / Mg, Hypoxia
Treatment: Early Defib
No Pulse = Defib
Pulse = Cardioversion
Supraventricular Tachycardia
Causes: Stimulants, Strenuous Exercise, Hypoxia, Heart Disease
Treatment:
1. Vagal maneuver/ Ice around neck
2. Adenosine: Rapid Push, Flush w/ NS - HR may stop
3. Cardioversion- Push Sync
Warfarin Monitor this level in blood
What is the antidote
Which foods need to be moderated when taken Warfarin
INR level
Vitamin K = Antidote
Moderate Green Leafy Vegetables
Only do CPR first in these 2 rhythms.
Asystole & PEA (Pulseless electrical activity)
