EKG Stuff Flashcards
What 5 things do you want to check for first with an EKG?
Rate, Rhythm (regular or not) P-waves PR interval, Abnormal QRS complexes
Name the ways to calculate rate
6 second interval
300 divided by number of big boxes (300,150,100 etc)
When do you want to use the 6 second interval method when calculating rate?
If the rhythm is irregular (sinus arrhythmia, etc)
What is a normal rate?
60-100 bpm
What is it called when the rhythm is irregular?
arrhythmia or dysrhythmia
When the rate is below 60 what is it called
bradycardia
When the rate is above 100 what is it called
tachycardia
When do you use the word sinus in the rhythm
When there is a p-wave for every QRS that looks normal and comes from the SA node
Name the pathway for conduction system in the heart
SA node AV node Bundle of his Bundle branches Purkinje fibers
Where is the SA Node and what does it do?
Upper right atria
It initiates the heart beat
influenced by vagus nerve
Where is the AV node and what does it do?
In between the right atria and ventricle at the floor of the right atria. It causes a delay in electrical impulse so the rest of the signals in the atria can meet up before going onto the ventricles.
It can act as a pacemaker if the SA node isn’t working
In a ECG waveform what is happening at the p-wave?
Atrial depolarization
In an ECG waveform what”s happening at QRS complex?
Ventricular depolarization
atrial re-polarization is hidden in this wave
In an ECG waveform what’s happening at the T wave?
Ventricular repolarization
What is a PR interval?
Measurement from beginning of P wave to beginning of QRS complex.
What is a normal PR interval?
3-5 little boxes
If the PR interval is longer than normal, what can that be indicative of?
AV block
How can you tell the difference between 1st degree and 2nd degree AV block?
1st degree just has a long PR interval but a QRS complex still follows.
2nd degree blocks have PR intervals that get longer and longer until it drops a QRS complex
What are the characteristics of sinus arrhythmia?
Rhythm is irregular
Rate is between 60-100 bpm
P-wave configuration is normal (sinus)
PR interval is within normal limits
What are some characteristics of Sinus Arrest?
SA node stops firing causing pause in electrical activity
During pause ventricle doesn’t contract either
What is a PAC?
Early electrical impulse originating in the atria which disrupts regular rhythm
How can you tell if it’s a PAC?
Early beat may have non sinus P-wave.
Everything this uniform except for the early beat
Early beat may have different PR measurements
You can see a regular rhythm behind the PACs
What is Atrial Flutter?
P-waves have a 3:1 ratio of QRS complexes
P-waves look uniform
How can you tell if the rhythm is A-Fib?
Multiple (ectopic) foci firing in atria causing small depolarizations all over the place in the atria
No P-waves
Irregular rhythm
QRS look normal
How can you tell the difference between A-fib and just noise?
The irregular rhythm can be a big indicator
What causes a PVC?
Ectopic beat in ventricles that causes early contraction.
What is bigeminy, trigeminy and quadgeminy?
PVC every other beat (bigeminy)
Every 3rd beat (trigeminy)
Every 4th beat (quadgeminy)
What is ventricular tachycardia?
When there are 3 or more PVC’s in a row
How can you tell if it’s a bundle branch block?
Wide QRS complexes Rabbit ears(2 Q waves ) (right bundle branch block)
