LO2 ECG Rhythms Flashcards
all sinus rhythms
come from SA node, 4 rhythms
- Upright uniform p wave
- 1p:1QRS
- QRS
Normal Sinus Rhythm
- P Wave
o Normal and upright; one in front of every QRS - PRI
o .12 - .20 - QRS
o Less than .12
o narrow - Sinus node fires regularly at 60-100 bpm with each beat conducted normally through to the ventricles
Sinus Bradycardia
- Regularity
o Regular - Rate
o Less than 60 bpm - P Wave
o Normal and upright; one in front of every QRS - PRI
o .12 - .20 and constant - QRS
o Less than .12 - Sinus node fires regularly at less than 60 bpm with each impulse conducting normally through to the ventricles
causes of Sinus Bradycardia
o Meds
o Hypothermia
o Drugs
Sinus Tachycardia
- Regularity
o Regular - Rate
o 100 - 160 bpm (above) - P Wave
o Normal and upright; one in front of every QRS - PRI
o .12 - .20 and constant - QRS
o Less than .12
Sinus Arrhythmia
- Regularity
o Irregular
o Common
o Has to do with respirations
—As you breath in it goes faster, breath out slows down - Rate
o 60 - 100 bpm (usually) - P Wave
o Normal and upright; one in front of every QRS - PRI
o .12 - .20 and constant - QRS
o Less than .12 - Sinus node fires in an irregular pattern with each impulse conducting through to the ventricles. Rate increases as patient breathes in and decreases as patient breathes out
Atrial Rhythms come from
atria
Premature Atrial Contractions (PAC’s)
Ectopic
- Just comes earlier than it should, looks like all the others
- Regularity
o Depends on underlying rhythm - Rate
o Usually, normal - P Wave
o Upright uniform P wave
o P wave of early beat differs from sinus P wave - PRI
o .12-.20 - QRS
o Less than .12 - Pacemaker is an irritable focus in atrium that fires prematurely and produces a single ectopic beat with conduction through to the ventricles
Atrial Flutter
comes from one place in the atria
Regularity
- Atrial rhythm regular;
o Ventricular rate reg/irreg
- Rate
o Atrial rate 250 -300;
o Ventricular rate varies - P Wave
o Characteristic Saw tooth
o Shark fin
o They look like this because they are coming from atria and not SA
o Each time it happens they look the same - PRI
o Unable to determine - QRS
o Less than .12 - A single irritable focus in the atria issues impulse conducted in a rapid, repetitive fashion. AV node blocks some of the impulses from being conducted.
Atrial Fibrillation
comes from all parts of atria and sends impulses
- Regularity
o Grossly irregular - Rate
o Atrial greater than 300; Ventricular varies greatly - P Wave
o No discernible P Waves - PRI
o Unable to measure - QRS
o Less than .12 - The atria are so irritable that a multitude of foci initiate impulses causing atria to depolarize. AV node blocks most of the impulses so there is only limited conduction to ventricles
Atrial Fibrillation 2 types
- A-Fib with SVR with slow ventricular response (SVR) below 99bpm
- A-Fib with RVR ventricular response (RVR) above 100 bpmi
Supraventricular Tachycardia (SVT)
- comes from one place in atria and goes around so fast you cant see p waves
- Regularity
o Regular - Rate
o greater than 150 bpm - pwave
o Upright, uniform, however rarely seen d/t rate, one in front of every QRS - PRI
o .12 - .20 – when seen - QRS
o Less than .12 - Tachycardia that originates from a pacemaker above the ventricles, that overrides the SA node.
- ALS call
- Try Vagul
Paroxysmal Supraventricular Tachycardia (PSVT)
- A rhythm changes from something to SVT
- Regularity
o Regular - Rate
o greater than 150 bpm - Pwave
o Upright, uniform, however rarely seen d/t rate, one in front of every QRS - PRI
o .12 - .20 – when seen - QRS
o Less than .12 - Paroxysmal means “occurring in spasms”. PSVT is a specific rhythm reflecting its tendency to begin and end abruptly
Bigeminy:
Trigeminy:
Quadreminy:
Couplet:
Bigeminy: every 2nd one is ectopic
Trigeminy: every 3rd one is ectopic
Quadreminy: every 4th one is ectopic
Couplet: 2 in a row
Treatment for atrial rhythms
A-Flutter- treat CP if they have
A-Fib- treat CP if they have
SVT- ALS ALWAYS
