Rate and Rhythm

Question 1

Leads I, II, III record electrical activity in the ___ plane

Answer 1

vertical

Question 2

Leads aVR, aVL, aVF record electrical activity in the ___ plane

Answer 2

vertical

Question 3

Leads V₁ - V₆ record electrical activity in the ___ plane

Answer 3

horizontal

Question 4

The rhythm strip at the bottom of the printout is typically ___ seconds. Lead ___ is most commonly monitored here.

Answer 4

10 seconds

Lead II

Question 5

Box method of rate

(What is BPM for 1 box, 2 boxes, etc.?)

Answer 5

Question 6

5 things to observe regarding rate + rhythm

Answer 6

Rate (normal, brady, tacky)

Rhythm (regular or irregular)

QRS (narrow or wide)

P-waves (present)

PR interval

Question 7

What is considered wide/narrow QRS

Answer 7

< 0.12 seconds is narrow

> 0.12 seconds is wide

Question 8

In NSR:

P-wave is upright in lead ___ and inverted in ___

Answer 8

Upright in lead II

Inverted in aVR

Question 9

Normal PR interval

Answer 9

0.12 - 0.20 seconds

Question 10

QTc is prolonged if > ___ ms in men or > ___ ms in women

Answer 10

440 ms in men

460 ms in women

Question 11

DDX of tachycardia, narrow + regular

Answer 11

Sinus tachycardia

Atrial flutter

SVT

Question 12

DDX of tachycardia, narrow + irregular

Answer 12

A-fib

Variable A-flutter

Multifocal atrial tachycardia (MAT)

Question 13

DDX of tachycardia, wide + regular

Answer 13

V Tach

SVT w/ BBB

Sinus tach w/ BBB

Antidromic WPW

NOTE: V-TACH UNTIL PROVEN OTHERWISE

Question 14

DDX of tachycardia, wide + irregular

Answer 14

Polymorphic ventricular tachycardia (PMVT)

A-fib w/ WPW

A-fib w/ BBB

Image: a) A-fib w/ BBB, b) V Tach

Question 15

DDX of bradycardia

Answer 15

Sinus bradycardia

AV blocks

Junctional rhythm

Ventricular rhythm