Rhythm recognition Flashcards
What patients needs ECG monitoring started immediately? What are some common presentations?
Unexplained syncope, especially during exercise; syncope + structural heart disease, syncope + abnormal ECG (esp prolonged QT)
In a collapsed patient, what type of cardiac rhythm technology should you use?
Defib (right clavicle, left mid axillary line). You are looking only for rhythm analysis - record abnormal on strip.
Then go for ECG.
At rest, the cells of the heart are polarised with what amount of difference?
90mV
The PR interval represents what?
AV node delay
How do you measure the PR interval?
What is the normal interval time?
Start of the P wave to the first deflection of the QRS complex
0.12-.2s (3-5 small squares)
What is the normal QRS?
<0.12s or <3 small squares on 25mm / s paper
How to read the rhythm strip?
1) Is there electrical activity
2) What is the Ventricular rate
3) Is the QRS reg or irreg
4) Is the QRS broad or narrow
5) Is atrial activity present
6) Is the atrial activity and ventricular activity related
What if there is doubt between asystole and fine VF?
Don’t defib
What is a normal heart rate?
What is bradycardia?
What is tachycardia?
60-100
<60
> 100
How do you calculate rate?
Count 30 squares and times by 10
Or
Count 15 squares and times by 20
If more than three (triplet) occur in rapid succession, what is this considered?
tachyarrythmia
When ectopic beats happen alternately to normal beats, what is this called?
bigeminy
If you cannot see atrial activity, do you guess?
No
What is the length of a normal p wave?
<0.12 sec
If the monitor shows VF? what now?
check the patient. if the patient is conscious, this ain’t VF