Week 10- Cardiac Monitor

Question 1

What does the monitor, monitor?

Answer 1

Rhythms
ETCO2- Ventilation
SpO2- Oxygenation
Non Invasive BP
Defibulator

Question 2

Most Common Types

Answer 2

Zoll
LifePak
Same functions- Service dependent

Question 3

MOH Standards PCP

Answer 3

Manual abilities
Sound features- Alarm/voice prompts
Perform basic ECG 12 lead
SpO2 monitoring
Print recordings
Carrying case
Easy to clean

Question 4

Who are we putting this on?

Answer 4

cardiovascular, respiratory or neurological compromise
ALL VSA pt’s
Unconscious or alter LOC collapse
Syncope
Suspected cardiac icshemia
SOB
CVA / OD’s
Major or multi system trauma
Electrocution/ submersion injuries
Hypothermia, heat exhaustion, heat illness

Question 5

Vital Signs- Adults:
Normotension
Hypotension
Bradycardia
Tachycardia
Tachypnea

Answer 5

Normotension- SBP> 100mmHg
Hypotension- SBP < 90mmHg
Bradycardia- HR <50 BPM
Tachycardia- HR >100 BPM
Tachypnea- RR > 28 Breaths

Question 6

When does a pediatric change to adult normal vital signs?

Answer 6

Age 10

Question 7

Weight Calculation for PEDS

Answer 7

age x 2 + 10 = weight in KG

Question 8

Hypotension in Children

Answer 8

SBP < 70 mmHg + (2x age in yrs)

Question 9

Defibrillation Pad Placement

Answer 9

Sternum and apex

used in cardiac arrest

shockable rhythms- ventricular fibrillation and pulseless ventricular (best chance of rescusistaion)

Question 10

SpO2 Monitor (type of reading, indication of ____ and what can also be calculated through SPO2)

Answer 10

Tape or clamp on finger/toes
Indication of OXYGENATION
HR is also calculated through the SpO2

Question 11

What can cause low perfusion in SpO2 monitor?

Answer 11

MI, hypothermia (all blood going to the core of body to perfusion vital organs)

Question 12

ETCO2- Nasal Prongs

Answer 12

SOB calls
Breathing assessment

Question 13

ETCO2- Inline, when to use it?

Answer 13

BVM
During Ventilation

Question 14

Boronchospams/Asthema ETCO2 waveform:

Answer 14

SHARK FIN shape
Air trapping

Question 15

ROSC

Answer 15

Value of ETCO2 will SKY ROCKET UP to 60-70mmHg

Question 16

Hyperventilation

Answer 16

DECREASED ETCO2, lots of bumps

Question 17

Normal ETCO2 Range

Answer 17

35-45 mmHg

Question 18

Cardiac Arrest ETCO2 LEVEL

Answer 18

Low ETCO2

Question 19

OD’s ETCO2 waveform:

Answer 19

Big long wave forms

Question 20

Application of limb leads 4 shows us what?

Answer 20

LEAD II

Question 21

Lead=

Answer 21

Wires

Question 22

Electrode=

Answer 22

Stickers

Question 23

Monitor paper tells us….

Answer 23

Time
Amplitude

Question 24

P wave shows…

Answer 24

Atrial Depolarization
- Present and upright

Question 25

QRS Complex indicates...

Answer 25

Ventricular Depolariaztion

Question 26

T wave indicates....

Answer 26

Ventricular Repolarization

Question 27

SIX SIMPLE EKG INTERPRETATION -STEPS

Answer 27

1. Identify and Examine P wave (straight and upright) 2. Measure PR interval (0.12-0.20 sec) 3. Measure QRS Complex (0.06-0.12 sec) 4. Identify Rhythm ( regular or irregular ) 5. Identify Heart Rate (SIX SECOND STRIPS: count number of R's in between the 3 lines and multiply by 10!!!) Big BOX method- 300 divided by the number of big boxes between 2 R's 6. Interpret :)

Question 28

4 LEAD PLACEMENT

Answer 28

Christmas on the bottom Black and white on top White to write (top) Red to bed (bottom)

Question 29

Limb leads

Answer 29

4 leads Arms and legs

Question 30

Normal Range of the Heart

Answer 30

60-100bpm

Question 31

12 lead- why?

Answer 31

ST change? for an MI

Question 32

ST elevation is indication of....

Answer 32

an MI (STEMI- ST ELEVATION MYOCARDIAL INFARCTION)

Question 33

INTERPRETING a 4 lead- LEAD II

Answer 33

1. Calculate the rate - 300 rule (regular) / 6 rule (irregular) 2. Rhythm - regular or irregular? - measure R waves 3. P waves - present and upright - evidence of the atria contracting 4. PR interval - 0.12-.20 secs (3-5 small boxes) 5. QRS duration - Normal duration 0.08-0.12 (less than 2 small boxes) - evidence of ventricular contraction

Question 34

T Wave shows:

Answer 34

ventricular repolarization!

Question 35

Normal Sinus Rhythm

Answer 35

Rhythm; Regular Rate: 80 bpm (60-100bpm) P waves: Upright and regular PR interval: greater than 5 small boxes? (0.12-0.20) P wave for every QRS? QRS: less than 2 small boxes? (0.04-0.12)

Question 36

Sinus Tachycardia

Answer 36

Normal but rate= ELEVATED

Question 37

Sinus bradycardia

Answer 37

normal but rate= LOW

Question 38

Arterial Fibrillation

Answer 38

Rhythm: irregular Rate; 90bpm Waves: non discernable PR interval: none QRS; 0.08 (norm; 0.04-0.12)

Question 39

Normal PR interval:

Answer 39

PR: 0.12- 0.20 secs (3-5 small boxes)

Question 40

Normal QRS interval:

Answer 40

QRS: less than 2 small boxes (0.04-0.12)

Question 41

What are the P waves evidence of?

Answer 41

Atria contracting