Week 3 Flashcards

1
Q

What is Step 1

A

Determine rhythm

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2
Q

What can rhythm be?

A
  1. regular (R-R intervals within 0.04 seconds)
  2. regularly irregular (a pattern exists)
  3. irregularly irregular (no pattern, chaotic)
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3
Q

How do you determine rhythm?

A

Use piece of paper with lines

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4
Q

What should be considered if rhythm is regularly irregular?

A

Respiratory Sinus Arrythmia

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5
Q

Explain Respiratory Sinus Arrythmia

A

Changes in venous return and vagal tone: during inspiratory venous return increases causing vagal tone to decrease (increases HR). During expiration a reduction in venous return increases vagal tone (reduces HR).

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6
Q

By how much does RSA change P-P interval

A

10%

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7
Q

Step 2

A

Determine the rate

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8
Q

How many large squares are in 1 minute?

A

300

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9
Q

What speed does the ECG paper move at?

A

25 mm/s

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10
Q

How do you calculate HR in a regular rhythm?

A

300/no. of large squares in R-R interval

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11
Q

How do you calculate HR in a irregular rhythm?

A

count no. of QRS complex in 30 large squares then x 10

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12
Q

Step 3

A

Evaluate the P wave

  1. Are P-waves present?
  2. Do they all have normal configurations?
  3. Are they all similar shape and size?
  4. Is there one P-wave for every QRS?
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13
Q

Step 4

A

Determine duration of PR interval

  1. is it between 0.12 - 0.2 seconds
  2. is the PR interval constant?
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14
Q

Step 5

A

Determine height and duration of QRS?

  1. is the duration normal? 0.05 - 0.1 seconds
  2. does a QRS complex appear after every P wave
  3. Are all QRS complexes the same size and shape?
  4. Are the QRS R/S waves too deep/high? 25 mm individually or 35 mm combined?
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15
Q

Step 6

A

Is ST segment isoelectric

  • 1.0 mm elevation
  • 0.5 mm depression

at 80 ms past j-point (2 squares)
Is the ST segement upsloping/downsloping or horizontal?

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16
Q

Step 7

A

Evaluation the T wave

  1. Are T waves present
  2. Do they have a normal shape
  3. Do the have a normal amplitude (10mm precordial leads)
  4. Do they all have the same amplitude?
  5. Do the T waves have the same deflection as QRS complex?
17
Q

Step 8

A

Determine the QT interval

  1. 0.35 - 0.44 seconds corrected
18
Q

Step 9

A

Evaluate any other components

  1. origin of rhythm (SA node/AV node/ventricles)
  2. rate (bradycardia/tachycardia)
  3. rhythm abnormalities