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27 Cards in this Set

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Identify the two main initial steps to evaluating an ECG.
1 – Recognize the patient’s name

2 - aVR tracing should be inverted – if not, the leads were placed incorrectly
List the ECG characteristics and evaluate a 12 lead ECG of a Normal Sinus Rhythm
Rate is 60-100

P wave upright in leads l&ll

Cycle length is even

P wave morphology is uniform

PR interval is identical
List the ECG characteristics and evaluate a 12 lead ECG of a Sinus Arrhythmia
variability in cycle lengths

varies with respiration
List the ECG characteristics and evaluate a 12 lead ECG of a Sinus tachycardia
Sinus rhythm between 100 and 180 beats per minute.
List the ECG characteristics and evaluate a 12 lead ECG of a Sinus Bradycardia
sinus rhythm with a rate less than 60 beats per minute
List the ECG characteristics and evaluate a 12 lead ECG of 1º AV Block
delay in impulse conduction through AV node

Defined as PR interval >0.20 seconds
List the ECG characteristics and evaluate a 12 lead ECG of 2º AV Block
Mobitz type I (wakenbach) PR interval becomes progressively longer until the AV node becomes fatigued and there is a dropped qrs complex (usually benign condition)

Mobitz type II block:
PP intervals remain constant but P fails to conduct through AV node to form qrs
List the ECG characteristics and evaluate a 12 lead ECG of 3º AV Block
Complete dissociation between atrial and ventricular complexes

Atrium and ventricle under independent foci
List the ECG characteristics and evaluate a 12 lead EKG of the
following bundle branch rhythms. (Based on notes and lecture)
-Complete RBBB
is qrs longer than 3 small squares (.12)

is there a prominant s wave inbetween R & R'

is it prominant in right chest leads (v1 & v2)
List the ECG characteristics and evaluate a 12 lead EKG of the
following bundle branch rhythms. (Based on notes and lecture)
-Incomplete RBBB
is qrs only slightly prolonged(.1-.12)

is there a prominant s wave inbetween R & R'

is it prominant in right chest leads (v1 & v2)
List the ECG characteristics and evaluate a 12 lead EKG of the
following bundle branch rhythms. (Based on notes and lecture)
- Complete LBBB
is qrs longer than 3 small squares (.12)

is there a flattened s wave inbetween R & R'

is it prominant in left chest leads (v5 & v6)
List the ECG characteristics and evaluate a 12 lead EKG of the
following bundle branch rhythms. (Based on notes and lecture)
-Incomplete LBBB
is qrs only slightly prolonged(.1-.12)

is there a prominant s wave inbetween R & R'

is it prominant in left chest leads (v5 & v6)
List the ECG characteristics and evaluate a 12 lead ECG of the following supra-ventricular rhythms:
Sinus Tachycardia
same p wave before qrs

narrow qrs

rate between 100-180bpm
List the ECG characteristics and evaluate a 12 lead ECG of the following supra-ventricular rhythms:
- Multifocal Artrial
Three or more morphologically different P waves

Rate 90-150

Rhythm irregularly irregular

narrow qrs

often seen with COPD
List the ECG characteristics and evaluate a 12 lead ECG of the
following supra-ventricular rhythms:
- Artrial Flutter
P-wave 250-350/minute

Regular P-P interval

P-wave of abnormal morphology--sawtooth pattern

Common conduction ratio is 2:1 or variable

narrow qrs
List the ECG characteristics and evaluate a 12 lead ECG of the
following supra-ventricular rhythms:
- Artrial Fibrillation
p waves 350-450 bpm

irritiable atrial foci that look like a wavy baseline

irregular conduction to ventricles to form NARROW qrs complexes
List the ECG characteristics and evaluate a 12 lead ECG of the following ventricular rhythms
- Monomorphic Ventricular Tachycardia
wide qrs

morphologically identicle qrs

p waves are non-distinct but may alter qrs waves slightly

complete p/qrs dissociation

between 100-350 bpm
List the ECG characteristics and evaluate a 12 lead ECG of the following ventricular rhythms
-Polymorphic Vent Tachycardia
wide qrs

qrs has markedly different morphology (from different foci)

between 100-350 bpm
List the ECG characteristics and evaluate a 12 lead ECG of the following ventricular rhythms
-Ventricular Fibrillation
wide qrs

qrs has markedly different morphology (from different foci)

>350 bpm
List the ECG characteristics and evaluate a 12 lead ECG of the
following pre-exitation syndrome rhythms:
-LJL Syndrome
AV node bipassed via "James bundle"

Short PR interval <.12.

Rapid AV conduction
List the ECG characteristics and evaluate a 12 lead ECG of the
following pre-exitation syndrome rhythms:
- WPN Syndrome
AV node bipassed via "Kent bundle"

Short PR interval

Delta wave, linking atrium directly to ventricle
Differentiate the following on a short rhythm strip:
-Supraventricular Tachy vs. Ventricular Tachycardia
supraventricular tachy will have a upright p wave before qrs & qrs will be narrow
Differentiate the following on a short rhythm strip
-Sinus Pause vs. Sinus Exit Block
Sinus pause is a sudden lengthening of P-P interval
The pause is always less than twice of normal P-P interval.

Failure of impulse conduction from the sinus node into atrium results in sinoatrial block.The pause as result of this is always multiple of underlying P-P interval
Differentiate the following on a short rhythm strip:
-PVC vs. PAC
PAC

-Originate in atrium

-P-wave morphology different from sinus

-PR-Interval may be short or long

-May or may not be followed by QRS

-May have narrow or wide QRS(depending on degree of aberrancy)


PVC
-QRS usually wide
-No preceding P waves
Differentiate the following on a short rhythm strip:
-Ventricular Bigeminy vs. Ventricular Couplets
Ventricular Bigeminy
-ventricular beat couples to each sinus beat
-coupling interval between sinus beat and ventricular beat is fixed

Ventricular Couplets
-2 ventricular premature beats follow a series of normal sinus beats
Identify the medication indicated and contraindicated in the
treatment of narrow QRS complex tachycardia.
Indicated:
-vagal manuvers
-IV adenosine
-IV VERAPAMIL, diltiazem
-IV profenone, sotalol

If refractory:
-IV procainamide
-IV amiodarone
Identify the medication indicated and contraindicated in the
treatment of wide QRS complex tachycardia.
Indicated:
-vagal manuvers
-IV adenosine
-procainamide

Contraindicated:
-digoxin
-VERAPAMIL
-