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14 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Sinus Brady
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Rate - < 60
Rhythm - regular Pacemaker - SA node P waves - upright normal PR interval - .12-.20 QRS - .04-.12 |
Stable Atropine .5mg max 3mg
Unstable TCP |
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Sinus Tach
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Rate - > 100
Rhythm - regular Pacemaker - SA node P waves - upright normal PR interval - .12-.20 QRS - .04-.12 |
TX underlying cause.
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Sinus Dysrhyyhmia
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Rate - 60 -100
Rhythm - irregular Pacemaker - SA node P waves - upright normal PR interval - .12-.20 QRS - .04-.12 |
Typically none needed
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Sinus Arrest
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Rate - Normal to slow depending on arrest duration
Rhythm - irregular Pacemaker - SA node P waves - upright normal PR interval - .12-.20 QRS - .04-.12 |
Stable Atropine .5mg max 3mg
Unstable TCP |
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Wandering Pace Maker
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Rate - usually normal
Rhythm - slightly regular Pacemaker - SA node, atrial tissue to AV node P waves - morphology changes beat to beat PR interval - varies QRS - .04-.12 |
Stable observe
Unstable adensine |
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Multifocal Atrial Tach
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Rate - > 100
Rhythm - irregular Pacemaker - ectopic sites in atria P waves - organized, discrete nonsinus P waves w/ at least 3 different forms PR interval - varies QRS - normal or wider complex |
TX of underlying cause
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Premature Atrial Contractions
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Rate - depends on underlying rhythm
Rhythm - usually regular except for the PAC Pacemaker - ectopic focus in the atrium P waves - upright normal except PAC differs from underlying rhythm PR interval - .12-.20 will vary with the PAC QRS - .04-.12 |
Stable observe
Symptomatic ALS (IV, O2) |
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PSVT
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Rate - 150 - 250
Rhythm - regular except onset and termination Pacemaker - Atria outside SA P waves - differs from SA P waves if seen at all. PR interval - usually .12-.20, can vary QRS - .04-.12 |
Vagal maneuvers
Adenosine 6mg, 12 mg, check wide complex tach or other possible underlying rhythm SYNCHRONIZED cardioversion 50 - 100 joules, sedate pt if time allows diazepam 5-10mg or Versed 2-5mg. Cardioversion contraindicated if suspect dig toxicity |
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A Flutter
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Rate - atrial 250-350, ventricular varies
Rhythm - atrial regular, Ventricular usually reg but irreg if block Pacemaker - Atria outside SA node P waves - Flutter (F) waves are present, sawtooth PR interval - usually constant but can vary QRS - .04-.12 |
Rate above 150
Stable Diltiazem .25mg/kg 2nd dose .35mg/kg Unstable SYNCHRONIZED cardioversion 50 - 100 joules, sedate pt if time allows diazepam 5-10mg or Versed 2-5mg. Cardioversion contraindicated if suspect dig toxicity |
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A Fib
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Rate - atrial 350-750, ventricular varies
Rhythm - irregularly irregular Pacemaker - numerous ectopic foci in atria P waves - none discernible PR interval - none QRS - .04-.12 |
Rate above 150
Stable Diltiazem .25mg/kg 2nd dose .35mg/kg Unstable SYNCHRONIZED cardioversion 50 - 100 joules, sedate pt if time allows diazepam 5-10mg or Versed 2-5mg. Cardioversion contraindicated if suspect dig toxicity |
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1st degree block
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Rate - depends on underlying rhythm
Rhythm - usually regular, can be slightly irreg Pacemaker - SA or atria P waves - > than .20 QRS - usually < .12, can be bizarre in shape if conductive system disease exists in the ventricles |
Generally no TX required
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2nd degree type 1
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Rate - atrial unaffected, Ventricular may be normal or slowed
Rhythm - atrial typically reg, Ventricular irreg with dropped complex Pacemaker - SA or atria P waves - Normal, some P waves with no QRS complexes PR interval - progressively longer until dropped complex then repeats QRS - usually < .12, can be bizarre in shape if conductive system disease exists in the ventricles |
Generally no TX required, < heart rate and symptomatic .5mg atropine every 3-5 min until satisfactory rate or 3mg
If above fails TCP |
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2nd degree type 2
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Rate - atrial unaffected, Ventricular is usually bradycardic
Rhythm - Reg or irreg, depending on whether the conduction ratio is constant or varied Pacemaker - SA or atria P waves - Normal, Some P waves with no complexes PR interval - Constant for conducted beats; may be > .21 QRS - may be normal; is often > than .12 due to abnormal ventricular depolarization sequence |
Stable generally no TX
Unstable .5mg atropine every 3-5 min until satisfactory rate or 3mg If above fails TCP |
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3rd degree
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Rate - atrial unaffected, ventricular 40-60 if junctional. < 40 if lower in ventricles
Rhythm - atrial and ventricular are usually reg Pacemaker - SA AV or Ventricle P waves - normal, no relationship to QRS often falling in QRS or T wave PR interval - no P-R relationship QRS - > .12 if pacemaker ventricular, < .12 if pacemaker junctional |
Stable generally no TX
Unstable .5mg atropine every 3-5 min until satisfactory rate or 3mg If above fails TCP |
