Cardiac Dysrhythmia Overview to help with ACLS Precourse ...

1 Rhythm Strip Samples to help with acls Precourse Assessment with Unique Block Tricks from Terry120 rhythm strips on Precourse assessment with the following matching choices:Agonal rhythm/asystoleAtrial FibrillationAtrial FlutterVentricular FibrillationMonomorphic Ventricular TachycardiaNormal Sinus RhythmPolymorphic Ventricular TachycardiaPulseless Electrical ActivitySupraventricular TachycardiaSecond-degree atrioventricular block (Mobitz I, Wenckebach)Second-degree atrioventricular block (Mobitz II block)Sinus bradycardiaSinus tachycardiaThird-degree atrioventricular blockRHYTHM & ETIOLOGYCRITERIAOVERVIEWUNIQUECRITERIASA MPLE STRIPS**Normal SinusRhythm Normal, NoneRHY RegularR 60-100P UprightPRI.

2 Normalrhythm**SinusTachycardia Exercise Anxiety Caffeine Nicotine Fever Shock CHF Hypotension Pain Hypoxemia Anterior MIRHY RegularR 100 - 160P UprightPRI - 160**SinusRHY RegularRate belowRhythm Strip Samples to help with acls Precourse Assessment with Unique Block Tricks from Terry2 RHYTHM & ETIOLOGYCRITERIAOVERVIEWUNIQUECRITERIASA MPLE STRIPSB radycardia Damage SA Normal sleepathletes Vagal Glaucoma Hypothermia Inferior MI Drugs MS,digoxin, Inderal IICPR below 60P UprightPRI **PVC/PVDP remature VentricularContraction/Depolarization Hypoxia, Hypotension anemia Ischemic hrt dis Electrolytes Myocarditis,pericarditis CHF Stress, fatigue,smoking,overeating, caffeine Hypoglycemia Sepsis Cyclic anti-depressants AcidosisAN ECTOPICBEATRHY IrregularR 60-100P UprightPRI , earlybeat hasVENT beat(wide &bizarre)

3 SupraventricularTachycardia Not visible suddenstart or RegularR 160 - 250P UprightPRI above160 - 250**Atrial FlutterRHY Regular orRegular orRhythm Strip Samples to help with acls Precourse Assessment with Unique Block Tricks from Terry3 RHYTHM & ETIOLOGYCRITERIAOVERVIEWUNIQUECRITERIASA MPLE STRIPS Ischemic heartdisease MI Dig toxicity Mitral, Tricuspidvalve disease Stress PE Hyperthyroid Often tempIrregularR Atrial 250 400 Vent: 70 - 150P none, F sPRI noneQRS , noP s (calledF s)Saw toothAtrial Fibrillation Ischemic heartdisease Dig toxicity CHF MI Mitral or Tricuspidvalve diseaseRHY IrregularR atrial 350-600 Vent.

4 Below100 controlled,above None f sPRI noneQRS , noP s (called f s)**PEAP ulselessElectrical Activity Looks like anyrhythm that shouldhave a pulse butdoes not**2nd degree AVBlock Type I Mobitz I,WenckebackRHY IrregularPRI varyQRS PsPRI longer &longer,Dropped QRSR hythm Strip Samples to help with acls Precourse Assessment with Unique Block Tricks from Terry4 RHYTHM & ETIOLOGYCRITERIAOVERVIEWUNIQUECRITERIASA MPLE STRIPS**2nd degree AVBlockType II or MobitzIIRHY Regular orIrregularPRI constantQRS normal orwideRegular orIrregularEXTRA Ps3rd degree AVBlock.

5 CompleteHeart Block Same as 1stdegreeRHY - RegularPRI varyQRS usuallywideRegularEXTRA PsPRI variesgreatly**VentricularTachycardiamon omorpic All complexes arethe same shapeand look the same Wide complextachycardiaRHY RegularR Above 100P NonePRI NoneQRS Wide,BizarreR over 100 All Vent beats**VentricularFibrillation Following V Tach Acute MI ElectrolyteImbalanceRHY ChaoticR NoneP NonePRI NoneQRS none,fibrillatory lineChaotic Strip Samples to help with acls Precourse AssessmentRHYTHM & ETIOLOGYCRITERIAOVERVIEWUNIQUECRITERIAT orasades dePointesPolymorphicventriculartachycard iaBest Treated withmagnesiumRHY ChaoticwavesR NoneP NonePRI NoneQRS pointstwistChaotic twist**Agonal Dying heart Drugs used incardiac arrestprovide someelectrical RegularR SlowP NonePRI NoneQRS very verywideSlow widebizarrestretched Pulse**Asystole Primary event incardiac arrest.

6 Untreated V-tach orV-fibRHY Noneunless only PsR No Vent rateP may bepresentPRI NoneQRS NoneStraight lineor only PsNo PulseCalculating Heart RateTable for Small Box MethodTo calculate the heart rate, count the number of squares (or small boxes)Small Boxesfrom R to R9 = 16814 = 10719 = 795 = 30010 = 15015 = 10020 = 756 = 25011 = 13616 = 9421= 727 = 21412 = 12517 = 8822 = 688 = 18813 = 11518 = 8323 = 65elp with acls Precourse Assessmentwith Unique Block Tricks from TerryUNIQUECRITERIASAMPLE STRIPC haotic wavyNo twistSlow widestretched outStraight lineor only PsNo PulseCalculating Heart Rate-note strips on pretest are longer than 6 calculate the heart rate, count the number of squares (or small boxes)

7 Between two QRS complexes (1500 divid19 = 7924 = 6329 = 5234 = 4439 = 3844 = 3420 = 7525 = 6030 = 5035 = 4340 = 3745 = 3321= 7226 =5831 = 4836 = 4241 = 3746 = 3322 = 6827 = 5632 = 4737 = 4142 = 3647 = 3223 = 6528 = 5433 = 4538 =4043 = 3548 = 31with Unique STRIPS note strips on pretest are longer than 6 two QRS complexes (1500 divided by X = HR)44 = 3445 = 3346 = 3347 = 3248 = 31 Rhythm Strip Samples to help with acls Precourse AssessmentHeart Blockelp with acls Precourse Assessmentwith Unique Block Tricks from TerryHeart Blocksand Tricks for Analysis from Terry2nddegree AV block Type IMobitz IWenckebackFrom TerryExtra P'sRhythm is always irregularfrom QRS to QRSPR intervals get longer andlonger2nddegree AV block TypeIIMobitz IIFrom TerryExtra P'sPR intervals on conductedbeats are the sameonly heart block with extraP's that has Heart BlockComplete Heart BlockFrom TerryExtra P'sRhythm is always regualrfrom QRS to QRSPR)

8 Intervals Unique AV block Type IebackFrom TerryExtra P'sRhythm is always irregularfrom QRS to QRSPR intervals get longer anddegree AV block TypeMobitz IIFrom TerryExtra P'sPR intervals on conductedts are the same- theonly heart block with extraP's that has Heart BlockComplete Heart BlockFrom TerryExtra P'sRhythm is always regualrfrom QRS to QRSPR Intervals Strip Samples to help with acls Precourse Assessment with Unique Block Tricks from Terry7