Title: Name That Rhythm!
1Name That Rhythm!
2Sinus Bradycardia (SB)
3V-paced
Spike before the QRS
4Whats the Difference Between Heart Blockage
Block?
5Idioventricular Rhythm
- Ventricular beats, but
- at a slow rate
Your patient is Going down the Drain if he stays
In this rhythm very Long!
6Pulseless Electrical Activity (PEA)
- Normal rhythm, but
- No Pulse
Gabriel is blowing his horn!!
Call Code!
7Mobitz I Wenkebach
- PR interval gradually longer until a QRS is
dropped - Pattern repeats
8Bigeminy
- Every second beat is a PVC
Geminy Cricket!
9Atrial Fibrillation (Afib)
- Irregular
- No definable P waves
- unable to count the of waves
10Premature Ventricular Contraction (PVC)
11Normal Values
60-100 beats per minute
.12-.20 seconds
PR Interval
lt .11 seconds
QRS Interval
12 13Failure to Capture
- Pacer spike is fired, but no beat follows
14Mobitz II
- PR interval consistent except some QRS missing
Example PR intervals .16 B - .16 B - .16 -
.16 - B
15Normal Sinus Rhythm (NSR)
- Rhythm is normal
- Rate normal 60-100
- PR normal .12-.20
- QRS normal lt .11
16Junctional Rhythm
17Pause
- Period of no electrical activity, then resumes
186 Beats of VT
19Paroxysmal Atrial Tachycardia (PAT)
- Sudden rate change gt 150 bpm
- QRS shape is similar before after rate change
20- 1 º AVB
- PR interval gt.20
PR intervals
.24 - .24 - .24 - .24 - .24
21Sinus Tachycardia (ST)
- Normal except HR gt100 bpm
22Ventricular Tachycardia (VT)
- Ventricular beats (wide QRSs)
- Rate gt 150 bpm
Call Code!
23Sinus Arrhythmia (SA)
24Asystole
Call Code!
My heart may stop if This guy was swimming With
me!!!
25Trigeminy
Every 3rd beat is a PVC
263rd Degree AV Block (3º AVB)
- Atria ventricles act independently
- Regular P waves
- Regular QRS complexes
- ButP waves and QRS not working together
- PR interval varies (but not in Wenkebach pattern)
- Harmful -- patient needs a pacemaker soon!
Example PR intervals .14 B - .20 B B -
.12 B - .44 - .32 - B
27Torsades de Pointes
- A form of VTach which looks like the rhythm strip
is twisting
Call CODE!
28Steps to Interpret Rhythms
- 1. Are the beats at regular or irregular
intervals apart? - 2. Do you see P, QRS, T pattern?
- 3. What is the HEART RATE?
- 4. What is the PR interval?
- 5. What is the QRS interval?
29A-paced
A spike before the P wave site
30- Mobitz II
- PR regular except some QRS are dropped
PR intervals
.12 B - .12 - .12 B - .12 B
QRS
31Atrial Flutter
- Numerous P waves that you can count
32Premature Beats
Wide QRS
PRlt.12
PR.12-.20
33- Wenkebach
- PR gradually longer until QRS dropped
PR intervals
.12 - .18 - .24 B - .12 - .18 - .24 B
34Ventricular Fibrillation (VF)
Call CODE!
35Failure to Sense
- Heart is beating just fine, but pacemaker fires
anyway - Spikes are not in a consistent place before P or
QRS --seen in many different places
36ST Elevation
QRS exits higher than it starts
37Wandering Atrial Pacemaker (WAP)
- P waves vary in shape (at least 3 different P
waves)
38- 3º AVB
- PR interval varies, but not in Wenkebach pattern
PR intervals
.12 B - .20 B B - .16 - .44 B - .32
39Premature Beats
3 Types
Premature Atrial Contraction (PAC) Premature
Junctional Contraction (PJC) Premature
Ventricular Contraction (PVC)
40Bundle Branch Blocks (BBB)
QRS gt.11
41AV-paced
Spikes before the P wave site QRS
42Premature Junctional Contraction (PJC)
- Early beat
- No P wave or PR interval is lt.12
43First Degree AV Block(1º AVB)
Example PR intervals .28 - .28 - .28 - .28 -
.28 - .28
44ST Depression
QRS exits lower than it starts
45Paroxysmal Supraventricular Tachycardia (PSVT)
- Sudden rate change gt150 bpm
- QRS may look different after rate change
46Types of AV Blocks
47Premature Atrial Contraction (PAC)
- Early beat
- Normal PR interval
The alarm clock Always goes off PREMATURELY!!
48Triplet
49Which rhythms are a CODE Blue?
- VT
- VFib
- Asystole
- Torsades
- PEA
50WAY TO GO!Youre catching on!