EKG RHYTHM IDENTIFICATION · PDF fileidentify the rhythm • regular or irregular • rate • p wave • p-r interval • qrs duration •eptopics / abnormalities wandering...

EKG RHYTHM IDENTIFICATION

PRACTICE

By:Steven Jones, NREMT–P

CLEMC

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

SINUS BRADYCARDIA

• REGULAR

• 37

• NORMAL

• 0.16 SECONDS

• 0.08 SECONDS

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

WANDERING ATRIAL PACEMAKER

• IRREGULAR

• 78-94

• VARIABLE IN MORPHOLOGY

• VARIABLE

• 0.08 SECONDS

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

SINUS TACHYCARDIA

• REGULAR

• 125

• NORMAL

• 0.12 SECONDS

• 0.08 SECONDS

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

SINUS ARRHYTHMIA

• REGULARLY IRREGULAR

• 60-95

• NORMAL

• 0.16 SECONDS

• 0.08 SECONDS

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

SINUS ARREST

• REGULAR

• 60

• NORMAL

• 0.16 SECONDS

• 0.08 SECONDS

• PAUSE … … …

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

SINOATRIAL BLOCK

• REGULAR

• 75

• NORMAL

• 0.16 SECONDS

• 0.08 SECONDS

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

MULTIFOCAL ATRIAL TACHYCARDIA

• IRREGULAR

• 125-170

• POLYMORPHIC

• VARIABLE

• 0.06 SECONDS

• P WAVE ECTOPICS

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

ATRIAL FIBRILLATION

• IRREGULARLY IRREGULAR

• 85-170

• NO DISCERNIBLE P WAVES

• NONE

• 0.04 SECONDS

• TRADEMARK IRREGULARITIES

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

ATRIAL FLUTTER

• REGULAR

• 65

• “SAWTOOTH” PATTERN

• UNDERMINABLE

• 0.08 SECONDS

• 4:1 CONDUCTION = AR 260

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

PAROXYSMAL ATRIAL TACHYCARDIA

• UNDERLYING IS REGULAR

• 100

• UNDERLYING NORMAL

• UNDERLYING 0.12 SECONDS

• 0.08 SECONDS

• SUDDEN ↑ IN SA CONDUCTION

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

3rd DEGREE AV BLOCK (CHB)

• REGULAR

• V – 35 / A – 75

• NOT “MARRIED” TO QRS

• NONE

• 0.28 SECONDS

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

2nd DEGREE AV BLOCK TYPE II

• REGULAR

• V – 25 / A - 68

• CONSTANT AND NORMAL

• PROLONGED 0.28 SECONDS

• 0.20 SECONDS

• DROPPED QRS DO NOT MARCH

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

2nd DEGREE AV BLOCK TYPE I

• REGULAR

• 47

• INCREASINGLY PROLONGING

• PROLONGED AND VARIABLE

• 0.12 SECONDS

• DROPPED QRS SEGMENTS

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

1st DEGREE AV BLOCK

• REGULAR

• 60

• NORMAL

• PROLONGED 0.36 SECONDS

• 0.08 SECONDS

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

JUNCTIONAL ESCAPE RHYTHM

• IRREGULAR – Underlying is Regular

• 55-68 – Underlying Rate is 68

• RETROGRADE to NORMAL

• 0.12 WHERE PRESENT

• 0.08 SECONDS

• INVERTED (RETROGRADE) P WAVES

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

JUNCTIONAL TACHYCARDIA

• REGULAR

• 136

• INVERTED P WAVES

• 0.12 SECONDS

• 0.06 SECONDS

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

SINUS RHYTHM WITHPREMATURE JUNCTIONAL CONTRACTION

• REGULAR

• 100

• NORMAL – Except for Ectopic

• 0.16 SECONDS

• 0.12 SECONDS

• PJC – 7th Beat

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

SINUS RHYTHM w/BBB

• REGULAR

• 78

• NORMAL

• 0.12 SECONDS

• 0.24 SECONDS

• WIDENED QRS

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

• REGULAR

• 94

• NORMAL WHERE PRESENT

• 0.12 SECONDS

• 0.12 SECONDS

• PVC Every Other Beat

SINUS RHYTHM w/ BIGEMINY PVC’s

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

VENTRICULAR TACHYCARDIA

• REGULAR

• 170

• NONE

• NONE

• WIDE AND BIZZARE

• NONE

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

TORSADE de POINTES

• IRREGULAR

• VARIABLE

• NONE

• NONE

• VARIABLE

• POLYMORPHIC

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

VENTRICULAR FIBRILLATION

• IRREGULAR

• UNATAINABLE

• NONE

• NONE

• NOT APPARENT

• CHAOTIC ELETRICAL ACTIVITY

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

IDIOVENTRICULAR RHYTHM

• REGULAR

• 30

• NO P WAVE

• NONE

• 0.24

• WIDE REGULAR QRS

IDENTIFY THE RHYTHM

• REGULAR or IRREGULAR

• RATE

• P WAVE

• P-R INTERVAL

• QRS DURATION

•EPTOPICS / ABNORMALITIES

ASYSTOLE

• REGULAR

• NONE

• NONE

• NONE

• NONE

• NONE